| Flap 1 | Flap 2 |
| impaired fasting glucose | fasting blood glucose of ≥ 110 mg/dL |
| obesity | BMI of ≥ 30kg, or waist girth of >100 cm |
| high serum HDL cholesterol | > 60 mg/dL |
| palpation of pulses | 30 secs with regular rhythm, 1-2 mins with irreg |
| apical pulse/PMI | 5th interspace midclavicular vertical line |
| brachial pulse | best in infants |
| radial pulse | most common monitoring site |
| (N) adult HR | 70 bpm; range 60-80 bpm |
| (N) newborn HR | 120 bpm; range 70-170 bpm |
| tachycardia | >100 bpm |
| bradycardia | <60 bpm |
| irregular pulse | variations in force and frequenc; may be due to arrhythmias, myocarditis |
| weak, thready pulse | stroke volume, cardiogenic shock |
| bounding, full pulse | shortened ventricular systole and decreased peripheral p°; aortic insufficiency |
| aortic valve | 2nd (R) ICS, sternal border |
| pulmonic valve | 2nd (L) ICS, sternal border |
| tricuspid valve | 4th (L) ICS, sternal border |
| bicuspid valve | 5th (L) ICS, midclavicular area |
| S1 sound "lub" | (N) closure mitral &tricuspid valves; beginning of systole; dec in 1st degree heart block |
| S2 sound "dub" | (N) closure aortic & pulmonic valves; end of systole; dec in aortic stenosis |
| S3 sound | assoc with ventricular filling; occurs soon after S2 |
| S3 sound | congestive (LV) heart failure in older individuals |
| S4 sound | assoc with ventricular filling and atrial contraction; occurs just before S1 |
| S4 | CAD, MI, aortic stenosis, or chronic HPN |
| systolic murmur | bet S1 & S2. may be normal or may indicate valvular dse (mitral valve prolapse) |
| diastolic murmur | bet S2 and S1. Usu indicates valvular dse |
| thrill | ab(N) tremor accompanying a vascular or cardiac murmur; felt on palpation |
| bruit | adventitious sound or murmur (blowing sound) of arterial or venous origin |
| bruit | common in carotid or femoral arteries; indicative of atherosclerosis |
