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57 Cards in this Set
- Front
- Back
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What are the 3 muscle layers of the heart?
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endocardium
myocardium epicardium |
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Which node contols heart rate & is referred to as the "pacemaker"?
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SA node
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What are the 5 phases of the EKG?
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P,Q,R,S, & T
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How often should adults over 20 yo have their cholesterol levels checked?
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Once q 5 years
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How are pulses graded?
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0= absent
1+= weak 2+=normal 3+=increased 4+=bounding |
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The difference between the apical & peripheral/radial pulses.
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pulse deficit
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What can the pulse deficit indicate?
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atrial fibrillation, atrial flutter, premature ventricular contractions & varying degrees of heart block
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If you detect an irregular rhythm, then what do you do & how?
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Auscultate for a pulse rate deficit by palpating the radial pulse while auscultating the apical pulse for a full minute.
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The ____ ____ pulse is not normally visible with the client sitting upright.
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jugular venous
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Fully distended jugular veins with the client's torso elevated more than 45 degrees indicate ____ _____ _____ pressure and may be the result of what?
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increased central venous pressure; R ventricular failure, pulmonary hypertension, pulmonary emboli, & cardiac tamponade
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How do you inspect the jugular venous pulse?
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The pt should be in a supine position w/the torso elevated 30 to 45 degrees.Stand on the R side of the pt & have the pt slightly turn their head to the L. The pulse should not be visible.
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When do you auscultate the carotid arteries?
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When the pt is middle-aged or older or if you suspect CVD.
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When auscultating the carotid arteries what would be the normal findings?
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No blowing or swishing or other sounds heard.
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When palpating the carotid arteries what would be normal findings?
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Pulses are bilaterally equal w/no variation in strength from beat to beat. Contour is smooth & rapid on the upstroke, and slower & less abrupt on the downstoke. No thrills noted & arteries are elastic.
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True or False:
Always palpate the carotid arteries before auscultating. |
False:
Always auscultate before palpating to avoid changing the HR. |
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How do you palpate the carotid arteries?
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Palpate each carotid artery alternately by placing the pads of the index finger & the middle fingers medial to the sternocleidomastoid muscle on the neck.
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What do you note when palpating the carotid arteries?
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Note amplitude, contour of the pulse, elasticity of the artery, & any thrills.
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What should you do if you detect occlusion during auscultation?
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Palpate the carotide arteries very lightly to avoid blocking circulation or triggering vagal stimulation.
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Name the different abnormal findings when assessing carotid pulses?
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A bruit, blowing, or swishing sound; pulse inequality; weak pulses; bounding pulses; variations in strength; a delayed upstroke; thrills; & loss of elasticity
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A vascular disorder caused by vasoconstriction or vasospasm of the fingers or toes.
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Raynaud's disease
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Raynaud's disease is characterized by what s/s?
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Rapid changes of color (pallor, cyanosis, & redness), swelling, pain, numbness, tingling, burning, throbbing, & coldness.
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Capillary refill indicates what?
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Reflects cardiac output & peripheral perfusion.
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Capillary refill time exceeding __ seconds may indicate what?
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2; May indicate vasoconstriction, decreased cardiac output, shock, arterial occlusion, or hypothermia.
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What is the order for assessment of the abdomen?
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Inspect, Auscultate, & Palpate
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What does Homan's sign indicate if it is positive?
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May indicate DVT or superficial thrombophlebitis.
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How do you assess for Homan's sign?
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Have the pt in the supine position w/their knee flexed about 5 degrees . Place your hand under the client's calf muscle & quickly squeeze the muscle against the tibia. Ask the client to report any pain or tenderness.
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What are the 4 abdominal quadrants?
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R Upper Quadrant, R Lower Quadrant, L Upper Quadrant, L Lower Quadrant
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Name the major organs in the RUQ?
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Ascending & Transverse colon, Gallbladder, Liver, Pancreas, R adrenal gland, R kidney
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Name the major organs in the RLQ?
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Appendix, Ascending colon, R kidney, R ovary
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Name the major organs in the LUQ?
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L adrenal gland, L kidney, Pancreas, Spleen, Stomach, Transverse descending colon
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Name the major organs in the LLQ?
