Term
| Are the ausculatory points exactly over the valves? |
|
Definition
| No, the 4 valve areas do not reflect the anatomical location of the valves. Rather they reflect the way our heart sounds radiate to the chest wall. Sounds travel in the direction of blood flow. |
|
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Term
| Area to ausculate for aortic area is: |
|
Definition
| 2nd intercostal space at the right sternal border |
|
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Term
| Area to ausculate for pulmonic area is: |
|
Definition
| 2nd or 3rd intercostal space at the left sternal border-the base of the heart. |
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Term
| Area to ausculate for Erb's point is: |
|
Definition
| 3rd to 5th intercostal space at the left sternal border |
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Term
| Area to ausculate for Tricuspid area is: |
|
Definition
| 4th or 5th intercostal space at the left lower sternal border |
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Term
| Area to ausculate for Mitral (Apical) area is: |
|
Definition
| 5th intercostal spcae near the left midclavicular line-the apex of the heart. |
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Term
| The base of the heart is at the _____ & the apex is at the _____. |
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Definition
| Heart is base at TOP & apex at BOTTOM. Opposite the lungs & what you would normally think. |
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Term
| S1 is the sound made by what valves closing? |
|
Definition
| S1 = tricuspid & mitral valves closing |
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Term
| S2 is the sound of what valves closing? |
|
Definition
| S2 = aortic & pulmonic valves closing |
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Term
| S1 sound makes "lub" or "dub"? S1 occurs at the same time as what pulse? |
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Definition
| S1 = LUB & occurs simultaneously with carotid pulse (arteries in neck). |
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Term
| S1 is heard as the loudest sound at what ausculatory points? |
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Definition
| Aortic & Pulmonic. So, the top/base of the heart. S1 can possibly be heard as loudest at Erb's point too. S1 is heard as loudest in these points with both the diagram & the bell if so. |
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Term
| A Split S1 is heard best where? |
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Definition
| over the tricuspid valve in the supine position |
|
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Term
| A split S1 is OK if heard in who? |
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Definition
|
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Term
| A split S1 may also be heard in patients with pulmonary ____. |
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Definition
|
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Term
| The quiet time follow S1 is called _____ & the ventricles are contracting. |
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Definition
|
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Term
| Systole is either "clear" meaning a quiet time without sound or there is a _________ murmur caused by turbulence. |
|
Definition
| murmur. "lub" whish "dub" = murmur |
|
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Term
| Are systolic murmurs as serious as diastolic murmurs? |
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Definition
| No systolic murmurs are NOT as serious as diastolic. A lot of pregnant women have systolic murmurs. |
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Term
| Blood normally flows silently through the heart, but a murmur is from turbulent blood that causes swooshing or blowing sound when ausculated. What are some conditions that cause turbulent blood flow? |
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Definition
| 1. increased blood velocity 2. valve defects 3. valve malfunction, and 4. abnormal chamber openings. If anemia, the murmur will go away when treated. |
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Term
| S2 is the sound of the _____ & _______ valves closing. |
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Definition
