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