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&&&&&&&&############################@@@@@@@@@@@@@@@@22/2026//2027
Galen - Health Assessment exam 3Galen - Health Assessment exam 3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!~~
What does a murmur sound like? gentle, blowing, swooshing sound
When does S3 occur? when the ventricles are resistant to filling during the rapid filling phase. Occurs directly
after S2 (LUB duppa). It is a dull, soft sound; and it is low pitched like "distant thunder".
Best heard in a quiet room, at the apex, with the bell held lightly and the patient in left
lateral position.
When does S4 occur? At the end of diastole, at presystole, when the ventricle is resistant to filling. The atria
contract and push blood into a noncompliant ventricle. S4 occurs just before S1 (daLUB
dup). Very soft sound of very low pitch. You need a good bell, it is best heard at the apex
with patient in left lateral position.
What are some hemodynamic changes with aging? Increase in systolic BP, increase of supraventricular and ventricular dysrhythmias, and in
ECG.
Does the heart size decrease or increase with age? NEITHER the heart size DOES NOT change.
Why might it be difficult to palpate the apical impulse of an the chest often increases in anterior posterior diameter with aging
older adult?
Is cardiovascular disease (CVD) a common cause of death? YES. CVD is the most common underlying cause of death in the world
What are the four healthful factors of a favorable lifestyle? No current smoking, no obesity, physical activity at least once per week, and a healthy
diet.
How does high blood pressure increase the risk of untreated hypertension causes direct damage to the arterial system and accelerates the
cardiovascular disease? process of atherosclerosis; it increases the workload on the heart, and it increases the
oxygen demand on the heart already compromised by atherosclerosis.
Who has the highest rate of hypertension? black Americans
How does smoking increase the risk of CVD? by increasing the oxygen demand on the heart, while causing a concomitant decrease in
oxygen supply, by an activation of platelets and fibrinogen, and by an adverse change in
the lipid profile.
How does Serum cholesterol increase the risk of CVD? High levels of low-density lipoprotein add to the lipid core of plaque formation in
coronary and carotid arteries, which results in MI and stroke.
How much physical activity can reduce the risk for CVD? about 150 min/week of moderate-intensity aerobic activity
what gender has a higher risk of CVD? WOMEN. CVD is the LEADING cause of death for women, claiming more lives than
cancer, chronic lower respiratory disease, and diabetes mellitus combined.
Why do women wait to seek care for CVD? Women experience different symptoms than men. For example, men typically experience
a crushing chest pain.
What are symptoms of acute cardiac syndrome (ACS)? discomfort with the jaw or teeth, unusual fatigue, arm pain, and shortness of breath.
!!!!!!!!!!!!!!!!!!!~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~&&&&&&&&############################@@
&&&&&&&&############################@@@@@@@@@@@@@@@@22/2026//2027
Galen - Health Assessment exam 3.pdfGalen - Health Assessment exam 3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
,!!!!!!!!!!!!!!!!!!!~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~&&&&&&&&############################@@
&&&&&&&&############################@@@@@@@@@@@@@@@@22/2026//2027
Galen - Health Assessment exam 3Galen - Health Assessment exam 3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!~~
What are women more likely to report when experiencing ACS fatigue, nausea, right arm pain, jaw pain, dizziness, and syncope.
than men?
What subjective data should you get from your patient when Are you experiencing any:
assessing the heart and neck vessels? chest pain
dyspnea
orthopnea
cough
fatigue
cyanosis or pallor
edema
nocturia
past cardiac history/family history
patient centered care
When asking a patient about their chest pain, what should you when did the pain start and have you had this pain before;
also ask? where is the pain and does it radiate to anywhere else;
what does it feel like? crushing, stabbing, burning, viselike, aching, heaviness;
What was the pain brought on by? emotions, environment, during sexual intercourse;
any associated symptoms? sweating, pale skin, etc;
what made pain worse/better?
Can chest pain have other origins? YES. Chest pain also many have pulmonary, musculoskeletal, or gastrointestinal origin.
What is Dyspnea? shortness of breath
What is dyspnea on exertion (DOE)? quantify exactly. for example, DOE after walking two level blocks.
Why is paroxysmal nocturnal dyspnea (PND) relevant with the PND occurs with heart failure. lying down increases volume of intrathoracic blood, and
heart? the weakened heart cannot accommodate the increased load.
What is orthopnea? the need to assume a more upright position to breathe.
Note the exact number of pillows used
When is edema dependent? when caused by heart failure
When is cardiac edema worse? At the evening but better in morning after elevating the legs all night.
What are risk factors for cardiovascular disease? elevated cholesterol, elevated BP, blood sugar levels above 100mg/dL or known DM,
obesity, cigarette smoking, low activity level, and any hormone replacement therapy for
postmenopausal women
How do you palpate the carotid artery? palpate each carotid artery separately NOT together. Avoid excessive pressure on the
carotid sinus area higher in the neck; excessive vagal stimulation here could slow down
the heart rate, especially in older adults. Feel the contour and amplitude of the pulse
(should be smooth with a brisk upstroke and slower downstroke)
Why should you never palpate both carotid arteries at once? to avoid compromising arterial blood to the brain.
what is a bruit and what does it indicate? it is a blowing, swishing sound indicating blood flow turbulence; is a marker for
atherosclerotic disease. This increases the risk of transient ischemic attack (TIA) and
ischemic stroke.
