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Nursing > 208 Concept: Perfusion: Topics assessment of heart, neck, vessels, peripheral vascular and lymphatic system > Flashcards

208 Concept: Perfusion: Topics assessment of heart, neck, vessels, peripheral vascular and lymphatic system Flashcards

1
Q

What is the precordium?

A

Area on the anterior chest overlying the heart and great vessels.

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2
Q

What is happening during the first heart sound (S1)?

A

Occurs with closure of the AV valves and signals the beginning of systole.

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3
Q

Where is S1 usually loudest?

A

At the apex of the heart.

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4
Q

What is happening during the second heart sound (S2)?

A

Occurs with the closure of the semilunar valves and signals the end of systole.

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5
Q

Where is S2 usually loudest?

A

At the base of the heart.

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6
Q

What causes S3?

A

Ventricular filling can at times create vibrations that can be heard over the chest.

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7
Q

When does S4 occur?

A

At the end of diastole, at presystole, when the ventricle is resistant to filling.

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8
Q

What do murmurs sound like?

A

Sound of noisy water flow created by a pile of stones or a sharp turn in a stream. Gentle, blowing, swooshing sound that can be heard on the chest wall.

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9
Q

What are the four characteristics of heart sounds?

A
  1. Frequency (pitch)
  2. Intensity (loudness)
  3. Duration
  4. Timing (systole or diastole)
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10
Q

What makes the heart unique?

A

Its automaticity. It can contract by itself, independently of any signals or stimulation from the body.

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11
Q

What comes first: electrical events or mechanical events in the heart?

A

Electrical events slightly precede mechanical events.

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12
Q

In the resting adult, how much blood does the heart normally pump through per minute?

A

4-6 L

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13
Q

Define cardiac output

A

CO= stroke volume x heart rate

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14
Q

Define preload.

A

The length to which the ventricular muscle is stretched at the end of diastole just before contraction.

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15
Q

True or false: According to the Frank-Starling law, the greater the stretch, the weaker the heart’s contraction.

A

False. The greater the stretch, the stronger the heart’s contriction.

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16
Q

For the health history component, what are you asking about?

A
  • Chest pain
  • Dyspnea
  • Othopnea
  • Cough
  • Fatigue
  • Cyanosis or pallor
  • Edema
  • Nocturia
  • Cardiac history
  • Family cardiac history
  • Personal habits (cardiac risk factors)
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17
Q

What additional health history questions would you ask for infants?

A
  • maternal health during pregnancy
  • Feeding (cyanosis while nursing or crying, finish without tiring)
  • Growth (baby growing as expected)
  • Activity (Mielstones achieved as expected? Play without tiring? How many naps?)
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18
Q

What additional health history questions would you ask for children?

A
  • growth
  • activity
  • joint pain and fever
  • headache and nosebleed
  • respiratory disease
  • Family history
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19
Q

What additional health history questions would you ask for pregnant women?

A

High blood pressure

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20
Q

What additional health history questions would you ask for older adults?

A
  • disease
  • medications
  • environment (stairs?)
21
Q

What is a thrill?

A

A palpable vibration. Feels like the throat of a purring cat. Signifies turbulent blood flow and accompanies lud murmurs.

22
Q

What is S1?

A

Start of systole.

23
Q

When you notice an irregularity in the heart rhythm, what should you check?

A

Pulse deficit.

24
Q

How do you check for a pulse deficit?

A

Auscultate the apical beat while palpating the radial pulse. The two counts should be identical. If not, subtract the radial rate from the apical rate and record the remainder as the pulse deficit.

25
Q

Related to timing, what is critical when defining a murmur?

A

It is crucial to define the murmur by its occurrence in systole or diastole.

26
Q

With infants, where should you check pulse?

A

Apical pulse

27
Q

What is the infant heart rate when it stabilizes after birth?

A

120 to 140 beats per minute

28
Q

What is a venous hum?

A

Represents turbulence of blood flow in the jugular venous system. Common in healthy children and has no pathological significance.

29
Q

What happens to a pregnant woman’s pulse rate?

A

Usually reveals that the resting pulse rate is increased by 10 to 15 beats per minute.

30
Q

What is orthostatic hypertension?

A

A sudden drop in blood pressure when rising to sit or stand. Common in older adults.

31
Q

Where can you palpate the temporal artery?

A

In front of the ear at the temple.

32
Q

Where can you palpate the carotid artery?

A

In the groove between the sternomastoid muscle and the trachea.

33
Q

What is the major artery that supplies the arm?

A

The brachial artery.

34
Q

What does the brachial artery bifurcate into?

A

Ulnar and radial arteries

35
Q

What is the major artery in the leg?

A

Femoral artery

36
Q

What is the function of the arteries?

A

To supply oxygen and essential nutrients to the tissues.

37
Q

What is ischemia?

A

Deficient supply of oxygenated arterial blood to a tissue, caused by obstruction of a blood vessel.

38
Q

What is peripheral artery disease?

A

Affects noncoronary arteries and usually refers to arteries supplying the limbs.

39
Q

What does the body have more of: veins or arteries?

A

Veins

40
Q

Are veins a low pressure or high pressure system?

A

low pressure system

41
Q

How is blood flow maintained in the veins?

A

a) the contracting of skeletal muscles that milk the blood proximally, back to the heart
b) the pressure gradient caused by breathing, in which inspiration makes the thoracic pressure decrease and the abdominal pressure increase
c) intraluminal valves, which ensure unidirectional flow

42
Q

Why are veins called capacitance vessels?

A

Because of their ability to stretch.

43
Q

What leads to venous stasis?

A

Problems with any of the following:

  • contracting skeletal muscle
  • competent valves in the veins
  • a patent lumen
44
Q

What are the functions of the lymphatic system?

A

a) to conserve fluid and plasma proteins that leak out of the capillaries
b) form a major part of the immune system that defends the body against disease
c) absorb lipids from the intestinal tract

45
Q

Define perfusion.

A

Perfusion refers to the flow of blood through arteries and capillaries delivering nutrients and oxygen to cells.

46
Q

What is the scope of perfusion?

A

Optimal perfusion - Impaired perfusion - no perfusion

47
Q

What are some populations at risk regarding perfusion?

A

Older adults have many risk factors for impaired perfusion. Coronary artery blood flow, stroke volume, and cardiac output decrease, increasing the risk for heart failure. Also the stiffening and thickening of the heart tissues decreases the ability to respond to the need for increased circulation and prolongs the time needed for the heart to return to a resting state after stress. Decreased elasticity of arteries limits the consistent forward movement of blood to organs. The valves in veins become less efficient, contributing to peripheral edema, and the sluggishness of blood flow contributes to deep vein thrombosis.

Social and Environmental Factors Low family income and low educational level are contributing factors to adverse cardiovascular disease outcomes. Social and psychological factors such as access to health care, medical compliance, eating habits, depression, and stress are thought to play a role in this relationship.

48
Q

What are some modifiable risk factors for impaired perfusion?

A
  • Smoking: Nicotine vasoconstricts
  • Elevated serum lipids: Contribute to atherosclerosis
  • Sedentary lifestyle: Contributes to obesity
  • Obesity: Increases risk for type 2 diabetes mellitus and atherosclerosis
  • Diabetes mellitus: Increases risk of atherosclerosis
  • Hypertension: Increases work of myocardium
49
Q

What are some unmodifiable risk factors for impaired perfusion?

A
  • Age: Increases with age
  • Gender: Men > women
  • Genetics: Family history

Nursing (29 decks)

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