Download Cardiac Assessment NRS 201

Denise Coffey MSN, RN
Anatomy Review
Anatomy Review

Chambers
 Atria right and left
 Ventricles right and left

Valves
 Atrioventricular
○ Tricuspid
○ Mitral
 Semilunar
○ Pulmonic
○ Aortic
Review Anatomy
Heart sounds
Direction of blood flow
 Cardiac cycle

 Diastole
 Systole
 Events in the right and left sides

Heart sounds
 First heart sound
 Second heart sound
 Effect of respiration
Heart Sounds

Extra heart sounds
 Third heart sound
 Fourth heart sound
Murmurs
 Characteristics of sound

 Frequency (pitch)
 Intensity (loudness)
 Duration
 Timing

Conduction
Neck vessels

Neck vessels
 Carotid artery
 Jugular veins
○ Internal
○ External
Review Anatomy
Subjective Data Collection

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Chest pain
Dyspnea
Orthopnea
Cough
Fatigue
Cyanosis or pallor

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Edema
Nocturia
Cardiac history
Family cardiac
history
Personal habits
(cardiac risk factors)
Objective Data Collection

Carotid arteries
 Palpate
 Auscultate for bruit

Jugular veins
 Inspect the jugular venous pulse
Objective Data Collection


Auscultate the heart sounds
Identify auscultatory areas
 Note the rate and rhythm
 Identify S1 and S2
 Listen to S1 and S2 separately
 Listen for extra heart sounds
 Listen for murmurs
Landmarking for Heart Sounds
Peripheral Vascular System
Arteries
 Temporal artery
 Carotid artery

Arteries in the arm
 Brachial
 Ulnar
 Radial

Arteries in the leg




Femoral
Popliteal
Dorsalis pedis
Posterior tibial
Peripheral Vascular System
Veins
Jugular veins
 Veins in the arm
 Veins in the leg

 Deep veins
 Femoral
 Popliteal
 Superficial veins
 Great saphenous
 Small saphenous
 Perforators (connecting veins)
Peripheral Vascular System
Peripheral Vascular System
Peripheral Vascular System
Lymphatic System
Subjective Data
Leg pain or cramps
 Skin changes on arm or legs
 Swelling
 Lymph node enlargement
 Medications

Objective Data
Objective Data
Legs—Inspect and
palpate
 Skin and hair
 Symmetry
 Temperature
 Calf muscle
 Inguinal lymph
nodes
 Femoral pulse
Popliteal pulse
 Posterior tibial pulse
 Dorsalis pedis pulse
 Pretibial edema
 Leg veins

 Assess while patient
stands
Objective Data Femoral Pulse
Objective Data Popliteal Pulse
Objective Data Posterior Tibial
Objective Data Dorsalis Pedis
Objective Data Pitting Edema
Abnormalities

Arms
 Raynaud’s syndrome
 Lymphedema

Legs


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Arteriosclerosis—ischemic ulcer
Venous (stasis) ulcer
Superficial varicose veins
Deep vein thrombophlebitis
Occlusions
 Aneurysms
