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33 Cards in this Set
- Front
- Back
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Murmur - conditions that lead too
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1. velocity of blood flow increases ... 2. viscosity of blood decreases (anemia) ... 3. structural defect in valve or unusual opening occurs in chamber
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CV health is closely interrelated with ...
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lifestyle, habits, disease
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Age related cardiac issues
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Systolic HTN (stiffness of ventricle) - LV wall thickens (smaller chamber/ decreased CO) - diminished SNS response - arrhythmias - EKG changes (PR interval increase) - increase CVD
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What does increased PR interval mean...
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increased length of time signal from SA node takes to travel to AV node + atrial depolarization
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Cross Cultural Risks
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Heart disease + CVA = increased in AA - HTN - Hypercholesterolemia - obesity - diabetes - smoking
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Carotid pulse correlates with which heart sound
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S1 - ventricular systole
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A murmur is
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gentle blowing, swooshing sound heard in chest wall --- result of turbulent blood flow in heart
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Things to consider when examining the aging adult
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1. orthostatic changes; 2. vagal reflex w/ carotid pressure (pulse rate decrease leads to fainting); 3. JVP measurement on R side vs L side; 4. chest anteroposterior diameter increases (barrel chested); ectopics
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Orthopnea
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SOB laying flat
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What's important about a cough
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could indicate pulmonary edema - pink frothy sputum
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When would pt w/ cardiac issue experience fatigue?
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later in day
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What happens w/ R sided heart failure
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blood backs up in venous system
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What happens w/ L side heart failure?
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blood backs up in lungs
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nocturia
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getting up at night to urinate
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what's problem w/ nocturia
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excess fluid accumulated during day .... at night kidneys work to get rid of the extra volume
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Subjective Cardiac Data
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chest pain - dyspnea - orthopnea - cough - fatigue - cyanosis or pallor - edema - nocturia - PMH - FMH - habits
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Important Subjective data for Aging Adult
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HTN - CAD - lung disease ... meds ... ADLs (need more help?, and SOB?)
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Cardiac Physical Exam
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VS & SpO2 + Inspect, palpate, auscultate
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Order of Exam
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1. Jugular venous pulsation, 2. carotid artery, 3. anterior chest pulsation (apical), 4. palpation across percordium, 5. auscultate
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Point of Maximal Impulse
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apical pulse - apex closets to chest wall + mitral valve
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why check for jugular venous distention
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noninvasive method to check right atrial pressure ... > w/ right sided HF ... if lying flat & still present raise to 30% ... looking for <3cm in healthy pt
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2 ways to check JVD
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measure height from sternum to top of JVD + exert pressure on liver = JV will distend, no problem if w/in 30 sec distention goes away
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Auscultating Heart Sounds - where hear normal
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S1 = apex ..... S2 = base
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What side of stethoscope use
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S1 & S2 = diaphragm .... S3 & S4 = bell ...
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Sequence for auscultating heart sounds
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Aortic .... Pulmonary .... Erb's Point .... Tricuspid .... Mitral
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Location of each ausculating point
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aortic - 2nd intercostal R side .... pulmonary - 2nd intercostal L side .... Erb's Point - 3rd intercostal L side ... Tricuspid - 5th intercostal L side ... Mitral - 5th intercostal L midclavicular
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order blood moves through heart
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superior & inferior VC = R atrium = tricuspid valve = R ventricule = pulmonary valve = lungs = L atrium = mitral valve = L ventricule = aortic valve = aorta
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Split heart sounds are the result of ...
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2nd valve closing lags .... S1 mitral & tricuspid ..... S2 aortic & pulmonary
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What creates S1 sound
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ventricular contraction (systole) + close of AV valves (mitral & tricuspid)
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What creates S2 sound
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rapid refill of ventricule + close of semilunar valves (aortic & pulmonary)
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When hear S3 & what creates sound
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Hear S3 right after S2 - caused by rush of atrical blood into ventricule + opening of AV valves
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When hear S4 & what creates sound
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Hear S4 right before S1 - caused by atria contracting & forcing blood into noncompliant ventricule
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Positions where may hear abnormal sounds best ...
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roll pt on left side to hear S3 & S4 + murmur ..... for murmur may also hear with pt sitting up & leaning forward
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