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techniques used for cardiovascular assessments
- inspection
- palpation
- auscultation
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what is the patient position while assessing cardiovascular?
sitting position or in supine position with the head raised about 30 degrees
the nurse is usually positioned at the right side of the patient
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how to assess peripheral vascular?
measuring blood pressure and assessing skin and perfusion of the extremities and the peripheral pulses.
assessment techniques are inspection and palpation, with the patient sitting or supine
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where to palpate the carotid artery?
medial to the sternomastoid muscle in the neck between the jaw and the clavicle
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carotid artery normal findings:
equal pulses bilaterally, with strength of +2/3.
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carotid artery abnormal findings:
absent, weak, thready pulse(indicate decrease CO), a forceful or bounding pulse (seen in hypertension), and an asymmetric pulse (impaired circulation)
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precordium normal and abnormal findings:
normal- no pulsation palpable over the aortic and pulmonic areas, with a palpable apical impulse.
abnormal- precordial thrills, which are fine, palpable, rushing vibrations over the right of left second intercostal space, and lifts of heaves, which involve a rise along the border of the sternum with each heartbeat
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how to auscultate heart sounds?
use systemic auscultation, beginning at the aortic area, moving to the pulmonic area, then to Erb's point, then tricuspid and finally to the mitral area
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abnormal heart sounds include:
extra heart sound (s3, s4, murmus, bruits) at any of the cardiac landmarks and abnormal rate or rhythm.
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what can extra heart sounds indicate
anemia or heart disease
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where to palpate peripheral pulses
- carotid
- brachial
- radial
- femoral
- popliteal
- dorsalis pedis
- posterior tibial
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what can cause damage to blood vessels and nerves and can lead to ischemia
- musculoskeletal trauma
- crush injuries
- orthopedic surgery
- external pressure from an cast or tight-fitting bandage
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the quantity of blood forced out of the left ventricle with each contraction
Stroke Volume
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is the amount of blood pumped per minute
cardiac output
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is the exchange of oxygen and carbon dioxide between circulating blood and tissue cells
internal respiration
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a decrease in the amount of the RBC or erythrocytes, results in insufficient hemoglobin available to transport oxygen
Anemia
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main blood vessels that supply blood to the heart
right and left coronary arteries, which branch off the aorta
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is a disturbance of the rhythm of the heart, which may lead to impaired oxygenation
dysrhythmia or arrhythmia
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cause of dysrhythmia
abnormal rate of electrical impulse generation from the SA node. they can also be caused by the abnormal conduction of electrical impulses through the heart
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symptoms of dysrhytmia
- decrease BP
- dizziness
- palpitations
- weakness and fainting
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what is stable angina
temporary imbalance between the the amount of oxygen needed by the heart and the amount delivered to the heart muscles.
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one type of acute coronary syndrome characterized by the death of heart tissue due to lack of oxygen
Myocardial Infraction
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myocardial ischemia sysptoms
- pain
- anxiety
- nausea
- vomiting
- indigestion
- SOB
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indicate less than optimal oxygentation
pallor(lack of color)
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indicates decrease blood flow or poor blood oxygenation
cyanosis(bluish discoloration)
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frequently heard on inspiration, are soft, high-pitched discontinuous popping sounds.
crackles
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suggest aneurysm and arterial stenosis
bruit
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closure of mitral and tricuspid valve during systole
lub
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closure of aortic and pulmonic during diastole
dub
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