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Precardium check off

performing a physical assessment , skill, neck,vessels, Precordium

heart and peripheral vascularAnswer
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.
Created by: garrowcousino
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