GALEN - HEALTH ASSESSMENT EXAM 3 QUESTIONS WITH COMPLETE SOLUTIONS

GALEN - HEALTH ASSESSMENT EXAM 3
QUESTIONS WITH COMPLETE SOLUTIONS


What does a murmur sound like? - ans-gentle, blowing, swooshing sound
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When does S3 occur? - ans- cx cx cx cx cxcx




when the ventricles are resistant to filling during the rapid filling phase. Occurs directly after
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S2 (LUB duppa). It is a dull, soft sound; and it is low pitched like "distant thunder". Best hear
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d in a quiet room, at the apex, with the bell held lightly and the patient in left lateral position.
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When does S4 occur? - ans- cx cx cx cx cxcx




At the end of diastole, at presystole, when the ventricle is resistant to filling. The atria contra
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ct and push blood into a noncompliant ventricle. S4 occurs just before S1 (daLUB dup). Ver
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y soft sound of very low pitch. You need a good bell, it is best heard at the apex with patient i
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n left lateral position.
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What are some hemodynamic changes with aging? - ans-
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Increase in systolic BP, increase of supraventricular and ventricular dysrhythmias, and in E
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CG.

Does the heart size decrease or increase with age? - ans-
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NEITHER the heart size DOES NOT change. cx cx cx cx cx cx




Why might it be difficult to palpate the apical impulse of an older adult? - ans-
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the chest often increases in anterior posterior diameter with aging
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Is cardiovascular disease (CVD) a common cause of death? - ans-
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YES. CVD is the most common underlying cause of death in the world
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What are the four healthful factors of a favorable lifestyle? - ans-
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No current smoking, no obesity, physical activity at least once per week, and a healthy diet.
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How does high blood pressure increase the risk of cardiovascular disease? - ans-
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untreated hypertension causes direct damage to the arterial system and accelerates the pr
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ocess of atherosclerosis; it increases the workload on the heart, and it increases the oxyge
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n demand on the heart already compromised by atherosclerosis.
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Who has the highest rate of hypertension? - ans-black Americans
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How does smoking increase the risk of CVD? - ans-
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by increasing the oxygen demand on the heart, while causing a concomitant decrease in ox
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ygen supply, by an activation of platelets and fibrinogen, and by an adverse change in the li
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pid profile. cx

,How does Serum cholesterol increase the risk of CVD? - ans-High levels of low-
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density lipoprotein add to the lipid core of plaque formation in coronary and carotid arteries,
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which results in MI and stroke.
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How much physical activity can reduce the risk for CVD? - ans-about 150 min/
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week of moderate-intensity aerobic activity
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what gender has a higher risk of CVD? - ans-
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WOMEN. CVD is the LEADING cause of death for women, claiming more lives than cancer
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, chronic lower respiratory disease, and diabetes mellitus combined.
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Why do women wait to seek care for CVD? - ans-
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Women experience different symptoms than men. For example, men typically experience
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a crushing chest pain.
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What are symptoms of acute cardiac syndrome (ACS)? - ans-
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discomfort with the jaw or teeth, unusual fatigue, arm pain, and shortness of breath.
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What are women more likely to report when experiencing ACS than men? - ans-
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fatigue, nausea, right arm pain, jaw pain, dizziness, and syncope.
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What subjective data should you get from your patient when assessing the heart and neck v
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essels? - ans-Are you experiencing any: cx cxcx cx cx cx




chest pain cx




dyspnea
orthopnea
cough
fatigue
cyanosis or pallor cx cx cx




edema
nocturia cx




past cardiac history/family history
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patient centered care cx cx




When asking a patient about their chest pain, what should you also ask? - ans-
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when did the pain start and have you had this pain before;
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where is the pain and does it radiate to anywhere else;
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what does it feel like? crushing, stabbing, burning, viselike, aching, heaviness;
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What was the pain brought on by? emotions, environment, during sexual intercourse;
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any associated symptoms? sweating, pale skin, etc;
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what made pain worse/better?
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Can chest pain have other origins? - ans-
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YES. Chest pain also many have pulmonary, musculoskeletal, or gastrointestinal origin.
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, What is Dyspnea? - ans-shortness of breath
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What is dyspnea on exertion (DOE)? - ans-
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quantify exactly. for example, DOE after walking two level blocks.
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Why is paroxysmal nocturnal dyspnea (PND) relevant with the heart? - ans-
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PND occurs with heart failure. lying down increases volume of intrathoracic blood, and the
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weakened heart cannot accommodate the increased load. cx cx cx cx cx cx




What is orthopnea? - ans-the need to assume a more upright position to breathe.
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Note the exact number of pillows used
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When is edema dependent? - ans-when caused by heart failure
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When is cardiac edema worse? - ans- cx cx cx cx cx cxcx




At the evening but better in morning after elevating the legs all night.
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What are risk factors for cardiovascular disease? - ans-
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elevated cholesterol, elevated BP, blood sugar levels above 100mg/ cx cx cx cx cx cx cx cx




dL or known DM, obesity, cigarette smoking, low activity level, and any hormone replaceme
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nt therapy for postmenopausal women
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How do you palpate the carotid artery? - ans-
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palpate each carotid artery separately NOT together. Avoid excessive pressure on the caro
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tid sinus area higher in the neck; excessive vagal stimulation here could slow down the hear
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t rate, especially in older adults. Feel the contour and amplitude of the pulse (should be smo
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oth with a brisk upstroke and slower downstroke)
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Why should you never palpate both carotid arteries at once? - ans-
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to avoid compromising arterial blood to the brain.
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what is a bruit and what does it indicate? - ans-
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it is a blowing, swishing sound indicating blood flow turbulence; is a marker for atherosclero
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tic disease. This increases the risk of transient ischemic attack (TIA) and ischemic stroke.
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When and why would you auscultate the carotid artery? - ans-
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You auscultate the carotid artery when the patient shows signs or symptoms of CVD. You a
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uscultate each carotid artery for the presence of a bruit. cx cx cx cx cx cx cx cx cx




Why do you want to avoid compressing the carotid artery when auscultating? - ans-
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compressing the artery could create an artificial bruit, and it could compromise circulation if cx cx cx cx cx cx cx cx cx cx cx cx cx cx




the carotid artery is already narrowed by atherosclerosis.
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How do you auscultate the carotid artery? - ans-
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apply over the angle of the jaw, the midcervical area, and the base of the neck. Then ask the
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