N 295 lecture 8 9 cardio student copy

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  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • Heart and Neck Vessel assessment
  • N 295 lecture 8 9 cardio student copy

    1. 1. Cardiovascular Assessment * <ul><ul><li>Precordium </li></ul></ul><ul><ul><li>Mediastinum </li></ul></ul><ul><ul><li>Apex & Base of Heart </li></ul></ul><ul><ul><li>Great Vessels </li></ul></ul>spring 2012
    2. 2. Physical Examination: Precordium <ul><ul><li>Inspect the Anterior Chest Area </li></ul></ul><ul><ul><li>Palpate the Apical Impulse </li></ul></ul><ul><li>WHERE? </li></ul><ul><li>HOW? </li></ul><ul><li>WHEN? </li></ul><ul><li>WHY? </li></ul><ul><ul><li>Palpate for Abnormal Pulsations </li></ul></ul><ul><ul><li>Auscultate 5 Anterior Areas </li></ul></ul>spring 2012
    3. 3. Abnormal Findings <ul><li>Ventricular Impulses: * </li></ul><ul><ul><li>Lift / Heaves </li></ul></ul><ul><ul><li>Accentuated Apical Impulse </li></ul></ul><ul><ul><li>Laterally Displaced Apical Impulse </li></ul></ul>spring 2012
    4. 4. Physical Examination: Auscultation Format * <ul><ul><li>1. Note Rate & Rhythm </li></ul></ul><ul><ul><li> NUMBER! Regular Irregular Regularly Irregular </li></ul></ul><ul><ul><li>2. Identify S1 </li></ul></ul><ul><ul><li>3. Identify S2 </li></ul></ul><ul><ul><li>4. Auscultate for gallops (S3, S4) </li></ul></ul><ul><ul><li>5. Auscultate for Murmurs </li></ul></ul><ul><ul><li>6. Position Changes </li></ul></ul>spring 2012
    5. 5. http://www.med.ucla.edu/wilkes/intro.html <ul><li>The Cardiac Cycle </li></ul><ul><ul><li>Systole </li></ul></ul><ul><ul><li>Diastole </li></ul></ul><ul><li>Heart Sounds </li></ul><ul><li>Normal Heart Sounds </li></ul><ul><ul><li>First Heart Sound S1 </li></ul></ul><ul><ul><li>Second Heart Sound S2 </li></ul></ul>spring 2012        
    6. 6. Physical Examination: Auscultation Format * <ul><ul><li>1. Note Rate & Rhythm </li></ul></ul><ul><ul><li> NUMBER! Regular Irregular Regularly Irregular </li></ul></ul><ul><ul><li>2. Identify S1 </li></ul></ul><ul><ul><li>3. Identify S2 </li></ul></ul><ul><ul><li>4. Auscultate for gallops (S3, S4) </li></ul></ul><ul><ul><li>5. Auscultate for Murmurs </li></ul></ul><ul><ul><li>6. Position Changes </li></ul></ul>spring 2012
    7. 7. Abnormal Findings <ul><li>Abnormal Heart Rhythms </li></ul><ul><ul><li>Sinus Bradycardia </li></ul></ul><ul><ul><li>Sinus Tachycardia </li></ul></ul><ul><ul><li>Sinus Arrhythmia </li></ul></ul><ul><ul><li>Atrial Fibrillation </li></ul></ul><ul><ul><li>Atrial Flutter </li></ul></ul><ul><ul><li>Ventricular Tachycardia </li></ul></ul><ul><ul><li>Venticular Fibrillation </li></ul></ul><ul><ul><li>Asystole “Flat Line” </li></ul></ul>spring 2012
    8. 8. Cardiac Cycle spring 2012
    9. 9. Some Extra Heart Sounds * http://www.med.ucla.edu/wilkes/intro.html <ul><ul><li>S3 SLOSH-ing –in </li></ul></ul><ul><ul><li>S1 S2 S3 </li></ul></ul><ul><ul><li>S4 a - STIFF’- wall                  </li></ul></ul><ul><ul><li>S4 S1 S2 </li></ul></ul><ul><ul><li>Murmurs </li></ul></ul>spring 2012
