NURS 222 Exam 1(Graded A+ actual test)

When auscultating the newborn heart sounds, determine the _____ (acronym only). This will aid in determining whether the right or left ventricle is dominant. If the right ventricle is dominant the impulse is maximal at the lower left sternal border. If the left ventricle is dominant, the impulse is at the apex. - Answer-PMI (point of maximal impulse) Abnormal, bluish discoloration of the tongue and mucous membranes caused by desaturation of arterial blood indicating cardiac and/or respiratory dysfunction is known as ____ cyanosis. - Answer-central Normal, bluish discoloration around the mouth which is associated with nipple or breast feeding and should resolve following the feeding is known as ____ cyanosis. - Answer-circumoral Peripheral cyanosis or bluish discoloration of hands and feet not involving the mucous membranes it often resolves by 48 hours or with stabilization of the infant is known as _____. It is considered normal intermittent. - Answer-acrocyanosis There are four individual heart sounds: S1, S2, S3, and S4. Which sounds are rarely heard in the newborn? ____ (S# and S#). Their presence denotes a pathologic process. - Answer-S3 and S4 Inspection of the general activity of the neonate, breathing patterns, presence or absence of cyanosis, and activity of the precordium are all important. Palpation of pulses, peripheral perfusion, and thrills is also imperative. _____, however, is the main focus of the exam. - Answer-auscultation Fetal circulation is anatomically and physiologically different from adult circulation in several important ways. In the fetus, oxygenation of the blood, removal of carbon dioxide and wastes occurs in the ____. - Answer-placenta The ____ (two words) permits the majority of blood from the placenta to bypass the liver and enter the inferior vena cava. When this blood enters the right atrium, most of it is diverted toward the atrial septum. - Answer-ductus venosusThe ____ (two words) is the opening in the interatrial septum that permits a portion of blood to flow from the right atrium directly to the left atrium. This blood then enters the left ventricle and aorta, to perfuse the head and upper extremities of the fetus. - Answer-foramen ovale A tubular communication between the pulmonary artery and the descending aorta that allows blood to flow between the pulmonary artery to the aorta, bypassing the fetal lungs is the ____ (two words). Only about eight percent of fetal cardiac output enters the lungs; 92 percent is diverted through this tube into the descending aorta. - Answer-ductus arteriosus