| Aortic & Pulmonic and correlates with the beginning of Diastole. |
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Term
| S2 is head as the loudest sound at the _____ & ______ ausculatory point and possibly at Erb's point with both the diaphragm and the bell side of the stethescope in all 3 exam positions. |
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Definition
|
|
Term
| S2 is heard as loudest in what exam positions? |
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Definition
| all 3 exam positions... supine, left lateral and sitting leaning forward. |
|
|
Term
| S2 "dubb" is usually heard as one sound, but may be heard as 2 sounds. The first noise is aortic valve closing & the second is the pulmonic valve closing if you hear 2 sounds. This occurs with increased pressure on the left sd of the heart and b/c of the route of myocardial depolarization. If S2 is heard as 2 distinct sounds, it is called a _____ S2. |
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Definition
|
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Term
| A splitting of S2 is okay when? |
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Definition
| It is okay if heard only on inspiration. If you think you might hear a split - ask the patient to hold their breath and it shouldn't occur. It may be abnormal if the split is heard during BOTH inspiration & expiration. A split S2 is usually heard on inspiration and sounds as if the HR is increasing. |
|
|
Term
| A split S2 is best heard where? |
|
Definition
| the pulmonic ausculatory point (base) in the supine position. |
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|
Term
| A split S2 is OK if heard in... who? |
|
Definition
| children or young adults. |
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|
Term
| _______ is the quiet time following S2, when the ventricles are ___________. |
|
Definition
|
|
Term
| Diastole is the time between S_ and the next S_. |
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Definition
|
|
Term
| What would you think if you heard "lub" "dub" "whish"? |
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Definition
| That is a diastlic murmur and they are usually pathologic. They're caused by some abnormality in and around the heart. Usually caused by regurgitated blood through the aortic valve. Ones that occur late in diastole are usually caused by mitral valve stenosis. |
|
|
Term
| The cardiac cycle has 2 phases: diastole (______ of the ventricles, known as filling) and systole (________ of the ventricles, known as emptying. |
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Definition
|
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Term
| ____ is the sound of blood rushing into the ventricles early in diastole. |
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Definition
|
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Term
| S3 AND S4 are best heard with the ____ of the stethescope b/c they are low pitched sounds. |
|
Definition
|
|
Term
| S3 is heard best at the ____ of the heard. This is what ausculatory points? What position is best? |
|
Definition
| S3 is heard best at the apex of the heart. So, the tricuspid & mitral points. Left lateral position brings the ventricles closer to the chest wall. |
|
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Term
| S3 occurs (early or late?) in diastole? Sounds like the word _________ . |
|
Definition
| Early in diastole, Kentucky = Ken (S1) tuck (S1) y (S3) |
|
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Term
|
Definition
| children or young adults, people with a high cardiac output or 3rd trimester of pregnancy = normal S3 sound. |
|
|
Term
| If an S3 is heard in older adults is this abnormal? What conditions cause this? |
|
Definition
| Yes, abnormal. Occurs with myocardial failure, congestive heart failure (CHF) or volume overload from valvular disease. |
|
|
Term
| Where is S4 sound heard best? |
|
Definition
| S4 is heard best at the tricuspid and mitral ausculatory points in the left lateral position. This position brings the ventricles closer to the chest wall. |
|
|
Term
| S4 occurs late in ______ and sounds like what word? |
|
Definition
| diastole, Tennessee = Ten (S1) ne S2 see (s4) |
|
|
Term
| What patients is S4 normal in? abnormal in? |
|
Definition
