correvt answers
Normal and abnormal jugular venous pressures Correct Answer.-JVD
>5cm abnormal
May be caused by:
- RV failure
- Cardiac tamponade
- Constrictive pericarditis
- SVC obstruction
- Increased thoracic pressure (PEEP, coughing)
Assessing mental acuity of chest pain patient Correct Answer.-A/O x4?
- Alertness
- Orientation
- Clarity of speech
- Ability to follow commands
- Anxiety/restlessness
- Different than before
Physical appearance of chest pain patient Correct Answer.-- Struggling
,- Diaphoretic
- Dyspnea
- Skin color
- Posture: sitting upright, unwilling to lie down, hand motions toward
chest
Identify the components of a routine inspection of chest pain patient
Correct Answer.-Check fingertips + nail beds for:
- cap refill within 3 seconds
- clubbing of fingers
Head + neck for:
- xanthoma (fatty streaking visible just under the skin)
- corneal arcus (grayish ring around the eyes)
JVD for distention
Abdominal jugular test or reflux
- positive result = sustained rise > 3cm or fall > 4cm after releasing
pressure
Identify a normal resting pulse pressure Correct Answer.-40 mmHg
,Dose a widened pulse pressure increase risk of cardiovascular disease?
Correct Answer.-Yes
Widened pulse pressure = indicator of increased cardiovascular risk
Equate 4mm of moderate indentation that takes 10-15 seconds to
disappear with how much pitting edema is present Correct Answer.-2+
pitting edema
Listening to the right lobe of the lung Correct Answer.-3 LOBES
*RLL cannot be assessed from the anterior chest
*RML can only be assessed from the anterior chest
Listening to the left lobe of the lung Correct Answer.-2 LOBES
*LLL cannot be auscultated from the anterior chest
Types of sounds we listen to with the bell of the stethoscope Correct
Answer.-Low-pitched sounds + murmurs (S3, S4)
Mitral + tricuspid diastolic rumbles
, S1, S2 as well
Apply to chest wall w/ minimal pressure
Types of sounds we listen to with the diaphragm of the stethoscope
Correct Answer.-High-pitched sounds (S1, S2)
Ejection clicks
Opening snaps
Murmurs produced by stenotic valves
Press against slim firmly to get the best sound effect
Where to listen to the aortic valve Correct Answer.-2nd intercostal space,
RSB
Where to listen to the mitral valve Correct Answer.-5th intercostal space,
left midclavicular line = apex
Where to listen to the pulmonic valve Correct Answer.-2nd intercostal
space, LSB