FROM PREP TO PERFECTION! YOUR NUR 507 EXAM 2 A+
BLUEPRINT.
Dyspnea
shortness of breath
Orthopnea
shortness of breath when lying down
Paroxysmal nocturnal dyspnea
difficulty breathing when sleeping (PND)
Location of apical pulse
between forth and fifth intercostal space on the midclavicular line
Thrill
vibrations
Order of blood flow through the heart
The right atrium pumps deoxygenated blood from the superior and inferior vena cava to
the right ventricle. The right ventricle pumps deoxygenated blood to the lungs through
the pulmonary artery. The left atrium pumps oxygenated blood in from the pulmonary
veins to the left ventricle. The left ventricle pumps oxygenated blood to the aorta and
does the most work of the heart.
Right side of heart = pulmonary circulation
Left side of heart: systemic circulation
Pulse rating scale
0 absent
+1 weak and thready
+2 normal
+3 full
+4 bounding
Edema grading scale
0 no edema
+1 barely discernible depression
+2 <5 mm depression, normal foot and leg contours
,+3 deep depressions (5-10 mm) with foot and leg swelling
+4 deeper depression (>1 cm) with severe foot and leg swelling
Venous stasis
a vascular problem that causes pressure in the veins, so blood pools up and "leaks"
causing blue/purple discoloration on skin
5 P's of circulatory check
Pain
Pallor
Paralysis
Paresthesia
Pulse
Cardiac output
the amount of blood teh heart pumps out in one minute; usually 6 L/min
Tachycardia
heartbeat too fast
Bradycardia
heartbeat too slow
Arrhythmia
Irregular heartbeat
S1
"lub" sound
Caused by atrioventricular (mitral and tricuspid) valves immediately after closure
Onset of systole
Heard loudest at teh apex of the heart
S2
"dub" sound
Caused by semilunar (pulmonic and aortic) valves immediately after closure
Onset of diastole
Heard loudest at the base of the heart
S3
, Heard best with the bell of the stethoscope with patient lying supine and then on left
side
Heard directly after S2 sound like a "gallop"
Normal in physically active young adults
Abnormal in patients >40 yrs and associated with heart failure
May indicate CHF, aortic valve regurgitation, or be present after MI
S4
Heard best with bell of stethoscope over the apex of the heart with patient lying on left
side
Soft, low-pitched sound at the end of diastole like a "thud"
May be due to scar tissue of hypertensive heart disease or coronary artery disease
Not heard in patients with atrial fibrillation
Abnormal S4 sounds are louder and higher pitched, aka "atrial gallop"
May be normal in healthy older adults without cardiac problems due to decreased
ventricular compliance with age
May indicate hypertrophy (thickening) of left ventricle, hypertension, aortic stenosis, or
be heard after an MI
EKG
Electrocardiogram
Provides vital info about the heart's electrical conduction system; records electrical
activity of heart
Helps diagnose abnormal heartbeats, heart rhythm, and tissue ishcemia (ischemia =
insufficient blood flow)
Rheumatic fever
An inflammatory disease that can damage the heart and heart valves
Common classifications of cardiac medications
BLUEPRINT.
Dyspnea
shortness of breath
Orthopnea
shortness of breath when lying down
Paroxysmal nocturnal dyspnea
difficulty breathing when sleeping (PND)
Location of apical pulse
between forth and fifth intercostal space on the midclavicular line
Thrill
vibrations
Order of blood flow through the heart
The right atrium pumps deoxygenated blood from the superior and inferior vena cava to
the right ventricle. The right ventricle pumps deoxygenated blood to the lungs through
the pulmonary artery. The left atrium pumps oxygenated blood in from the pulmonary
veins to the left ventricle. The left ventricle pumps oxygenated blood to the aorta and
does the most work of the heart.
Right side of heart = pulmonary circulation
Left side of heart: systemic circulation
Pulse rating scale
0 absent
+1 weak and thready
+2 normal
+3 full
+4 bounding
Edema grading scale
0 no edema
+1 barely discernible depression
+2 <5 mm depression, normal foot and leg contours
,+3 deep depressions (5-10 mm) with foot and leg swelling
+4 deeper depression (>1 cm) with severe foot and leg swelling
Venous stasis
a vascular problem that causes pressure in the veins, so blood pools up and "leaks"
causing blue/purple discoloration on skin
5 P's of circulatory check
Pain
Pallor
Paralysis
Paresthesia
Pulse
Cardiac output
the amount of blood teh heart pumps out in one minute; usually 6 L/min
Tachycardia
heartbeat too fast
Bradycardia
heartbeat too slow
Arrhythmia
Irregular heartbeat
S1
"lub" sound
Caused by atrioventricular (mitral and tricuspid) valves immediately after closure
Onset of systole
Heard loudest at teh apex of the heart
S2
"dub" sound
Caused by semilunar (pulmonic and aortic) valves immediately after closure
Onset of diastole
Heard loudest at the base of the heart
S3
, Heard best with the bell of the stethoscope with patient lying supine and then on left
side
Heard directly after S2 sound like a "gallop"
Normal in physically active young adults
Abnormal in patients >40 yrs and associated with heart failure
May indicate CHF, aortic valve regurgitation, or be present after MI
S4
Heard best with bell of stethoscope over the apex of the heart with patient lying on left
side
Soft, low-pitched sound at the end of diastole like a "thud"
May be due to scar tissue of hypertensive heart disease or coronary artery disease
Not heard in patients with atrial fibrillation
Abnormal S4 sounds are louder and higher pitched, aka "atrial gallop"
May be normal in healthy older adults without cardiac problems due to decreased
ventricular compliance with age
May indicate hypertrophy (thickening) of left ventricle, hypertension, aortic stenosis, or
be heard after an MI
EKG
Electrocardiogram
Provides vital info about the heart's electrical conduction system; records electrical
activity of heart
Helps diagnose abnormal heartbeats, heart rhythm, and tissue ishcemia (ischemia =
insufficient blood flow)
Rheumatic fever
An inflammatory disease that can damage the heart and heart valves
Common classifications of cardiac medications