| An S4 is okay in children & young adults, athletes & some older patients after they exercise. Most of the time it is not normal though. S4 is usually associated with HTN, coronary artery disease, aortic and pulmonic stenosis and acute MI. |
|
|
Term
| What position is the head of the bed in for assessing jugular vein distention? Is patient looking at you or away from side assessing? |
|
Definition
| 45 degrees, pt. is turned away from the sd being examined & then you can inspect for jugular vein distention - there should be none. |
|
|
Term
| If there is jugular vein distention, what conditions cause it? |
|
Definition
| increased central venous pressure from RIGHT ventricular failure, pulmonary HTN and pulmonary emboli. |
|
|
Term
| Should you be able to see pulsations/heaves over the 5 points you ausculate? |
|
Definition
| Might see one visible over the mitral (apical) pulse and that is okay, it is the point of maximum impules (PMI). Pulsations over the precordium should have no heaves (lifts) over the ausculatory points. |
|
|
Term
| When inspecting each of the ausculatory points for "thrills", what part of your hand do you use & what are you inspecting for? |
|
Definition
| pads of your fingers, palpable murmurs |
|
|
Term
| If the apical pulse or PMI is not over the mitral point in the midclavicular line then what? |
|
Definition
|
|
Term
| What position should the pt. be in to best feel & count the apical pulse? |
|
Definition
| left lateral position. to bring the apex closer to the chest wall. |
|
|
Term
| In the left lateral position, what points are you listening at? what for? with what side of stethescope? |
|
Definition
| Apex: Mitral (apical) and Tricuspid points. Listening for S3 & S4 murmurs. Use the BELL b/c you're listening for low-pitched sounds. |
|
|
Term
| WHen in the sitting, leaning forward position what points are you listening at? What for? which side of the stethescope? |
|
Definition
| Aortic & Pulmonic points (base of heart), listening for aplit S1 or S2 and murmurs. Use the DIAPHRAGM side b/c these are HIGH pitched. Should be single systole & diastole clear. |
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|
Term
| Pallor in the skin tone when elevated & rubor when dependent, loss of hair on legs (often with thin shiny skin) and ulcers all result from what? |
|
Definition
|
|
Term
| Cyanosis or rusty/brown pigment around the ankles is what? |
|
Definition
|
|
Term
| In class Gale showed a venous stasis ulcer where it is purple & the pressure is coming from where? |
|
Definition
| Pressure comes from the inside - there is an accumulation of blood |
|
|
Term
| Checking skin temp of peripheral extremities to the trunk... use what part of hand? How should the heat go? What would cause unequal warmth? |
|
Definition
| Use back of hand, temperature should be equal bilaterally & should increase in temp as you move distally to centrally. Trunk is the warmest. Peripheral arterial disease would cause unequal warmth. |
|
|
Term
| What lymph nodes are in the groin? |
|
Definition
| Inguinal nodes (also called superficialinguinal) |
|
|
Term
| What are the names of the pulses on neck, in forearm (antecubital fossa) and wrist? |
|
Definition
| Carotid, Brachial, Radial |
|
|
Term
| What are the names of the pulse in hip & and behind the knee? Which one is it not unusual for it to be difficult or impossible to detect, yet circulation is normal? |
|
Definition
| Femoral and Popliteal. Popliteal Pulse is normal to be difficult/impossible to detect. |
|
|
Term
| What pulse is behind the ankle? ... it is just below the medial malleolus and the groove between the ankle & the achilles tendon? |
|
Definition
|
|
Term
| If edema in the ankles makes it impossible to assess posterior tibial pulse, what do you do? |
|
Definition
| Doppler Ultrasound helps to assess pulse |
|
|
Term
| What pulse is on the top of your foot? |
|
Definition
| Dorsalis Pedis, comes from the extensor tendon of the big toe. |
|
|
Term
| What position does the patient need to be in to assess for variscosities & thrombophlebitis? |
|
Definition
| Client needs to stand - can't assess while they are supine. |
|
|
Term
| What is normal for veins? why do vericose veins occur? who are they normal in? |
|
Definition
| Veins should be flat and barely seen under skin surface. Variscosities are normal in older pt's & is normal. Varicose veins result from incompetent valves in the veins, weak vein walls or an obstruction above the varicosity. Despite the vein being dilated, blood flow is decreased or discoloration on the skin surface over the vein. |
