Diphragm
High frequency sounds
Peripheral Vascular system
Arteries, arterioles, capillaries, venules, veins
Alcohol withdrawal assessment
CIWA protocal
Bell
Low frequency sounds
Base of heart
Top of the heart
Apex of heart
Bottom of the heart
Lub dub
S1 and S2 sounds
S1 sound
Closing of AV valves, beginning of systole
S2 sound
Closure of semi-lunar valves, end of systole beginning of diastole
Diminished lung sounds
Sounds less on one side or throughout due to poor air movement, lung space, etc.
Heart murmurs
Caused by incomplete valve closure, added whoosh sound
Rhonchi
Airflow obstruction
-Secretions: Mucus, infections
-Sometimes cleared with coughing
-upper airways
Wheezes
Air squeezed through narrowed passageways/ high pitched sound
Crackles
Air moving through mucus or fluid
-May be heard on inspiration or expiration
Pleural friction rub
May be heard on inspiration or expiration
Stridor
Heard on inspiration
-Loud, high pitched crowing
-Velcro rale (crackle):Pulmonary fibrosis
When to not palpate abdomen
Appendicitis, acute abdomen, known or suspected AAA
Order of assessment for abdomen
Look, listen, feel
Inspection, auscultation, palpation
Ileus/ paralytic ileus
Loss of forward flow of intestinal contents due to decreased peristalsis
Pulse deficit
Difference between apical and radial pulse
Montgomery straps
Used for patients with frequent wound dress changes
We ask patients to swallow during NG insertions in order to?
close the epiglottis over the larynx to help NG passage into the esophagus
