NSG 3160 Exam 3 Questions & answers
How do you assess the carotid artery?
gently palpate one side at a time for pulses
What are heaves or lifts?
forceful thrusting of the ventricles during systole when the ventricles are enlarged
- ventricular hypertrophy
What is the sternal notch aligned with?
The clavicle
Why do you auscultate the carotid artery?
atherosclerosis is a common occurrence especially in older people
bruit maybe heard as a result of atherosclerosis
Why does the bruit happens?
turbulence of blood flow
creates swooshing sound
How do you assess for increased central venous pressure?
assessing JVD - sitting up patient 30-45 degree angle, assess jugular vein
What does it mean if the patient has JVD?
heart failure - fluid overload in the venous system
What is the angle of louis aligned with?
second ribs
,What do you assess at the midclavicular line and the 5th intercostal space?
apical pulse and mitral valve
What does it mean when you can feel a thrill over the chest?
patient may have murmur
How do you assess for thrill?
palmar aspect of the fingers at the apex left sternal border
How do you assess for heart sounds?
Diaphragm - high pitch sounds
bell - low pitch sounds
What creates the heart sounds?
closure of the valves
Where do you listen for the heart sounds?
Aortic - R 2nd IC
Pulmonic - L 2nd IC
Erb's point - L 3rd IC
Tricuspid - L 5th IC, L sternal border
Mitral - 5th IC, midclavicular line
What creates the S1 sound?
closure of AV valves (M&T), beginning of systole
best heard at the apex
What creates the S2 sound?
closure of semilunar valves (P&A), beginning of diastole
,best heard at base
What do you have to do when you hear an irregular rhythm?
assess radial and apical pulse - the difference is the pulse deficit
What are some extra heart sounds?
S3
S4
summation sounds
murmur
pericardial friction rub
What are some modifiable risk factors for cardiovascular disease?
lifestyle - smoking, HTN, obesity, diabetes, increased cholesterol, alcohol,
exercise, diet, stress
How do you assess chest pain?
Assessment of chest pain:
onset - when did it start
location - where is the pain? does it radiate?
character - crushing, stabbing, burning
what brought it on
what makes it worse
what makes it better
does rest relieves the pai
What happens to the vessels as we age?
thickening, stiffening of arteries (arteriosclerosis) leading to higher BP
What might the changes in the vessels lead to as we age?
Higher incidence of CVD - number one cause of death!!
, What are some things you can teach the patient about promoting cardiac health?
diet
exercise - walking for at least 30 min. 5 times a week
smoking
stress
What are some of the risk factors for pulmonary disease?
smoking
environmental exposure (working in a factory)
history of respiratory infections
What is the normal costal angle?
90 degrees
What are some things that change with aging?
thorax less mobile - costal cartilage becomes calcified
respiratory muscles weaken
lung becomes less distensible, harder to inflate, recoil
decreased number of alveoli - decreased surface for gas exchange
What causes the increased risk for respiratory complications after surgery in
older adults?
decreased ability to cough, increased secretion, and decreased reflexes lead to
increased post-op atelectasis, infection
Why is the angle of Louis is an important landmark?
It is at the same level as the second ribs and help count ribs.
Where do the lobes of the lungs start?
How do you assess the carotid artery?
gently palpate one side at a time for pulses
What are heaves or lifts?
forceful thrusting of the ventricles during systole when the ventricles are enlarged
- ventricular hypertrophy
What is the sternal notch aligned with?
The clavicle
Why do you auscultate the carotid artery?
atherosclerosis is a common occurrence especially in older people
bruit maybe heard as a result of atherosclerosis
Why does the bruit happens?
turbulence of blood flow
creates swooshing sound
How do you assess for increased central venous pressure?
assessing JVD - sitting up patient 30-45 degree angle, assess jugular vein
What does it mean if the patient has JVD?
heart failure - fluid overload in the venous system
What is the angle of louis aligned with?
second ribs
,What do you assess at the midclavicular line and the 5th intercostal space?
apical pulse and mitral valve
What does it mean when you can feel a thrill over the chest?
patient may have murmur
How do you assess for thrill?
palmar aspect of the fingers at the apex left sternal border
How do you assess for heart sounds?
Diaphragm - high pitch sounds
bell - low pitch sounds
What creates the heart sounds?
closure of the valves
Where do you listen for the heart sounds?
Aortic - R 2nd IC
Pulmonic - L 2nd IC
Erb's point - L 3rd IC
Tricuspid - L 5th IC, L sternal border
Mitral - 5th IC, midclavicular line
What creates the S1 sound?
closure of AV valves (M&T), beginning of systole
best heard at the apex
What creates the S2 sound?
closure of semilunar valves (P&A), beginning of diastole
,best heard at base
What do you have to do when you hear an irregular rhythm?
assess radial and apical pulse - the difference is the pulse deficit
What are some extra heart sounds?
S3
S4
summation sounds
murmur
pericardial friction rub
What are some modifiable risk factors for cardiovascular disease?
lifestyle - smoking, HTN, obesity, diabetes, increased cholesterol, alcohol,
exercise, diet, stress
How do you assess chest pain?
Assessment of chest pain:
onset - when did it start
location - where is the pain? does it radiate?
character - crushing, stabbing, burning
what brought it on
what makes it worse
what makes it better
does rest relieves the pai
What happens to the vessels as we age?
thickening, stiffening of arteries (arteriosclerosis) leading to higher BP
What might the changes in the vessels lead to as we age?
Higher incidence of CVD - number one cause of death!!
, What are some things you can teach the patient about promoting cardiac health?
diet
exercise - walking for at least 30 min. 5 times a week
smoking
stress
What are some of the risk factors for pulmonary disease?
smoking
environmental exposure (working in a factory)
history of respiratory infections
What is the normal costal angle?
90 degrees
What are some things that change with aging?
thorax less mobile - costal cartilage becomes calcified
respiratory muscles weaken
lung becomes less distensible, harder to inflate, recoil
decreased number of alveoli - decreased surface for gas exchange
What causes the increased risk for respiratory complications after surgery in
older adults?
decreased ability to cough, increased secretion, and decreased reflexes lead to
increased post-op atelectasis, infection
Why is the angle of Louis is an important landmark?
It is at the same level as the second ribs and help count ribs.
Where do the lobes of the lungs start?