!!!!!!!!!!!!!!!!!!!~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~&&&&&&&&############################@@
&&&&&&&&############################@@@@@@@@@@@@@@@@22/2026//2027
Galen - Health Assessment exam 3.pdfGalen - Health Assessment exam 3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
&&&&&&&&############################@@@@@@@@@@@@@@@@22/2026//2027
Galen - Health Assessment exam 3Galen - Health Assessment exam 3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!~~
What does a murmur sound like? gentle, blowing, swooshing sound
When does S3 occur? when the ventricles are resistant to filling during the rapid filling phase. Occurs directly
after S2 (LUB duppa). It is a dull, soft sound; and it is low pitched like "distant thunder".
Best heard in a quiet room, at the apex, with the bell held lightly and the patient in left
lateral position.
When does S4 occur? At the end of diastole, at presystole, when the ventricle is resistant to filling. The atria
contract and push blood into a noncompliant ventricle. S4 occurs just before S1 (daLUB
dup). Very soft sound of very low pitch. You need a good bell, it is best heard at the apex
with patient in left lateral position.
What are some hemodynamic changes with aging? Increase in systolic BP, increase of supraventricular and ventricular dysrhythmias, and in
ECG.
Does the heart size decrease or increase with age? NEITHER the heart size DOES NOT change.
Why might it be difficult to palpate the apical impulse of an the chest often increases in anterior posterior diameter with aging
older adult?
Is cardiovascular disease (CVD) a common cause of death? YES. CVD is the most common underlying cause of death in the world
What are the four healthful factors of a favorable lifestyle? No current smoking, no obesity, physical activity at least once per week, and a healthy
diet.
How does high blood pressure increase the risk of untreated hypertension causes direct damage to the arterial system and accelerates the
cardiovascular disease? process of atherosclerosis; it increases the workload on the heart, and it increases the
oxygen demand on the heart already compromised by atherosclerosis.
Who has the highest rate of hypertension? black Americans
How does smoking increase the risk of CVD? by increasing the oxygen demand on the heart, while causing a concomitant decrease in
oxygen supply, by an activation of platelets and fibrinogen, and by an adverse change in
the lipid profile.
How does Serum cholesterol increase the risk of CVD? High levels of low-density lipoprotein add to the lipid core of plaque formation in
coronary and carotid arteries, which results in MI and stroke.
How much physical activity can reduce the risk for CVD? about 150 min/week of moderate-intensity aerobic activity
what gender has a higher risk of CVD? WOMEN. CVD is the LEADING cause of death for women, claiming more lives than
cancer, chronic lower respiratory disease, and diabetes mellitus combined.
Why do women wait to seek care for CVD? Women experience different symptoms than men. For example, men typically experience
a crushing chest pain.
What are symptoms of acute cardiac syndrome (ACS)? discomfort with the jaw or teeth, unusual fatigue, arm pain, and shortness of breath.
!!!!!!!!!!!!!!!!!!!~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~&&&&&&&&############################@@
&&&&&&&&############################@@@@@@@@@@@@@@@@22/2026//2027
Galen - Health Assessment exam 3.pdfGalen - Health Assessment exam 3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
,!!!!!!!!!!!!!!!!!!!~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~&&&&&&&&############################@@
&&&&&&&&############################@@@@@@@@@@@@@@@@22/2026//2027
Galen - Health Assessment exam 3Galen - Health Assessment exam 3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!~~
What are women more likely to report when experiencing ACS fatigue, nausea, right arm pain, jaw pain, dizziness, and syncope.
than men?
What subjective data should you get from your patient when Are you experiencing any:
assessing the heart and neck vessels? chest pain
dyspnea
orthopnea
cough
fatigue
cyanosis or pallor
edema
nocturia
past cardiac history/family history
patient centered care
When asking a patient about their chest pain, what should you when did the pain start and have you had this pain before;
also ask? where is the pain and does it radiate to anywhere else;
what does it feel like? crushing, stabbing, burning, viselike, aching, heaviness;
What was the pain brought on by? emotions, environment, during sexual intercourse;
any associated symptoms? sweating, pale skin, etc;
what made pain worse/better?
Can chest pain have other origins? YES. Chest pain also many have pulmonary, musculoskeletal, or gastrointestinal origin.
What is Dyspnea? shortness of breath
What is dyspnea on exertion (DOE)? quantify exactly. for example, DOE after walking two level blocks.
Why is paroxysmal nocturnal dyspnea (PND) relevant with the PND occurs with heart failure. lying down increases volume of intrathoracic blood, and
heart? the weakened heart cannot accommodate the increased load.
What is orthopnea? the need to assume a more upright position to breathe.
Note the exact number of pillows used
When is edema dependent? when caused by heart failure
When is cardiac edema worse? At the evening but better in morning after elevating the legs all night.
What are risk factors for cardiovascular disease? elevated cholesterol, elevated BP, blood sugar levels above 100mg/dL or known DM,
obesity, cigarette smoking, low activity level, and any hormone replacement therapy for
postmenopausal women
How do you palpate the carotid artery? palpate each carotid artery separately NOT together. Avoid excessive pressure on the
carotid sinus area higher in the neck; excessive vagal stimulation here could slow down
the heart rate, especially in older adults. Feel the contour and amplitude of the pulse
(should be smooth with a brisk upstroke and slower downstroke)
Why should you never palpate both carotid arteries at once? to avoid compromising arterial blood to the brain.
what is a bruit and what does it indicate? it is a blowing, swishing sound indicating blood flow turbulence; is a marker for
atherosclerotic disease. This increases the risk of transient ischemic attack (TIA) and
ischemic stroke.
!!!!!!!!!!!!!!!!!!!~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~&&&&&&&&############################@@
&&&&&&&&############################@@@@@@@@@@@@@@@@22/2026//2027
Galen - Health Assessment exam 3.pdfGalen - Health Assessment exam 3!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
