CCBC NURN155 EXAMS SCRIPT ANSWERS AND
QUESTIONS SET A+
✔✔Thrill - ✔✔palpable vibration (purring cat)
✔✔Lift (Heave) - ✔✔PMI so strong that it lifts your finger
✔✔Jugular Venous Distension (JVD) - ✔✔Marker of fluid volume
✔✔S1 & S2 - ✔✔LUB DUB (normal heart sound)
✔✔S3 & S4 - ✔✔Extra heart sounds (Dysrhythmias)
✔✔Murmurs - ✔✔Sounds created by abnormal, turbulent flow of blood in the heart
- velocity of blood increases
- viscosity of blood decreases
- structural defects in valves
- unusual openings occur in chambers
✔✔Auscultation Points - ✔✔
✔✔S1 - ✔✔Closure of Mitral & Tricuspid valves
Beginning of ventricular systole
Heard loudest at Apical Pulse
Corresponds with carotid pulse
✔✔S2 - ✔✔Closure of Aortic & Pulmonic valves
Beginning of ventricular diastole
Loudest at apex
✔✔S3 (ventricular gallop) - ✔✔Well....darn, you! Well...darn, you!
Blood enters non-compliant ventricles
✔✔S4 (atrial gallop) - ✔✔Darn, you're... screwed! Darn, you're... screwed!
, Blood enters from the atrium with atrial contraction into non-compliant ventricular
chambers at the end of ventricular diastole
✔✔Pericardial Friction Rub - ✔✔-Inflammation in pericardium
-"scratchy" sound
- Best heard in the 3rd ICS left side (Erb's Point)
✔✔Peripheral Vascular System - ✔✔Blood flow
Condition of skin and nails
Integrity of venous system
Pulses & Sufficiency of arterial circulation
✔✔Carotid Bruit - ✔✔Noise from carotid artery narrowing heard with stethoscope
(blowing/swishing sound)
✔✔Capillary Refill - ✔✔- Depress and blanch nail beds - release and note time for color
return
- Normal if color returns in 1-2 seconds
✔✔Skin Inspection - ✔✔Color (pale, cyanotic, mottled)
Moisture (moist, dry)
Temperature (cool, warm)
✔✔Edema - ✔✔Accumulation of fluid in the intercellular space
✔✔Pitting Edema - ✔✔Leaves an indentation in the tissue with pressure
✔✔Brawny Edema - ✔✔Chronic edema, with discoloration of the extremity, occurs with
long standing swelling. This rarely abates and does not pit with pressure
✔✔Non-pitting Edema - ✔✔Swelling is evident, but no pit is formed with pressure;
swelling will abate with treatment
✔✔Perfusion Related Equipment - ✔✔Doppler
TEDs
SCDs
✔✔Doppler Ultrasonic stethoscope - ✔✔Detect a weak peripheral pulse
Measure a low blood pressure
Magnifies pulsatile sounds
✔✔TEDs (Thromboembolic device
Elastic stockings) - ✔✔Aid in maintaining external pressure on the muscles of lower
extremities to promote venous return
QUESTIONS SET A+
✔✔Thrill - ✔✔palpable vibration (purring cat)
✔✔Lift (Heave) - ✔✔PMI so strong that it lifts your finger
✔✔Jugular Venous Distension (JVD) - ✔✔Marker of fluid volume
✔✔S1 & S2 - ✔✔LUB DUB (normal heart sound)
✔✔S3 & S4 - ✔✔Extra heart sounds (Dysrhythmias)
✔✔Murmurs - ✔✔Sounds created by abnormal, turbulent flow of blood in the heart
- velocity of blood increases
- viscosity of blood decreases
- structural defects in valves
- unusual openings occur in chambers
✔✔Auscultation Points - ✔✔
✔✔S1 - ✔✔Closure of Mitral & Tricuspid valves
Beginning of ventricular systole
Heard loudest at Apical Pulse
Corresponds with carotid pulse
✔✔S2 - ✔✔Closure of Aortic & Pulmonic valves
Beginning of ventricular diastole
Loudest at apex
✔✔S3 (ventricular gallop) - ✔✔Well....darn, you! Well...darn, you!
Blood enters non-compliant ventricles
✔✔S4 (atrial gallop) - ✔✔Darn, you're... screwed! Darn, you're... screwed!
, Blood enters from the atrium with atrial contraction into non-compliant ventricular
chambers at the end of ventricular diastole
✔✔Pericardial Friction Rub - ✔✔-Inflammation in pericardium
-"scratchy" sound
- Best heard in the 3rd ICS left side (Erb's Point)
✔✔Peripheral Vascular System - ✔✔Blood flow
Condition of skin and nails
Integrity of venous system
Pulses & Sufficiency of arterial circulation
✔✔Carotid Bruit - ✔✔Noise from carotid artery narrowing heard with stethoscope
(blowing/swishing sound)
✔✔Capillary Refill - ✔✔- Depress and blanch nail beds - release and note time for color
return
- Normal if color returns in 1-2 seconds
✔✔Skin Inspection - ✔✔Color (pale, cyanotic, mottled)
Moisture (moist, dry)
Temperature (cool, warm)
✔✔Edema - ✔✔Accumulation of fluid in the intercellular space
✔✔Pitting Edema - ✔✔Leaves an indentation in the tissue with pressure
✔✔Brawny Edema - ✔✔Chronic edema, with discoloration of the extremity, occurs with
long standing swelling. This rarely abates and does not pit with pressure
✔✔Non-pitting Edema - ✔✔Swelling is evident, but no pit is formed with pressure;
swelling will abate with treatment
✔✔Perfusion Related Equipment - ✔✔Doppler
TEDs
SCDs
✔✔Doppler Ultrasonic stethoscope - ✔✔Detect a weak peripheral pulse
Measure a low blood pressure
Magnifies pulsatile sounds
✔✔TEDs (Thromboembolic device
Elastic stockings) - ✔✔Aid in maintaining external pressure on the muscles of lower
extremities to promote venous return
