NU2011 Exam 2 Study Guide with Complete Solutions

NU2011 Exam 2 Study Guide with Complete Solutions Where to examine during the cardiac exame - Ans:-2nd to 5th intercostal. Direction of blood flow through the heart - Ans:-blood flows from inferior vena cava to the superior vena cava- enters the heart in the right atrium- blood flows from the right atrium to the right ventricle through the tricuspid valve to the right ventricle. Blood flows from the right ventricle through the pulmonary semilunar valve to the pulmonary artery and is taken to the lungs to be oxygenated. Blood from lungs is taken to the left atria via the pulmonary vein- blood goes from left atria to the left ventricle through the bicuspid (mitral) valve- blood goes from the left ventricle to the aorta through the aortic semilunar valve and enters the aorta and goes into the body. Heart sounds - Ans:-results from the movements of the valves and blood flow in the heart. Normal heart sounds: S1 and S2 - noises they make, when they are heard and where they are heard the loudest - Ans:-S1: isometric contraction- systole hear "lub" from the AV valve. heard loudest at mitral and tricuspid areas. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/29 S2: isometric relaxation- diastolic: hear "dub" from the semilunar valve. - heard loudest at aortic and pulmonic areas. *results from movement of valves and blood flow in heart. no extra sounds should be heard in the heart. Abnormal Heart sounds: S3 and S4 - Ans:-S3: heart noise heard in rapid filling phase caused by resistance in the left ventricle. *sounds like Tennessee. S4: heart noise heard right before S1 is heard- due to increased compliance of the left ventricle. sounds like *Kentucky 5 Landmarks no where to listen to heart noises (APETM) - Ans:-1. Aortic area: right 2nd intercostal 2. Pulmonic: Left 2nd intercostal 3. Erb's pt: Left 3rd intercostal 4. Tricuspid: Left of sternum: 4-5th ICS. 5. Mitral area: Left 5th ICS, medial to midclavicular line. Inspection: where you should stand how pt lays PMI - Ans:-- observe from right side- person should be supine. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/29 - Observe each precordial area for pulsations and also note breathing. - Pulsation known as apical pulse or point of maximal pulse may be seen in the mitral area. Palpation - Ans:-palpate person while supine- palpate precordial area and apical pulse (might have to have them lay on left side to find the pulse. Ausculate - Ans:-1. proceed from one landmark to another- use both bell and diaphragm. 2. listen for rate and rhythm, identify S1 and S2 (lub, dub). Assess for S3 and S4 Apex and base of heart - Ans:-S1: heard LUB loud at the apex S2: heard DUP loud at the base. Arterial pulses (8) - Ans:-1. temporal 2. carotid 3. brachial 4. radial 5. femoral 6. popiteal 7. Posterior tibialis ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/29 8. Dorsalis pedis pulse. Palpation of arterial areas - Ans:-1. use fingertips and second fingers. *carotid 2. Observe rate and rhythm and compare with the apical pulse and note bounding of pulse, weakness and irregular patterns. Quality of arterial pulse - Ans:-0= absent 1+= weak 2+= normal 3+= increased, full volume and bounding. Jugular vein inspection - Ans:-drains the blood from head and neck- if vein distended could mean heart failure. - person supine at 30-40 degree angle (remove pillow). have them turn head to left- look for vein near suprasternal notch and clavicle. Estimate the JVP - Ans:-hold a ruler on sternal angle, align the straight edge on the ruler- adjust the straight edge to the level you see pulsation. read the level of intersection on the vertical ruler. *Normal is 2Cm or less ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/29 Exercise Patterns center on (3) and (6) parameters - Ans:-activity level, exercise program and leisure activities. measured using the following parameters: 1. movement capability 2. activity tolerance 3. self-care abilities 4. use of assisstive devices 5. change in patterns 6. satisfaction and perceived problems Physical Fitness - Ans:-ability to respond to routine physical demands with enough reserve energy to cope with a sudden challenge. Healthy People 2020 goals (6) - Ans:-1. reduce the number of adults who do not engage in any physical activity or leisure time. 2. Increase the proportion of adolescents and adults who meet the federal require