    10. 10. Abnormal Findings * <ul><li>Murmurs: </li></ul><ul><ul><li>1. Innocent Murmurs </li></ul></ul><ul><ul><li>2. Physiologic Murmurs </li></ul></ul><ul><ul><li>3. Pathologic Murmurs </li></ul></ul><ul><li>Conditions Producing Murmurs: </li></ul><ul><ul><li>1. Stenosis </li></ul></ul><ul><ul><li>2. Regurgitation </li></ul></ul><ul><ul><li>3. Congenital Heart Disease </li></ul></ul>spring 2012
    11. 11. Describing Heart Murmurs <ul><li>Attributes of Murmurs </li></ul><ul><ul><li>1. Location 5. Pitch </li></ul></ul><ul><ul><li>2. Timing 6. Quality </li></ul></ul><ul><ul><li>3. Radiation 7. Configuration </li></ul></ul><ul><ul><li>4. Intensity </li></ul></ul>spring 2012
    12. 12. More Extra Heart Sounds <ul><ul><li>Pericardial Friction Rubs </li></ul></ul><ul><ul><li>Ejection Clicks </li></ul></ul>spring 2012
    13. 13. NECK VESSELS <ul><li>Carotid Artery Pulse </li></ul><ul><li>Jugular Venous Pulsation </li></ul><ul><li>CVP vs JVD </li></ul>spring 2012
    14. 14. Physical Examination <ul><li>Carotid Arteries </li></ul><ul><ul><li>1. </li></ul></ul><ul><ul><li>2. </li></ul></ul><ul><li>Jugular Veins </li></ul><ul><ul><li>1. </li></ul></ul><ul><ul><li>2. </li></ul></ul>spring 2012
    15. 15. Health History <ul><li>Chest Pain </li></ul><ul><li>Dyspnea </li></ul><ul><li>Orthopnea </li></ul><ul><li>Cough </li></ul><ul><li>Fatigue </li></ul><ul><li>Cyanosis </li></ul><ul><li>Pallor </li></ul><ul><li>Palpitations </li></ul><ul><li>Dizziness </li></ul><ul><li>Edema </li></ul><ul><li>Nocturia </li></ul><ul><li>Past Cardiac History </li></ul><ul><li>Family Cardiac History </li></ul><ul><li>Lifestyle and Health Practices </li></ul>spring 2012
    16. 16. Developmental Considerations: Older Adults <ul><li>1. </li></ul><ul><li>2. </li></ul><ul><li>3. </li></ul><ul><li>4. </li></ul>spring 2012
    17. 17. Abnormal Findings: Diseases <ul><li>Ventricular Hypertrophy </li></ul><ul><li>Angina Pectoris </li></ul><ul><li>MI </li></ul><ul><li>CHF </li></ul><ul><li>Bacterial Endocarditis </li></ul><ul><li>Pericarditis </li></ul><ul><li>Valvular Heart Disease </li></ul>spring 2012
    18. 18. Assessing Clients Diagnostic or Supportive Devices <ul><li>Artificial Cardiac Pacemakers </li></ul><ul><li>Hemodynamic Monitoring </li></ul><ul><li>Antiembolic Stockings </li></ul><ul><li>Chest Tubes </li></ul><ul><li>EKG monitoring </li></ul><ul><li>Intravenous Catheters </li></ul><ul><li>Pneumonic Compressive Stockings </li></ul><ul><li>Pulse Oximetry </li></ul>spring 2012
    19. 19. Risk Factors for Heart Disease <ul><li>Non-modifiable </li></ul><ul><li>Modifiable </li></ul>spring 2012 Health Promotion Measures 1. 2. 3. 4.
    20. 20. Nursing Diagnoses <ul><li>Decrease Cardiac Output </li></ul><ul><li>Altered Tissue Perfusion </li></ul><ul><li>Dysfunctional Grieving </li></ul>spring 2012

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