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PMI point of maximal impulse
The point on the chest wall over the heart at which
point of maximal impulse the contraction of the heart is best seen or felt;
normally at the fifth intercostal space in the left
midclavicular line in adults
temporal, carotid, apical, brachial (preferred for small
pulse sites
children), radial (commonley used), ulnar, femoral,
popliteal, posterior tibial, dorsalis pedis
rate, rhythm (regular vs
characteristics of pulse irregular), volume 60-100
volume strength-bounding, thready, capillary refill
respiration exchange of oxygen and co2
external respiration exchange of gases between lungs and blood
internal respiration Exchange of gases between cells of the body and the blood
assessing respiration Rate per minute, depth, rhythm, pattern (eupnea, apnea),
respiratory effort
stertorous breathing Breathing that sounds like snoring
extra breath sounds that are not normally heard, such as
adventitious sounds
crackles, rhonchi, wheezes, and pleural friction rubs.
wheezes musical, whistling sounds
crackles or rales air moving over secretions in the lungs
rhonchi low pitched, rattling, or bubbling, snoring or sonorous wheezing
sounds
A high pitched sound generated from partially
stridor
obstructed air flow in the upper airway.
strenght of
hearth
four qualites of BP
blood
thickness
blood volume
, peripheral vascular resistence
- age
- physical activity
- emotional status
- medications
- size and condition of arteries
- arm position
factors affecting BP
- muscle contraction
- blood volume
- dehydration
- cardiac output
- site of measurement
pulse pressure difference between systolic and diastolic pressure
amputation
of arm
mastectom
don't take bp at these sites
y
presence of a
shunt casts,
braces,
dressings
recent vascular
surgery iv
infusion
a series of five sounds (four sounds followed by an
Korotkoff sounds absence of sound) heard during the auscultatory
determination of blood pressure and produced by
sudden distention of the artery because of the
proximally placed pneumatic cuff
essential caused by disease
hypertension/primary
hypertension
secondary hypertension high blood pressure caused by the effects of another disease