NUR 265 ACTUAL EXAM 2 | QUESTIONS AND ANSWERS | LATEST
EXAM
What is the S1 sound?
closing of mitral and tricuspid valves. LUB sound
louder than S2 at apex
what is the S2 sound?
closing of pulmonic and aortic valves. DUB sound
louder than S1 at the base
what is the sound of S3?
Volume overload problem a low-frequency, brief vibration occurring in early
diastole at the end of the rapid diastolic filling period of the right or left
ventricle
what is the sound of s4? when can you hear it?
Atrial gallop right before S1.
young healthy adults
older ppl something wrong with ventricle. "stiff"
Heart murmur
an abnormal sound from the heart produced by defects in the chambers or
valves.
Dyspnea
difficult or labored breathing
nocturnal dyspnea
difficulty breathing at night
risk factors of cardiac problems
smoking, diet, alcohol use, exercise, stress, trans fats, animal fats,
hypertension, obesity, weight gain and hyperlipidemia
history on infants
Mothers' health during pregnancy
cyanosis? ( breast feeding, crying?)
,Does mom smoke, diabetes?
eat without tiring
meeting growth milestones
how many naps? how long?
history on children?
meeting growth milestones?
any blue coloring during activity?
able to keep up with age mates?
squatting to rest or assuming knee-chest position while sleeping?
chest pain?
F/H?
physical assessment
Inspection- starts from the doorway. CP?
auscultation
palpation
inspect
starts first
Palpate
Lightly for pulse
artery should be soft and pliable
pulse should be strong
palpate each separately
Auscultate
bruit: blowing or swishing
venous hum: Child
assessment of jugular vein
inspect supine at 45 degree angle
- fullness
- pulsations
what causes distended jugular veins?
heart failure/ typically on the right side
OLDCARTS
, Onset
Location
Duration
Characteristics
Aggravating and Alleviating Factors
Related Symptoms
Treatment
Severity
precordium:
area of the chest wall overlying the heart and great vessels.
inspect- lift or heave
palpate- pulsation
auscultate- 5 locations
PMI
point of maximal impulse
normal HR
60-100 bpm
Bradycardia
slow heart rate
Tachycardia
Fast heart rate (HR greater than 100bpm)
pericardial friction rub
high-pitched, scratchy extracardiac sound is heard when the precordium is
inflamed. "inflammation in the heart" - pt has to hold breath for a couple
seconds to check.
listening to a murmur
timing, loudness, pitch, pattern, quality, location, radiation.
* Left lateral or lean forward to listen down at apex
changes in pregnancy
Heart elevates upward and to the right~PMI changes to 4th ICS.
HR increases
stroke volume increases
EXAM
What is the S1 sound?
closing of mitral and tricuspid valves. LUB sound
louder than S2 at apex
what is the S2 sound?
closing of pulmonic and aortic valves. DUB sound
louder than S1 at the base
what is the sound of S3?
Volume overload problem a low-frequency, brief vibration occurring in early
diastole at the end of the rapid diastolic filling period of the right or left
ventricle
what is the sound of s4? when can you hear it?
Atrial gallop right before S1.
young healthy adults
older ppl something wrong with ventricle. "stiff"
Heart murmur
an abnormal sound from the heart produced by defects in the chambers or
valves.
Dyspnea
difficult or labored breathing
nocturnal dyspnea
difficulty breathing at night
risk factors of cardiac problems
smoking, diet, alcohol use, exercise, stress, trans fats, animal fats,
hypertension, obesity, weight gain and hyperlipidemia
history on infants
Mothers' health during pregnancy
cyanosis? ( breast feeding, crying?)
,Does mom smoke, diabetes?
eat without tiring
meeting growth milestones
how many naps? how long?
history on children?
meeting growth milestones?
any blue coloring during activity?
able to keep up with age mates?
squatting to rest or assuming knee-chest position while sleeping?
chest pain?
F/H?
physical assessment
Inspection- starts from the doorway. CP?
auscultation
palpation
inspect
starts first
Palpate
Lightly for pulse
artery should be soft and pliable
pulse should be strong
palpate each separately
Auscultate
bruit: blowing or swishing
venous hum: Child
assessment of jugular vein
inspect supine at 45 degree angle
- fullness
- pulsations
what causes distended jugular veins?
heart failure/ typically on the right side
OLDCARTS
, Onset
Location
Duration
Characteristics
Aggravating and Alleviating Factors
Related Symptoms
Treatment
Severity
precordium:
area of the chest wall overlying the heart and great vessels.
inspect- lift or heave
palpate- pulsation
auscultate- 5 locations
PMI
point of maximal impulse
normal HR
60-100 bpm
Bradycardia
slow heart rate
Tachycardia
Fast heart rate (HR greater than 100bpm)
pericardial friction rub
high-pitched, scratchy extracardiac sound is heard when the precordium is
inflamed. "inflammation in the heart" - pt has to hold breath for a couple
seconds to check.
listening to a murmur
timing, loudness, pitch, pattern, quality, location, radiation.
* Left lateral or lean forward to listen down at apex
changes in pregnancy
Heart elevates upward and to the right~PMI changes to 4th ICS.
HR increases
stroke volume increases
