Cardiac Assesment
Describe the sequence for assessing heart sounds?
Aortic — Pulmonic — Erb's Point — Tricuspid — Mitral
Erb's Point
Third intercostal space left sternal border
Describe the differences between S1 and S2
S1 is heard loudest at the apex while S2 is heard loudest at the base.
Which cultural group is at greatest risk for CAD?
African Americans
Describe the Layers of Heart Muscle
Pericardium - sac that attaches to the great vessels and surrounds the heart
Parietal membrane – serous membrane
Myocardium – thickest layer
Endocardium – thin layer of endoethelial tissue forms the innermost layer of the heart
Describe the sequence for the cardiac assessment?
Inspection — Palpation — Auscultation
Apex
4th-5th intercostal space left midclavicular line
Which valves are open during Systole?
Aortic and Pulmonic
List three modifiable risk factors for the prevention of heart disease?
Nutrition - Obesity
Smoking & Alcohol Intake
Two common symptoms associated with heart failure?
Nocturnal Dyspnea & Orthopnea
Cardiac Subjective Data
Chest Pain, Dsypnea, Orthopnea, Cough, Fatigue, Cyanosis or Pallor, Edema, Nocturia, Past Cardiac
History, Family Cardiac History, Patient-Centered Care (Cardiac risk factors)
Aortic Valve
Second right intercostal space
Mitral and Tricuspid
List two modifiable risk factors in the prevention of heart disease?
Exercise
Hypertension & Diabetes (compliance)
What is involved with palpation in the cardiac assessment?
Palpation of the Apical Impulse or for the presence of any thrills.
Pulmonic Valve
Second left intercostal space
What are extra heart sounds?
S3 and S4; S3 occurs when the ventricles are resistant to filling during the early filling phase (prodiastole)
this occurs immediately after S2. as blood pours into the ventricles. S4 occurs at the end of diastole when the ventricle is resistant to filling.
How can nurses educate patient in the prevention of heart disease?
Balanced diet (managing cholesterol)
Exercise
Smoking cessation
Compliance with HTN & Diabetes Management
Cardiac Ischemia & Associated Symptoms
Severe pain & pressure "Elephant on the chest"
Tricuspid Valve
Left lower sternal border
What is a heart murmur?
A turbulence of blood flow caused by conditions where the velocity of blood either increases or decreases or by structural defects in the valves.