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what does S1 sounds like? What causes S1?
- Lub
- closure fo the mitral and tricuspid valves signals the beginning of ventricular systole (contraction)
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what does S2 sound like? what causes it?
- dub
- closure of the aortic and pulmonic valves signals the beginning of ventricular diastole (relaxation)
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what causes and S3 sound? and is i normal? what part of you stethescope is it best heard w/?
- sound is produced by rapid ventriuclar filling and can be normal finding in children and young adults.
- bell
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what is S4 caused by? is it normal? how is it best heard?
- produced by a strong atrial contraction and can be normal finding in older and athletic adults and children.
- bell
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what is a murmur? what does it sound like? what part of stethescope do you use? what are the 2 types of murmurs?
- heard when blood vol. is increased int he heart, or the flow of blood is impeded or altered from normal.
- blowing or swishing sound
- bell
- Systolic- heard after S1Diastolic- head just after S2
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what is a thrill? is it normal?
- palpable vibratons that may be present w/ murmurs or cardiac malformation
- use your ulnar surface of your hand to feel for vibrations
- abnormal
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what is a bruit?
produced by obstructed peripheral blood flow and are ehard as a blowing or swishing sound with the bell of the stethescope
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Where do you find the aortic site?
right of the sternum @ 2 ICS
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where do you find the pulmonic site?
left of the sternum @ the 2nd ICS
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where do you find the Erb's point?
left of the sternum @ 3rd ICS
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where do you find tricuspid site?
left of the sternum @ 4th ICS
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where is the apical/mitral site?
left midclavicular line @ 5th ICS
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pulse and bp are indicators of?
cardiovascular status
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what is a heave? is it normal or abnormal?
- visible elevations of the chest wall that are seen with heart failure, and are often located along the left sternal border or at the PMI
- abnormal
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how do you inspect the jugular vein?
- hob 30-45 degrees
- assess for right sided heart failure
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all pulse sites can be palpated bilaterally to make comparisons except for which pulse site?
Carotid
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name the 7 major pulses and their locations
- carotid- either side of trachea, medial to stenocleidomastoid muscle
- radial- radial side of the wrist
- brachial- antecubitl fossa above the elbow
- femoral- midway between the symphysis pubis and the anterosuperior illiac spine
- popliteal- behind the knee
- dorsalis pedis- top of the foot, along a line w/ the groove between the first toe and the extensor endons of great toe
- posterior tibial- behind and below the medial malleolus of the ankles
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what does a brown pigment of the skin indicate?
venous insufficiency
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what does shingy and thin skin w/o hair on toes and foot indicate?
arterial insuffiiciency
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what is the Homan's sign? if its positive what would your suspicion be?
- leg is supported and flexed slightly at the knee while the foot is dorsiflexed. A report of pain in calf would be a + homans
- phlebitis or deep vein thrombosis (DVT)
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what are the 3 positions that are best for assessing for heart sounds; normal and abnormal.
- sitting, leaning forward
- lying supine
- turned toward the left side- best position for picking up extra heart sounds or murmurs
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whcih of the following should be performed on a client following a total knee replacement to assess the peripheral vascular system of the affected extremity (select all)
ROM
Skin color
Skin temp
presence of lesion
capillary refill
edema
- Skin color
- Skin temp
- capillary refill
- edema
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