2024 Latest Advanced Health Assessment Cardiovascular SOLUTIONS 100% PASS

Advanced Health Assessment Cardiovascular SOLUTIONS 100% PASS What is the first step in the cardiovascular assessment ? - ANSWER Supine with HOB 30 degrees: - JVP - Carotid Pulses - Inspect and palpate pericordium - PMI Where would you inspect and palpate the pericordium ? - ANSWER 2nd R/L intercostal spaces What is the pericordium? - ANSWER The region of the thorax directly in front of the heart. What is another term for the apical pulse - ANSWER Point of maximum impulse What do you measure when assessing the PMI - ANSWER diameter, location, amplitude, and duration How do you measure the PMI - ANSWER - Lay the patient on their left, lateral, decubitus - Listen with the bell of the stethoscope What are the six regions of the heart you auscultate with he bell and diaphragm. - ANSWER Aortic, pulmonic, erbs, tricuspid (2) and mitral What technique is used to auscultate aortic regurgitation - ANSWER Sitting the client up and having them lean forward while exhaling fulling and auscultation with the diaphragm What last longer, diastole or systole? - ANSWER diastole When does cardiac upstroke occur? - ANSWER During systole Where is S1 heard the loudest? - ANSWER apex of the heart Where is S2 heard the loudest? - ANSWER base of the heart What occurs during inspect of the cardiovascular system? - ANSWER PMI or apical pulse Where is the point of maximal impulse? - ANSWER 4th or 5th ICS, 7-9 cm from sternum What occurs during palpation of the cardiovascular system? - ANSWER - Heaves and Lifts ~ flat palm (rhythmically lift; may indicate chamber enlargement) - Thrills ~ ball fo your hand (buzzing or vibratory; underlying turbulent blood flow ~ auscultate for a murmur if felt.) - RV impulses ~ subxiphoid region - S1 and S2 ~ firm pressure on the chest wall What occurs during auscultation of the cardiovascular system? - ANSWER - Diaphragm ~ high pitched sounds (AV and MV regurgitation and pericardial friction rubs) - Bell ~ low pithed sounds and highly sensitive (S3 and S4 along with Mitral stenosis) Define the grading scale for murmurs - ANSWER Grade 1-6 1: "tuned in" faint 2: Quiet, head once stethoscope is immediately placed on the chest 3: moderately loud 4: Loud with palpable thrill 5: Loud with palpable thrill, heard with the stethoscope slightly off of the chest. 6: Loud with palpable thrill, heard with the stethoscope entirely off of the chest. Differentiate between pitch and quality of murmurs - ANSWER The pitch can be high, medium or low; whereas the quality can be blowing, harsh, rumbling, and or musical. Differentiate between standing and squatting and the abnormalities that would be more prominent with each. - ANSWER While auscultating you can identify MV prolapse and distinguish between hypertrophic CMO and AS standing: increase in intensity for AS squatting: increase in intensity for MV prolapse and CMO LV volume and vascular tone decreases in intensity while standing and increases while squatting. Do veins or arteries hold 2/3's of the circulating blood flow? - ANSWER Veins What pulses are palpable in the arms? - ANSWER brachial, radial, and ulnar What pulses are palpable in the abdomen? - ANSWER Celiac, superior and inferior iliac. * bowel ischemia and infarction What pulses are palpable in the legs? - ANSWER femoral, popliteal, dorsalis, posterior tibial, and pedis What can easily be mistake for a the patient's pulse while palpating? - ANSWER yours the examiner What important lymph nodes pertain to the cardiovascular system? - ANSWER Epitrochlear, lateral and central axillary, and infraclavicular What is a abnormal Ankle-brachial index measurement? - ANSWER 0.9 What is characterizes renal artery disease? - ANSWER Diabetes, ESRD, HTN, atherosclerosis disease How can you screen for renal artery disease? - ANSWER US, MRI and CT What presents with abdominal pain or back pain? - ANSWER AAA Characterize an Abdominal aortic aneurysm - ANSWER - Diameter 3cm - Men Female - Tall - Men 65-75 who smoke more than 100 cigarettes in their lifetime - Identified through US What corresponds with pain, weakness and pallor of the lower extremities? - ANSWER Venous stasis ulcers