Advanced Physical Assessment Exam 2 Save
Terms in this set (44)
•The ventricles contract
-The right ventricle pumps blood into the pulmonary arteries
Systole (pulmonic valve is open)
-The left ventricle pumps blood into the aorta (aortic valve is
open)
•The ventricles relax
-Blood flows from the right atrium → right ventricle (tricuspid
Diastole valve is open)
-Blood flows from the left atrium → left ventricle (mitral valve is
open)
,cardiac output stroke volume x heart rate
blood pressure cardiac output x vascular resistance
Preload volume overload
Afterload pressure overload
•BP Goal: <140/90 mmHg (JNC VIII)
•Normal<120and<80
blood pressure •Prehypertension 120-139and/or80-89
•Grade 1 hypertension140-159and/or90-99
•Grade 2 hypertension >160 and/or >100
•LDL: <70 mg/dL with CVD and at very high risk of heart disease
(those with metabolic syndrome) ;
< 100 mg/dL for high risk patients (for example: DM and or
multiple heart disease risk factors)
Cholesterol < 130 mg/dL otherwise
•TC: 75-169 mg/dL for those age 20 and younger
100-199 mg/dL for those over age 21
•HDL: > 45 mg/dl
•TG: <150 mg/dl
, •P - provocative-palliative factors
•Q - quality
chest pain attributes (PQRST) •R - region
•S - severity
•T - Timing
•Recall that the jugular veins reflect right atrial pressure
•Steps for examination
-Raise the head of the bed or examining table to 30°
-Turn the patient's head gently to the left
-Identify the topmost point of the flickering venous pulsations
Jugular Venous Pressure (JVP)
-Place a centimeter ruler upright on the sternal angle
-Place a card or tongue blade horizontally from the top of the
JVP to the ruler, making a right angle
-Measure the distance above the sternal angle in centimeters -
a 3 - 4 centimeter elevation is normal
- most suitable for listening to high pitched sounds and
murmurs. The sounds are the S1, S2, ejection sounds, clicks,
diaphragm of sethoscope opening snaps, and murmurs.
- should be applied to the chest wall with firm pressure, so that
when it is removed, an indentation is seen on the patient's skin.
- best suited for listening for low pitched sound and murmurs:
include S3, S4 and mitral and tricupsid rumbles.
- should be applied to the chest wall with very light pressure,
Bell of stethoscope
barely making an airtight seal. If too much pressure is applied
the scope will act as a diaphragm, only high pitched sounds will
be heard 'BELL LIGHTLY HELD"
Terms in this set (44)
•The ventricles contract
-The right ventricle pumps blood into the pulmonary arteries
Systole (pulmonic valve is open)
-The left ventricle pumps blood into the aorta (aortic valve is
open)
•The ventricles relax
-Blood flows from the right atrium → right ventricle (tricuspid
Diastole valve is open)
-Blood flows from the left atrium → left ventricle (mitral valve is
open)
,cardiac output stroke volume x heart rate
blood pressure cardiac output x vascular resistance
Preload volume overload
Afterload pressure overload
•BP Goal: <140/90 mmHg (JNC VIII)
•Normal<120and<80
blood pressure •Prehypertension 120-139and/or80-89
•Grade 1 hypertension140-159and/or90-99
•Grade 2 hypertension >160 and/or >100
•LDL: <70 mg/dL with CVD and at very high risk of heart disease
(those with metabolic syndrome) ;
< 100 mg/dL for high risk patients (for example: DM and or
multiple heart disease risk factors)
Cholesterol < 130 mg/dL otherwise
•TC: 75-169 mg/dL for those age 20 and younger
100-199 mg/dL for those over age 21
•HDL: > 45 mg/dl
•TG: <150 mg/dl
, •P - provocative-palliative factors
•Q - quality
chest pain attributes (PQRST) •R - region
•S - severity
•T - Timing
•Recall that the jugular veins reflect right atrial pressure
•Steps for examination
-Raise the head of the bed or examining table to 30°
-Turn the patient's head gently to the left
-Identify the topmost point of the flickering venous pulsations
Jugular Venous Pressure (JVP)
-Place a centimeter ruler upright on the sternal angle
-Place a card or tongue blade horizontally from the top of the
JVP to the ruler, making a right angle
-Measure the distance above the sternal angle in centimeters -
a 3 - 4 centimeter elevation is normal
- most suitable for listening to high pitched sounds and
murmurs. The sounds are the S1, S2, ejection sounds, clicks,
diaphragm of sethoscope opening snaps, and murmurs.
- should be applied to the chest wall with firm pressure, so that
when it is removed, an indentation is seen on the patient's skin.
- best suited for listening for low pitched sound and murmurs:
include S3, S4 and mitral and tricupsid rumbles.
- should be applied to the chest wall with very light pressure,
Bell of stethoscope
barely making an airtight seal. If too much pressure is applied
the scope will act as a diaphragm, only high pitched sounds will
be heard 'BELL LIGHTLY HELD"