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L Kidney, L Ovary, Descending & Sigmoid Colon
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How does eating affect peristalsis?
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Eating increases peristalsis.
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What does hypoactive bowel sounds indicate?
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Diminished bowel motility.
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What does hyperactive bowel sounds indicate?
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Increased bowel motility.
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What does absent bowel sounds indicate?
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No bowel motility and constitutes an emergency.
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Why do we measure abdominal girth?
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To assess pt's risk factor for CVD & to evaluate the progress of distention.
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What are the 6 Fs of abdominal distention?
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fat, feces, fetus, fibroids, flatulence, & fluid
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Name some risk factors for Gallbladder cancer.
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over 70 yo
female after menopause Native American New Zealand Maori history of gallstones chronic inflammation of gallbladder porcelain gallbladder common bile duct abnormalities gallbladder polyps typhoid cancer obesity diet high in carbs & fats & low in fiber cigarette smoking environmental exposure to industrial chemicals |
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Name some ways to reduce risk of Gallbladder cancer.
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stop smoking
avoid obesity follow ACS diet & exercise avoid industrial chemical exposure schedule periodic medical exams |
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Colitis, cramping, GERD, renal tumor are all examples of different sources of what?
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abdominal pain
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What habits increase your risk for GERD?
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•Obesity
•Exercising immediately after eating (especially jogging or strenuous activity) •Smoking •Lying down soon after meals •Bending over or straining, especially soon after meals •Alcohol (especially excess) use •Eating chocolate •Drinking carbonated beverages, caffeinated beverages, and decaffeinated coffee •Eating spicy foods or acidic foods like citrus oe tomatoes The use of certain medications and supplements certain medical conditions |
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What habits increase your risk for esophageal cancer?
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smoking
alcohol diet high in fat older than 70 yo male African American GERD Barretts esophagus occupational exposure to chemicals frequent exposure to very hot liquids caustic injury to esophagus tylosis severe iron deficiency history of previous cancers achalasia |
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What do you do if you do not find a pulse?
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You use a doppler to find the pulse.
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Name the 10 pulse sites.
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temporal, carotid, apical, brachial, radial, ulnar, femoral, popliteal, posterior tibial, dorsalis pedis
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What do you document when assessing bowel sounds?
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Intensity, pitch, & frequency of the sounds
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What are the locations for checking heart sounds?
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Aortic area, Pulmonic area, Erb's point, Tricuspid Area, Mitral area
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What are the names of the major lymph nodes?
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Inguinal nodes, Axillary nodes, Epitrochlear nodes
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What does HRT help postmenopausal women?
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Lowers their chance of heart disease.
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How is pitting edema documented?
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1+= slight pitting
2+= deeper than 1+ 3+= noticeably deep pit 4+= very deep pit |
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True or False:
Smoking increases your chance for chronic arterial insufficiency. |
True
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What habits increase your risk for GERD?
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•Obesity
•Exercising immediately after eating (especially jogging or strenuous activity) •Smoking •Lying down soon after meals •Bending over or straining, especially soon after meals •Alcohol (especially excess) use •Eating chocolate •Drinking carbonated beverages, caffeinated beverages, and decaffeinated coffee •Eating spicy foods or acidic foods like citrus oe tomatoes The use of certain medications and supplements certain medical conditions |
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What habits increase your risk for esophageal cancer?
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smoking
alcohol diet high in fat older than 70 yo male African American GERD Barretts esophagus occupational exposure to chemicals frequent exposure to very hot liquids caustic injury to esophagus tylosis severe iron deficiency history of previous cancers achalasia |
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What do you do if you do not find a pulse?
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You use a doppler to find the pulse.
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Name the 10 pulse sites.
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temporal, carotid, apical, brachial, radial, ulnar, femoral, popliteal, posterior tibial, dorsalis pedis
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What do you document when assessing bowel sounds?
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Intensity, pitch, & frequency of the sounds
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What are the different tests performed for abdominal assessment?
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RUQ pain or tenderness, hypersensitivity, Obturator, Psoas, rebound tenderness, Rovsing's sign, Ballottement technique, fluid wave test, shifting dullness
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What are the different test performed for vascular & arterial insufficiency?
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Position change, ABPI, Manual compression, Trendelenburg
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