NURS1921 Exam IV Assessing Heart Sounds/Cardiac Landmarks

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JARoberts
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111604
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NURS1921 Exam IV Assessing Heart Sounds/Cardiac Landmarks
Updated:
2011-10-23 21:31:25
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NURS1921 Exam IV Assessing Heart Sounds Cardiac Landmarks
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Based on lecture by Mrs. Pijut
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  1. What are the Cardiac Landmarks?
    Remember by using:

    • All = Aortic
    • Pigs = Pulmonic
    • Eat = Erb's
    • Too = Tricuspid
    • Much = Mitral (Apical)
  2. When assessing the Aortic heart beat, what anatomical landmark should you auscultate?
    2nd intercostal space, right sternal border
  3. When assessing the Pulmonic heart beat, what anatomical landmark should you auscultate?
    2nd intercostal space, left sternal border
  4. When assessing the Erb's point, what anatomical landmark should you auscultate?
    3rd intercostal space, left sternal border
  5. When assessing the Tricuspid heart beat, what anatomical landmark should you auscultate?
    4th or 5th intercostal space, left sternal border
  6. When assessing the Apical heart beat, what anatomical landmark should you auscultate?
    5th intercostal space, midclavicular line
  7. Which part of the stethoscope should be used to asses heart sounds?
    Both the bell and the diaphragm

    Bell for low pitched sounds

    Diaphragm for high pitched sounds
  8. What does Rheumatic Fever cause?
    Valvular Insufficiency (by leaving nodules on valves)

    May be considered an expected finding in a pt with Hx of Rheumatic Fever
  9. What are you assessing when auscultating the heart?
    • (Closure of the heart valves)
    • Rate
    • Rhythm
    • Abnormal Sounds
  10. What are normal sounds when auscultating the heart?
    • S1 (lub) & S2 (dub)
    • S1 loudest at Apex & S2 loudest at Base
  11. S1
    • Mitral and Tricuspid Valve Closure
    • Beginning of systole
  12. S2
    • Aortic and Pulmonic Valve Closure
    • Beginning of Diastole
  13. Gallop Rhythms
    • Abnormal diastolic filling sounds
    • Can occur seperately or together
    • Loudest at mitral area/apex
    • Best heard with bell
  14. S3
    • Early filling sound
    • Often normal <30 years old
    • "TENNessee"
  15. S4
    • Late filling sound
    • May be "normal" in older adults
    • "kenTUCKy"
  16. Murmurs
    • Due to valve defects, high CO2, structural defects or weak contractions.
    • Swishing sound
    • Audible vibration due to turbulent blood flow
  17. Rubs
    • Due to inflamed pericardial pleura
    • Scratchy sound
    • Pleura rub together to make grating sound
  18. Bruits
    • Due to turbulent flow (stenosis)
    • Swishing sound over carotid
  19. Normal findings when palpating the heart
    Pulsation at Apex (mitral area) which is the PMI
  20. Abnormal findings when palpating the heart
    • Lifts of Heaves: rise along the sternal border with each beat
    • Thrills: Fine, palpable vibrations
  21. What might a patient presenting with peripheral edema be suffering from?
    • Right Side Heart Failure
    • Fluid collects in the extremities
  22. What might a patient presenting with CHF (Pulmonary Edema) be suffering from?
    • Left Side Heart Failure
    • Fluid collects in the lungs
  23. How much blood does the heart pump every minute?
    3-6 liters
  24. What might a patient with JVD be suffering from?
    Right Side Heart Failure
  25. What are signs and symptoms which would warrant a focused cardiovascular assessment?
    • Chest Pain
    • Palpitation
    • Syncope or dizziness
    • Edema
    • Fatigue
    • Dyspnea, orthopnea or cough
    • Extremity changes

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