What are some cardiac risk factors?
- High fat diet
- Smoking
- Alcohol
- Lack of exercise
What history information might a client give you that indicates heart disease/failure?
Fatigue
chest pain
Orthopnea
Edema
Nocturia
When taking vital signs, what are some red flags that are associated with the heart:
- Blood pressure/ Respirations
- Skin
- High blood pressure and respiratory
- Pallor or cyanosis
When palpating the carotid artery, what do you do?
- palpate while client is sitting/relaxed
- Palpate ONE side inside sternomastoid muscle
When palpating the carotid, why do you want to avoid:
- Palpating both sides simultaneously
- Palpating too high?
- Client could pass out (lack of blood flow)
- palpating too high can decrease BP and blood flow
What data do you collect when palpating the carotid?
- Contour and amplitude
- Bruits
Pulse amplitude rated from (+1) - (+4)
- +2 is normal
What are bruits caused by?
How do you find them?
When vessel is occluded by 1/2-2/3
Blowing,swishing sound when ausculating
What part of the neck do you ausculate?
Use bell :
- at jaw
- mid cervicle area
- base of neck
What does jugular vein distention indicate?
High Central venous pressure-
amount of blood returning to the heart
What are some signs of right sided heart failure?
Jugular vein distension
Edema
High peripheral venous pressure
The valve that separates the right atrium and ventricle:
The valve that separates the left atrium and ventricle
Tricuspid valve
Bicuspid valve
What does happens during systole (cardiac cycle)
-S1 and S2
S1= AV valves close
-ventricles contract
S2= Semilunar valves close
-All four valves closed and ventricles relaxed
What happes during Diastole (cardiac cycle)
- S3 and S4
S3= AV valves open once blood accumulates in atria (silent)
S4= Atrial contraction
What is this inspection method:
Inspecting precordium
Observing chest right in front of heart (precordium)
Look for heaves/lifts (ventricular hypertrophy)
Where do you find the Aortic region when ausculating?
2nd Intercostal space
Righ Sternal Boarder
Where do you find the Pulmonic region when ausculating?
2nd intercostal space
Left sternal boarder
Where do you find the Mitral/apex region when ausculating?
5th Intercostal space
Left midclavicular
Where do you find the tricuspid region when ausculating?
5th intercostal space
Left Sternal border
Where do you find the apical pulse?
Apex
- 5th intercostal space
- Left midclavicular line
What are these abnormailities:
- Heart Thrills
- Extra pulsation
- Thrill= Turbulent blood flow that causes vibration and loud murmurs
- Extra palpations: Extra sounds/pulsations
When performing ausculation, what order do you listen?
How long?
Several beats in each region:
Atrial
Pulmonary
Tricuspid
Mitral
What is a typical heartrate?
What do you do if pulse is irregular?
60-100 bpm
- Determine if it’s sinus arrythmia (normal in young adults)
- Determine if there is a pulse deficit
What are heart murmurs?
What are the types?
Turbulent blood flow in heart caused by valves
- Stenosis= Valve too hard (wont open fully)
- Regurgitation= valve too soft (opens too easily)
What do you document about heart murmurs if present?
- What region is murmur loudest
- When does it occur in cardiac cycle
- How loud (Grade 1 - Grade 6)