|
|
Term
| When assessing the various pulse points bilaterally we are assessing symmetry & how much can the rate shouldn't vary more then __ - __ seconds. |
|
Definition
|
|
Term
| Bilaterally we will assess with pulses: |
|
Definition
| count the RATE (15 sec's X 4), assess symmetry - rate shouldn't vary more then 2-4 sec.'s, Rhythm: should be regular as opposed to irregular, assess the Amplitude |
|
|
Term
|
Definition
| 1+ = Thready or Weak, 2+ = Normal, 3+ = Bounding |
|
|
Term
|
Definition
| 0=absent, there is an occlusion somewhere above it. This doesn't mean you can't find it, that is nonpalpable. Means they have peripheral vascular disease and there is not a pulse. 1+=barely palpable, diminished, 2+=normal or expected. You "expect" the dorsalis pedis to be weaker than the more central pulses. 3+=full, increasing - not necessarily abnormal. Could have increased pulse b/c of exercise. 4+=bounding (it is just racing) |
|
|
Term
| Sequence for examining the abdomen: |
|
Definition
| Inspect, Ausculate, Percuss, Palpate. |
|
|
Term
| Why is the sequence for the abdomen imp./diff. then other parts? |
|
Definition
| b/c you want to be able to hear natural bowel sounds before you palpate & stir them up. want an accurate count on bowel sounds. |
|
|
Term
| Peripheral Vascular Disease includes 5 common disorders (aortic aneurysms, cerebrovascular disease, deep vein thrombosis and pulmonary embolism, peripheral arterial occlusive disease (PAOD) and varicose veins). What are the major risk factors for arterial peripheral vascular disease (PVD)? |
|
Definition
| Age-older adults, Black race/ethnicity, Diabetes Mellitus, Smoking, HTN, High blood-lipid levels, coronary or cerebral vascular disease, low kidney function, MALES, family history, unhealthy diet. |
|
|
Term
| What are the major risk reduction tips for peripheral arterial disease? |
|
Definition
| Stop Smoking, Control HTN, Eat a low-fat diet, control high blood sugars of DM, limit alcohol intake, get regular exercise. |
|
|
Term
| What are the risk factors for venous PVD? |
|
Definition
| Surgery, Pregnancy, Obesity, Use of hormone replacement therapy, use of oral contraceptives, job with prolonged standing, limited physical activity or poor fitness, FEMALES, increasing age, genetics (non african american), family history, lack of dietary fiber, wearing constrictive clothing |
|
|
Term
| Risk reduction techniques for venous PVD? |
|
Definition
| get regular exercise, avoid prolonged standing, increase physical activity to moderate level, maintain weight within ideal range height and body structure, increase dietary fiber intake, avoid constrictive clothing (anything that compresses vessels) |
|
|
Term
| Normal capillary refill time? causes of delayed capillary refill are... |
|
Definition
| no longer then 1-2 seconds. Vasoconstriction, decreased cardiac output, shock, arterial occlusion, or hypothermia. |
|
|
Term
| ________ disease is a vascular disorder caused by vasoconstriction or vasospasm of the fingers or toes and is characterized by rapid changes in color, swelling, pain, throbbing or coldness. |
|
Definition
|
|
Term
| Skin is normally warm to the touch. A cool extremity may be a sign of_____________. |
|
Definition
| arerial insufficiency. Cold fingers & hands are common with Raynaud's Disease. |
|
|
Term
| How do you elicit Homan's sign and the possible causes of a positive Homan's sign? |
|
Definition
| Controversial in pt's w/ a history of DVT b/c it may dislodge a clot. Client is supine and you push their calf muscle against their tibia bone to assess for pain & tenderness. This method differentiates between calf & achilles tendon pain. Another method you sharply dorsiflex the foot. If there is pain/tenderness in either: it is abnormal & a positive Homan's sign. |
|
|
Term
| What abdominal structures are in the right lower quadrant (RLQ)? |
|
Definition
| appendix, ascending colon, cecum, right kidney (lower pole), right ovary & tube, right ureter |
|
|
Term
| What abdominal structures are in the right upper quadrant? |
|
Definition
| ascending and transverse colon, duodenum, gallbladder, liver, right adrenal gland, right kidney, right ureter |
|
|
Term
