Nursing 313 Exam 2 Questions With Complete Solutions
*Cardiovascular Assessment*
- what are some subjective findings for patients dealing with
peripheral vascular system issues? Correct Answers 1) leg pains
or cramps
2) skin changes on arms or legs
3) selling
4) lymph node enlargement
5) medications
6) smoking history
*Cardiovascular Assessment*
1) describe precordium auscultation Correct Answers - Identify
by palpation-auscultatory areas where you will listen; these
include four traditional valve "areas"
1) Aortic (2nd RICS --- just right of sternum)•
2) Pulmonic (2nd LICS --- just left of sternum)
3) Tricuspid (4th LICS ---just left of sternum)
4) Mitral/PMI (5th LICS --- midclavicular line; apex)
*Cardiovascular Assessment*
a) *peripheral vascular system*
- where do we assessment this system on the body?
,- what should we inspect for
- what should we palpate for?
b) *heart and neck*
- where do we assessment this system on the body?
- what should we inspect for
- what should we palpate for? Correct Answers a) *peripheral
vascular system*
- upper and lower extremities
- inspect for color on skin/nailbeds, lesions, edema, muscle
size/symmetry
- palpate for temperature, texture, capillary refill <2 seconds,
edema, and pulses (radial, brachial, etc...)
b) *heart and neck*
- neck vessels (inspect and palpate and auscultate carotids)
- precordium (inspect anterior chest, palpate PMI and heart
valve landmarks, auscultate aortic, pulmonic, tricuspid, mitral)
*Cardiovascular Assessment*
a) what is a Doppler ultrasonic probe?
b) when should we use it? Correct Answers a)
- used to detect a weak peripheral pulse
- doppler probe magnifies pulsatile sounds from heart and blood
vessels
- count pulse and mark site with skin marker
,b) we use this when we can detect a pulse (because its very
weak)
*Cardiovascular Assessment*
a) what is central perfusion?
b) what is tissue/local perfusion? Correct Answers a) *central
perfusion*
- Force of blood movement generated by cardiac output
- Requires adequate cardiac function, blood pressure, and blood
volume
- Cardiac output (CO) = Stroke volume × heart rate
b) *tissue/local perfusion*
- Volume of blood that flows to target tissue
- Requires patent vessels, adequate hydrostatic pressure, and
capillary permeability
*Cardiovascular Assessment*
how can we check capillary refill? Correct Answers - press
down on the nail and assess how quick the capillary refills with
blood
- the ideal return is less than 2 seconds.
*delayed refill can be caused by the patient being cold*
*Cardiovascular Assessment*
, how can we palpate neck vessels? Correct Answers 1) Palpate
carotid artery
- Yields important information on cardiac function
- Palpate each carotid artery medial to sternomastoid muscle in
neck; palpate gently
- Palpate only one carotid artery at a time.
1) Contour: Smooth 2) Amplitude: 2+ is normal
3) Same bilaterally
*Cardiovascular Assessment*
how do we auscultate for neck vessels? Correct Answers
*Auscultate carotid artery*
- Auscultate each carotid artery for presence of a bruit
- Lightly apply bell of stethoscope over carotid artery at three
levels:
1. Angle of jaw
2. Midcervical area
3. Base of neck
*Ask the person to take a breath, exhale, and hold it briefly
while you listen.*
*Cardiovascular Assessment*
how do we describe the characteristics of heart sounds? Correct
Answers 1. Frequency (pitch)—Heart sounds are described as
*Cardiovascular Assessment*
- what are some subjective findings for patients dealing with
peripheral vascular system issues? Correct Answers 1) leg pains
or cramps
2) skin changes on arms or legs
3) selling
4) lymph node enlargement
5) medications
6) smoking history
*Cardiovascular Assessment*
1) describe precordium auscultation Correct Answers - Identify
by palpation-auscultatory areas where you will listen; these
include four traditional valve "areas"
1) Aortic (2nd RICS --- just right of sternum)•
2) Pulmonic (2nd LICS --- just left of sternum)
3) Tricuspid (4th LICS ---just left of sternum)
4) Mitral/PMI (5th LICS --- midclavicular line; apex)
*Cardiovascular Assessment*
a) *peripheral vascular system*
- where do we assessment this system on the body?
,- what should we inspect for
- what should we palpate for?
b) *heart and neck*
- where do we assessment this system on the body?
- what should we inspect for
- what should we palpate for? Correct Answers a) *peripheral
vascular system*
- upper and lower extremities
- inspect for color on skin/nailbeds, lesions, edema, muscle
size/symmetry
- palpate for temperature, texture, capillary refill <2 seconds,
edema, and pulses (radial, brachial, etc...)
b) *heart and neck*
- neck vessels (inspect and palpate and auscultate carotids)
- precordium (inspect anterior chest, palpate PMI and heart
valve landmarks, auscultate aortic, pulmonic, tricuspid, mitral)
*Cardiovascular Assessment*
a) what is a Doppler ultrasonic probe?
b) when should we use it? Correct Answers a)
- used to detect a weak peripheral pulse
- doppler probe magnifies pulsatile sounds from heart and blood
vessels
- count pulse and mark site with skin marker
,b) we use this when we can detect a pulse (because its very
weak)
*Cardiovascular Assessment*
a) what is central perfusion?
b) what is tissue/local perfusion? Correct Answers a) *central
perfusion*
- Force of blood movement generated by cardiac output
- Requires adequate cardiac function, blood pressure, and blood
volume
- Cardiac output (CO) = Stroke volume × heart rate
b) *tissue/local perfusion*
- Volume of blood that flows to target tissue
- Requires patent vessels, adequate hydrostatic pressure, and
capillary permeability
*Cardiovascular Assessment*
how can we check capillary refill? Correct Answers - press
down on the nail and assess how quick the capillary refills with
blood
- the ideal return is less than 2 seconds.
*delayed refill can be caused by the patient being cold*
*Cardiovascular Assessment*
, how can we palpate neck vessels? Correct Answers 1) Palpate
carotid artery
- Yields important information on cardiac function
- Palpate each carotid artery medial to sternomastoid muscle in
neck; palpate gently
- Palpate only one carotid artery at a time.
1) Contour: Smooth 2) Amplitude: 2+ is normal
3) Same bilaterally
*Cardiovascular Assessment*
how do we auscultate for neck vessels? Correct Answers
*Auscultate carotid artery*
- Auscultate each carotid artery for presence of a bruit
- Lightly apply bell of stethoscope over carotid artery at three
levels:
1. Angle of jaw
2. Midcervical area
3. Base of neck
*Ask the person to take a breath, exhale, and hold it briefly
while you listen.*
*Cardiovascular Assessment*
how do we describe the characteristics of heart sounds? Correct
Answers 1. Frequency (pitch)—Heart sounds are described as
