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Precardium check off
performing a physical assessment , skill, neck,vessels, Precordium
heart and peripheral vascular | Answer |
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what equiptment and supplies r needed 4 a heart and neck vessel assessment? | stethoscope w/ bell & diaphrigm, small pillow penlight, watch w/ 2nd hand (2) centimeter rulersHow is procedure |
How is procedure explained to client? | Explain that anterior of chest will be exposed, Several different position changes, |
1. Ausculate carotid artery for bruits/explain how | bell over carotid artery client hold breath |
How do you find the carotid artery? | R & L common carotid artery extend from aortic arch, located in the groove b/t trachea & R & L sternocleidomastoid muscles,slightly below the manadable |
Palpate each carotid artery 4 amplitude , contour, of the pulse, elasticity of the vessel and thrills/explain procedure | palpate alternately by placing the pads of the index and middle finger medial to the sternocleidomastoid muscle on the neck. |
amplitude & Contour of the pulse is asessed ? | Pulses =/y strong, 2+ w/ no variation in strength/ amplitude from beat to beat, contour = smooth rapid upstroke, slower less abrupt on downstroke |
elasticity of the vessels ssessed? | elastic is assessed by feeling /lots the abality for the vessel to streatch and return to shape |
thrills are assessed? | by palpation /evidenced by sensation similar to purring cat |
How does one inspect for jugular venous pulse? | stand right side of client, client = supine w/ torso elevated 30 to 45 degres. Ask client to turn head slightly to left. Shine light on neck =+pulsations. Next I>suprasternal notch areaareas around clavicles 4 pulse of internal jugular vein |
veinHow is the jugular venous pulse measured? | client = supine w/ head of bed 30, 45, 60 and 90 degres, observe 4 distention, protrusion, bulging.not be seen @ 45 degrees |
How is the precordium inspected for pulsations? | client = supine position, head bead = 30-45 degres, stand on clients right side, note apical impulse & any other abnormal pulsations. |
where is the is the apical pulse found? | mitral area (AKA) 4th or 5th intercoastal space @ the midclivicular line. |
what is noted about the apical pulse? | Location,= mitrial area size = 1-2 cm duration,brief first 2/3 systole(or -) strength, may not be palpable |
If apical impulse cannot be palpated what should next be done? Why? | client = L lateral position . This will displace the heart towards the left chest wall/also relocates apical impulse further left |
Where should one palpate for abnormal pulsations or vibriations while assessing the precordium? | Apex, LSB, Base |
How does one auscultate heart sounds 4, rate rythm (apical and radial pulses, pulse rate deficit S1 and S2? | (me) = right side of client, client = supine, diaphragm A precordium 4 high pitch sounds, bell = low pitch sounds gallups |
While ausculating the heart S1 and S2 are noted by? | Focus 1 sound @ atime 1st not rate rythem than, identify the 1st and 2nd heart sounds, concentrate on each sound individually listen 4 extra heart sounds, murmurs and finally w/ client in different positions |
Aortic area = ? | 2 ICS @ R sternal boarder (AKA) base of the heart |
Pulmonic area = ? | 2 or 3 ICS @ left sternal boarder (AKA) base of heart |
Erb's Point =? | 3-5 ics @ L sternal boarder |
Tricuspid area =? | 4 or 5 intercoastal space @ lower left sternal boarder |
Mitral (Apical) pulse = | 5 intercoastal space near midclivicular line |
Name the 4 BASIC steps of assessing the Neck vessels | 1, A, Carotid Artery 4 bruits,2, P, carotid artery, 3. I 4 jugular venous pulse, 4. Measure jugular venoue preassure |
Name the 7 BASIC steps of assessing the Precordium | I1. =I 4 visible pulsations, 2. P apical pulse, 3. P @ apex LSB & base.$. A. heart sounds 5. A. S1 and S2 6A 4 extra heart sounds 7. A client in left lateral position sitting up leaning foward and exhaling. |