| what abdominal structures are in the left upper quadrant? |
|
Definition
| Pancreas, Spleen, Stomach, left adrenal gland, left kidney, left ureter, transverse descending colon |
|
|
Term
| what abdominal structures are in the left lower quadrant (LLQ)? |
|
Definition
| left kidney (lower pole), left ovary & tube, left ureter, descending and sigmoid colon |
|
|
Term
| What abdominal structures are in the midline? |
|
Definition
| bladder, uterus, prostate gland |
|
|
Term
| Gallbladder cancer is the ___th most common GI cancer. Women or Men are affected more? Gallstones are the most common risk factor (especially early onset or large gallstone). What ethnicity has highest rate of gallbladder cancer? |
|
Definition
| 5th. Women are affected 2.5 times more then men. Native American. |
|
|
Term
| Normal findings for color of skin & abnormal findings. |
|
Definition
| abdominal skin may be paler. abnormal: purple discoloration=indicates bleeding/trauma, Yellow=jaundice, pale+taut skin=ascites, redness=inflammation, bruises=areas of discoloration are abnormal. |
|
|
Term
| Normal findings for the vascularity of abdomen: Are dilated superficial capillaries without a pattern in older clients normal? |
|
Definition
| scattered fine veins may be visible. blood in veins over umbilicus flows to head. blood in veins lower then umbilicus flows toward the lower body. Yes, Dilated, random superficial capillaries are normal in older clients. |
|
|
Term
| Scarring is an alert for possible internal _______. |
|
Definition
|
|
Term
| What scars are normal & abnormal? |
|
Definition
| normal: pale, smooth, minimally raised old scars. abnormal: nonhealing scars, red, inflammation. deep, irregular scars may result from burns. Keloids (excess scar tissue) are more common in african americans and asians. |
|
|
Term
| Are moles normal on abdomen? |
|
Definition
| Yes, flat or raised. abnomal: changes in mole size, reddish or purplish moles are abnormal. |
|
|
Term
| Abdomen's can be flat, round or scaphoid (indented almost, seen in thin adults). THe abdomen should be rounded. What would an abnormal abdomen look like? |
|
Definition
| a protruberant or distended abdomen d/t obesity, air (gas) or fluid accumulation. Lower distention below umbilicus may be a full bladder, uterine enlargement, or an ovarian cyst or tumor. |
|
|
Term
| The major causes of abdominal distention are sometimes called the 6 F's. what are they? |
|
Definition
| fat, feces, fetus, fibroids, flatulence and fluid. |
|
|
Term
| Normally abdomens are symmetric. Why would one be asymmetric? |
|
Definition
| organ enlargement, large masses, hernia, diastasis recti or bowel obstruction. can further assess by asking client to raise their head. a mass within the abdominal wall is more prominent when the head is raised. |
|
|
Term
| Normal abdominal movement is: |
|
Definition
| respiration (esp. seen in male clients), slight pulsation of abdominal aorta (esp in thin people), normally peristaltic waves are not seen although they may be visible in thin people normally. |
|
|
Term
| Abnormal movement findings would be: |
|
Definition
| dominished abdominal breathing and especially a change to abdominal breathing may reflect pain, vigorous, wide pulsations are seen with abdominal aneurysm. Peristaltic waves are increased and progress from LUQ to RLQ with intestinal obstruction. |
|
|
Term
| Bowel sounds occur every 5-15 seconds. Easy way to remember, one bowel sound per respiratory breath. Normally hear at a rate of 5-30 per minute. Bowel sounds are most active in what quadrant often? |
|
Definition
| RLQ over the ileocecal valve |
|
|
Term
| Stomach gurgling is hyperactive bowel sounds that are normal and are called: |
|
Definition
|
|
Term
| How do we ausculate the abdomen correctly? |
|
Definition
| Start by listening in RLQ for 1 full minute, sounds occur iregularly 5-30 per minute, then continue clockwise - go, RUQ, LUQ, LLQ. There are higher pitched sounds on lg. intestine & lower pitched sounds on small intestine. |
|
|
Term
| Abnormal bowel sounds include: |
|
Definition
| no bowel sounds for a minimum of 1 minute up to 5 minutes. hypoactive bowels following abdominal surgery or in late bowel obstruction is an emergency. Hyperactive bowels with increased motility caused by diarrhea, gastroenteritis, bowel obstruction. |
|
|
Term
| Abdominal percussion techniques are where? What percussion sounds where on abdomen? |
