NURS 190 Physical Assessment Midterm Review

NURS 190 Physical Assessment Midterm Review Midterm PA review Assessment of apical pulse - Mitral point, the maximum intensity pulse - Between 5/6 intercostal space at mid-clavicular line - Moves during pregnancy (landmark) - Easily palpated, easiest location to palpate for a heart beat over the apex - Best site used for children under the age two - S1 louder here - Pt sitting upright - Asses for one minute Screening of HTN in relation to Africans and Hispanics (high risk) Africans have a higher rate than Caucasians and Hispanics - AF females over the age 20 have higher risk than other ethnic groups of same age - Caucasians have higher cholesterol serum levels than African Americans - White females between 65-74 have high CVD than blacks - Native Indians under 35 have twice the heart disease mortality of other groups and African Americans w/ heart failure have higher mortality than blacks Mitral-regurgitation - Blood from LV to the left atrium - The valve is not closing properly (bicuspid valve) - Symptoms: rheumatic fever, MI, Rupture of chordae tendineae - You’ll find a murmur at apex, sound is transmitted to left axillae Peripheral pulses (know the grading scale +1, +2, etc) - Rate: beats per minute - Rhythm: regularity of the beats - Symmetry: Pulses on both sides should be similar - Amplitude: strength of beat o 4= Bounding o 3 = Increased o 2 = Normal o 1= weak o 0= absent / non-palpable Breast exam assessment - Use the finger pads of the first three fingers in dime-sized circular motion Incidence of breast cancer is highest in upper outer quadrant including the axillary “tail of Spence” 1- Down the midaxillary line, across the inframammary ridge at the firth or sixth rib, up at the lateral edge of the sternum, across the clavicle and back of the midaxilla - Female w/ pendulous breast: palpate with one hand under the breast to support it and the other hand pushing against the breast tissue in a downward motion - Nipple should not be squeezed, only palpated, note for any discharge, it should be nontender and areolar Is free from masses - Free from redness, rashes, lumps lesions - With the palmar surface of your fingers, reach deep into axilla.