Week 9: CVS/PVS Flashcards
(24 cards)
CVS Structures
- Preocordium: anterior chest over heart
- Mediastinum encases heart
- Chambers: atria/ventricles
- Values: AV and semilunar
- Superior boarder is base, apex is bottum
- Systolic ( ventricle contraction AV open between SI and S2) End of systole marks S1 Lubb
- Diastole ( relax of ventricles, AV open , between S2 and SI) Systole marks S2 Dubb
Neck Vessles
- Carotid arteries
- Jugular: external (JVD) indicate poor heart rate ane venous pressure empties unoxygenated blood into superior cava
- Right JV indicates pressure and blood flow
Acute Symptoms
- Chest pain/SOB
- Cyanosis central or peripheral
- Dysnpea
- Diaphoresis
- BP
- Assume chest pain is cardio, assess and intervene
- OPQRSTUV ( vtials, x ray, ascultation)
Subjective Assessment
Bio data
- Family/personal history
- SOB
- Chest pain
- Allergies
- meds
- Smoking
- Diet
- Excerise
- Stress
- Dyspena
- Orthopena
- Cyanosis or pllor
- Tachycardia
CVS releated systems
- Chest pain
- Dysnpea
- Orthopena
- Faitgue
- Cough
- Cynasosis/pallor
- Edema ptting
- Hypertension
- Diaphoresis
- Hemoptysis ( pul diease)
- Heave/lift: sustained forceful thursting of ventricle, hypertrophic
Objective Colletion
I-P-A
- position and gather, explain listening to many locations is normal
- Hygine
- Aoritc Pulomonic Erib Point Tripcuspid Mitral Values
- Apex S1 louder base S2 louder Apex
Assess pulse, neck vessles I-A-P, Precordium APE2MAN and Apical pulses I-A-P
Inspection JVD
- Assess venous pressure
- Nurse stand pt ride side and turn away
- Flat/Distended/ no JVD present
Inspection
JVD, cynaosis, cartoid artery pulsations, preocordium ( lesions , color, massess, pulsations) Capillary refill, skin tugor , peripheral cyanosis, clubbing. Circulation, sensation, movement upper and lower extremites.
Inspection carotid symmetry
Palpation
- Cartoid
- Brachila
- radial
- Tibia
- Pedis
- Regular, stength. rate
Palpation
- Palmar aspect over apex and base: pulsations, tenderness, lumps
- Usally no pulsations
- Apical impulse with one pad
- Wait before cartoid palpation
Ascultation
Ascultation of cartoid arteries bilaterally ( note any brutits)
1. Inspect cartoid
2. Ascultaton cartoid using bell: compare bilaterally for swishing or crackles. Pt exhale and hold- Ascultate swishing/blowing prior to palpation one at time.
3. Palpate strength and rythum
- Ascultation of Heart Sounds valve closure: 60-100BPM
- S1 Lubb: louder near base of mirtial and tricupsid
- S2 Dubb: louder near aroritc and pulmonic base
- Assess apical 1 min
- Note rate and rythum
- Note any adventious heart sounds, extra sounds , murmurs S3/S4 Sounds
Steps to Ascultate
- rate/rythum
- Z pattern
- Bell and Diaphram: S1 systolic lubb and S2 diastolic dubb.
- S1 with cartoid pulse louder in mirtal and tricupsid
- S2 louder at base Aortic/Pulomonic
Older adults
- Increased BP
- Pulse stiff
- heart issues
Ascultation Sounds
- Lubb and Dubb sounds mark closure of Av valves
- Listen S1 Systolic and S2 Diastolic sepretaly
- Lub-Dubb is 1 heart beat and listen for extra sounds
- S1= carotid artery pulse, louder among mitral and tricupsid (base)
- S2 = louder at apex
- Erbs is equal
- Irregular beat = pulse deficit 1 min
Assessment of PVS
- Rate ( beats per min 50-100)
- Rythum (regular or non)
- Force ( same between beats +3 full +2 normal +1 weak
- Equality: assess pulse bilaterally to compre
- If irregular asssess for defict 1 minute
Subjective Data
- Cramps
- Color pallor/cyanotic
- C-S-M
- Edema
- Temperature
PVS 6 P’s
Pain, paraesethia, pallor
pulelessness, cold, paralysis
C-S-M
Circulation ( pulse, temp, color, brisk cap refill, tugor, edea)
Sensation: pain , touchMovement
Upper limb assessment
Color, size, symmetry, temp, clubbing and cap refill <2seconds, skin mobility/tugor
- Palpation of Radial, ulnar, brachial pulse bilaierally
- C-S-M both
- Assess temperature, skin mobile, pulses
Lower Limb assessment
Inspect and palpate: skin, symmetry, temp, pulses, 1-4+ pitting edema bilaterally.
Color of lower limbs
6P’s and c-s-m
- Compare for temperature, skin texture, cap refill
Pulse Points: Dorsalisi pedis and post. tibia bilaterally, lymph nodes
DVT
- Deep Vein Thrombosis
- Edema, warmth, pain
- Risk for pul. embolism, dyspnea, chets pain, tachycardia, diaphoresis (sweating)
Objective Scales
Pitting Edema: press firm on skin over dirsum, tibia for second release, normal finding is no indent.
+1 2mm mild, slight
+2 4mm Moderate
+3 6mm deep pitting, swelling of leg
+4 8mm very deep swelling
Bilateral demea: heart issues
Unilertal: occulsion of vein
For PULSE: rate, force, rythum +3-0
Risk for Older Adults
PAD
Artersclerosis
Atherosclerosis
DVT
System promotion
Primary (healthy lifestyle, prevent diease) Secondary ( early detection) Teritary ( minimize symptoms, treatment)
- Smoking
- Excerise
- stress
- Nutrition