|
Definition
| there are different patterns. Liver & spleen=dullness (full bladder can be dull too), Tympany (or resonance) in interspace on abdomen. |
|
|
Term
| What is a normal liver span? |
|
Definition
| 6-12 cm in the front-midclavicular. Percussion on back in midsternal line is 4-8 cm. (it is greater in men + tall clients, less in shorter clients) |
|
|
Term
| What age does liver size decrease normally? |
|
Definition
|
|
Term
| Hepatomegaly & Atrophy can account for a different liver span size that is abnormal. T or F? |
|
Definition
|
|
Term
| The lower border of liver dullness is located at the costal margin, 1-2 cm below. To assess the lower border, begin at the RLQ at the midclavicular line and percuss upward. mark point where sound goes from tymoany to dullness (this is the liver). What do we do different to assess the top border of the liver? |
|
Definition
| Have the client hold their breath. Start up upper right MCL and percuss downward where it changes from lung resonance to liver dullness. mark this point. and measure between the 2 marks. |
|
|
Term
| If you can't correctly assess the percussion of the span of the liver, what test can you perform? |
|
Definition
| the scratch test. ausculate & start in RLQ, scratch up abdomen towards the liver. |
|
|
Term
| How do locate where the costvertebral angles are? What do you do to assess for tenderness? What are causes for tenderness there? |
|
Definition
| Use heel of closed fist to strike firmly. Tenderness is often associated with renal disease (pyelonephritis). |
|
|
Term
| What part of hand & how far down in light vs. deep abdominal palpation? |
|
Definition
| Use pads of fingers, depth of 1 cm for light palpation. Use palmar surfaces of fingers, depth of 5-6 cm. |
|
|
Term
| When assessing heart & pulses what can help reduce visual stimuli, decrease distractions and enhance your ability to concentrate? |
|
Definition
| closing you eyes might helps auditory stimuli |
|
|
Term
| When doing a whole body exam, it is convenient to assess the heart and neck vessels immediately following what? |
|
Definition
| assessment of the thorax & lungs |
|
|
Term
| Be careful not to confuse pulsations of the carotid arteries with pulsations of the _________ veins. |
|
Definition
|
|
Term
| Do we ausculate or palpate the carotid arteries first? |
|
Definition
| Always ausculate carotid arteries first b/c palpation can slow the heart rate, therefore changing the strength of the carotid impulse. |
|
|
Term
| If you detect occlusion during ausculation of the carotid artery, can you palpate? |
|
Definition
| yes, palpate VERY lightly to avoid blocking circulation or triggering vagal stimulation and bradycardia, hypotension or cardiac arrest. |
|
|
Term
| The apical pulse was originally called the point of maximum impulse (PMI). However, this term is not used anymore b/c .... ? |
|
Definition
| a maximal impulse may occur in other areas of the precordium as a result of abnormal conditions. |
|
|
Term
| When palpating the apical pulse, if it can not be palpated have the client assume what position? |
|
Definition
| the left lateral position. this displaces the heart toward the left chest wall and relocates to the apical impulse farther to the left. |
|
|
Term
| Why is the apical impulse harder to feel in older clients? |
|
Definition
| increased anteroposterior chest diameter |
|
|
Term
| If you are having difficulty differentiating S1 from S2 palpate the _________ pulse, this harsh sound that occurs with this pulse is S1. |
|
Definition
|
|
Term
| How should client breath when ausculating? |
|
Definition
| Do not let them hold their breath or a normal/abnormal split will subside. |
|
|
Term
| While ausculating, keep in mind that the development of a pathologic __ may be the earliest sign of heart failure. |
|
Definition
|
|
Term
| Do african americans or caucasians have higher HDL levels? |
|
Definition
| african americans have higher HDL (good cholesterol levels), but also have higher lifestyle risk factors than white americans for coronary heart disease. |
|
|
Term
| Who has highest rate of HTN... african americans, whites or hispanics? |
|
Definition
| african americans have higher rates of HTN then whites. Hispanics have lower rates then either group. |
|
|
Term
| Blood pressure correlates with _______ _______ which could be d/t the role of melanin as a reservoir for heavy metals such as sodium. |
