2023-2024 NURS507 Cardiovascular Study Guide With Answers (201 Solved Questions)

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NURS 507 Exam2:StudyGuideQuestions(201Terms)withVerified Solutions 2023-2024.Cardiovascular assessment includes:-Correct Answer:1. Cardiacvascular system2. Peripheral vascular systemCardia is performed with a __ exam.-Correct Answer:pulmonary examPeripheral vascular is done when ____.-Correct Answer:Examining theextremities.Chest Pain requires you to use...-Correct Answer:OPQRSTU pain scaleCardiac Assessment (7)-Correct Answer:1. Chest pain (at rest, withexertion)2. Dyspnea (at rest, with exertion)3. Orthopnea (SOB when lying down)4. Paroxysmal noctural dyspnea (PND)5. Peripheral edema6. Past cardiac history

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7. Cardiac risk factorsCardiac risk factors-Correct Answer:diabetes (#1 risk factor for CADand sudden cardiac death)family historysmokingobesityFirst step: Inspect (4 steps)-Correct Answer:a. Lie px at 30 degreesb. Look for pulsation (apical impulse b/t fourth and fifth rib) this is mosteasily seen in children or thinner adultsc. Observe for a "heave" or a lift"d. Inspect vessels of the neck

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Never palpate __ carotid arteries at ___.-Correct Answer:Neverpalpate both carotid arteries at the same time.Second Step: Palpate (feel) (7 steps)-Correct Answer:a. palpate carotidarteries one at a timeb. apical impulse (point of maximal impulse)c. heaves/liftsd. thrillse. left lateral decubitus position may be usefulf. should occupy only one interspace (4th or 5th) midclavical line of justmedialg. may not be palpable in various circumstancesCardiac Ascultation mnemonic-Correct Answer:"All Patients EagerlyTake Meds""All physicians enjoy taking money"A-Aortic area

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P-pulmonic areaE-Erb's pointT-tricuspid areaM-mitral apexHow many heart tones are there?-Correct Answer:Five heart tonesAortic area-Correct Answer:second intercostal space along rightsternal borderPulmonic area-Correct Answer:second intercostals space at leftsternal borderErb's point-Correct Answer:third intercostal space at left sternalborderTricuspid area-Correct Answer:fifth intercostal space along the leftsternal border

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mitral area-Correct Answer:fifth intercostal space, midclavical line.This is where the PMI is found. Known as th point of maximal impulse.note: with enlarged hearts mitral area may present at anterior axillarylineAuscultation of Heart (2 types)-Correct Answer:1. S1 and S2 heartsounds (use diaphragm at areas of A, P, E, T, M) and listen for "lub""dub" or S1, S2 sound2. Apical pulse (left of sternum, b/t 4th and 6th ICS at MCL. 30 sec ifregular, 60 sec if irregular)S1-Correct Answer:closure of mitral, tricuspid valves.beginning of systole

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"LUB" (greater at apex)S2-Correct Answer:closure of aortic, pulmonic valves,beginning of diastole"DUB" (greater at base)Cardiac Ascultation (4 things to know)-Correct Answer:1. cardiac cycle2. pulse deficit3. extra heart sounds (split S1/S2, S3/S4 "gallop", murmurs/clicks/rubs)4. stethoscope use (listen with diaphragm going down and then bell ineach osculatory position going up)

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Carotid arteries (ascultate)-Correct Answer:listen with bell over eachartery for bruits (noise due to turbulence that sounds like a cat purring).Murmurs-Correct Answer:for now, only try to describe whern theyoccur.Normal Cardiac Assessment-Correct Answer:No chest pain/pressureor SOBNo pulsations, heaves, or liftsApical impulse in 4th of 5th ICS at MCLNo thrillRate 60-100 bpm (athletes might be 40-60)Normal S1 and S2

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No extra heart soundsCardiac documentation-Correct Answer:"no heaves or lifts. Apicalimpulse palpated at 5th ICS at left MCL. Regular rate and rhythm.Normal S1 and S2. No S3 and S4, murmurs, clicks or rubs."Age related cardiac considerations-Correct Answer:Rate faster inchildren and can quicken or slow in the respiratory cycleS3 and innocent murmurs common in kids"venous hum" common in children due to turbulent blood flow injugular venous sys.Systolic murmurs common in older adults due to aortic sclerosisCardiac Assessment "pearls"-Correct Answer:-take your time

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-concentrate on one heart sound at time-don't press too hard on stethoscope-feel peripheral pulse while osculating in order to verify which sound iss1-to differntiate b/t pleural friction rub and pericardial friction rub, havepx. hold their breath. If you hear something, then it is a pericardial rub.If not, then pleural.Peripheral Vascular Asssessment (4)-Correct Answer:1. legpain/cramping2. leg swelling3. changes in the skin4. non-healing soresPVA: Arterial System (inspect)-Correct Answer:skin shows signs ofinsufficiency

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pulse graded 0-4 (+2 expected findings)capillary refillclubbingPVA: Arterial System (palapate)-Correct Answer:check for symmetrypalpate peripheral pulses (rate strength on 0-4 (+2) scaleassess extremities for symmetry, color, varicositiesassess temp. of hands and feetperform capillary refill testPULSES (rate, rhythm, and quality)-Correct Answer:0-absent1-weak/thready

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2-normal3-full (sometimes seen in pregnant women)4-boundingAssess peripheral vasculature-Correct Answer:nail bed color, shape,configurationlook for cyanosis and clubbingCapillary refill test-Correct Answer:should be less than 3 seconds afterblanching1. pressure applied to nail bed until it turns white2. blood returned to tissuePVA: venous-Correct Answer:inspect, palpate-skin for insufficiency-variscosities

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Edema is graded: 0-4 (+)EDEMA Scale-Correct Answer:Assess by placing thumb over dorm ofthe foot or tibia for 5 seconds0-no edema1+: barely discernible depression2+: a deeper depression (<5mm) w/ normal foot an leg contours3+: deep depression (5-10mm) with foot and leg swelling4+: more than 1cm with severe foot and leg swellingVernous Stasis-Correct Answer:Scalling, redness, skin taunt and shiny,possible ulcerations."venous stasis ulcers"

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What does the lymphatic system do?-Correct Answer:part ofcirculatory that transports excess interstitial fluid back into thebloodstream.it actively filters microorganisms and prevents unwanted substancesfrom re-entering the bloodstream.What is the third vascular system?-Correct Answer:The LymphaticsystemWhat are you looking for?-Correct Answer:thousands of nodes thatare part of hematological and immune systeminflammation of the nodes can be indicative of infectionUnilateral lymph node enlargement is indicative of what?-CorrectAnswer:neoplasm (cancer)

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5 P's of Circulatory Checks-Correct Answer:PPPPPPain, pallor, paralysis, parathesia, pulseExpected findings of PVA:-Correct Answer:no complaints of pain orsensory lossno lesions, ulcers, skin changesno varicositiesno clubbing, cyanosis, edemacapillary refill of less than 3 secondspulses 2+ and symmetric

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PV Documentation-Correct Answer:"No clubbing, cyanosis, or edema.No varicosities. Capillary refill less than 3 seconds. Pulses 2+ andsymmetric. No thrills or bruits."Age-related PV considerations-Correct Answer:kids w/ congenitalheart disease may inhibit cyanosis or clubbing in toes/fingersolder adults more apt. to have changes associated with arterial and orvenous insufficiencyolder adults have have weaker pulses and bruits due to atheroscleroticdiseasePeripheral Assessment "Pearls"-Correct Answer:always look ofsymmetrycheck for edema over BONY PROMINENCES (ex. medial malleolus)

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