|
Definition
|
|
Term
| Who has a higher incidence rate, earlier onset and longer duration in mortality of HTN - white or black women? |
|
Definition
|
|
Term
| _________ is needed in developing countries b/c of the widespread increases in CHD d/t lifestyle practices that increase risk. |
|
Definition
|
|
Term
| What is the best method for prevention of CHD? |
|
Definition
| a population based approach, especially educating young children to adopt and maintain healthy lifestyles. |
|
|
Term
| Whether or not abdominal viscera is palpable depends on ____________, structural consistency and _______/ |
|
Definition
|
|
Term
| In many people the liver extends just below the right _________ margin, where it may be palpated. If palpable it has a soft consistency. The liver functions as an accessory digestive organ and has a variety of metabolic and regulatory functions. |
|
Definition
|
|
Term
| When the spleen enlarges, what happens? |
|
Definition
| the lower tip extends down and toward the midline. |
|
|
Term
| Sensitivity to ____ may diminish with aging. elderly patient must be carefully assessed for acute abdominal conditiions. |
|
Definition
|
|
Term
| Elderly or neuromuscular or conciousness impaired clients are at risk for lung __________ & ___________. |
|
Definition
|
|
Term
| Why do elderly clients experience a decline in appetites? |
|
Definition
| various factors such as altered metabolism, decreased taste sensation, decreased mobility and possibly depression. If appetite declines, the client's risk for nutritional imbalance increases. |
|
|
Term
| Older clients are at particular risk for potential complications with diarrhea, F & E imbalance. Why? |
|
Definition
| Because they have a higher fat to lean muscle ratio |
|
|
Term
| Why are older people more prone to UTI's? |
|
Definition
| the activity bacteria in the urinary tract declines with age. |
|
|
Term
| when preparing for the abdominal exam, where should the clients arms be? |
|
Definition
| by there side. if they are raised behind there head or folded there it will tense the ab muscles. |
|
|
Term
| What happens to bowel sounds post-op? |
|
Definition
| resume gradually depending on type of surgery. The small intestine functions normally in the first few hours post-op, stomach emptying takes 24-48 hours to recover, and the colon requires 3-5 days to recover post-op. |
|
|
Term
| The lower border of the liver dullness may be hard to find b/c of ... |
|
Definition
|
|
Term
| Ausculating for vascular sounds in the abdomen is esp imp if the client has ___ or you suspect _________ insufficiency in the legs. |
|
Definition
|
|
Term
| bowel sounds occur normally every _____ seconds. one bowel sound to one breath sound. |
|
Definition
|
|
Term
| Splenic percussion results can be obscured by ____ in the stomach or bowel, before declaring splenomegaly. rule out other sources of dullness (full stomach, feces, etc...) |
|
Definition
|
|
Term
| Increasing pitch of bowel sounds is most diagnostic of _________ b/c it signifies intestinal distention. |
|
Definition
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| If the client is older then 50 or has HTn, assess the width of the ______ . |
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| Be CAREFUL WHEN PALPATING the _______! and be sure to palpate with your fingers below the costal margin so you do not miss the lower edge of an enlarged one. |
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| Testing for rebound tenderness is done at beginning or end of assessment? |
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| end of assessment b/c a positive response produces pain & muscle spasm that can interfere with exam. |
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| Do you palpate a pulsating midline mass? |
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| NO!!! it may be a dissecting aneurysm that can rupture from the pressure of palpation. avoid deep palpation over tender organs as in the case of polycystic kidney disease, Wilms Tumor, transplantation, or suspected splenic trauma. |
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| _______ Americans have much higher rates for gallblader disease then most other populations. High rates also occur in New Zealand. |
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