performing a physical assessment , skill, neck,vessels, Precordium
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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
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| How is procedure explained to client? | Explain that anterior of chest will be exposed, Several different position changes,
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| 1. Ausculate carotid artery for bruits/explain how | bell over carotid artery client hold breath
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| 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
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| 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.
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| 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
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| elasticity of the vessels ssessed? | elastic is assessed by feeling /lots the abality for the vessel to streatch and return to shape
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| thrills are assessed? | by palpation /evidenced by sensation similar to purring cat
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| 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
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| 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
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| 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.
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| where is the is the apical pulse found? | mitral area (AKA) 4th or 5th intercoastal space @ the midclivicular line.
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| 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
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| 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
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| Where should one palpate for abnormal pulsations or vibriations while assessing the precordium? | Apex, LSB, Base
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| 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
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| 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
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| Aortic area = ? | 2 ICS @ R sternal boarder (AKA) base of the heart
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| Pulmonic area = ? | 2 or 3 ICS @ left sternal boarder (AKA) base of heart
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| Erb's Point =? | 3-5 ics @ L sternal boarder
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| Tricuspid area =? | 4 or 5 intercoastal space @ lower left sternal boarder
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| Mitral (Apical) pulse = | 5 intercoastal space near midclivicular line
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| 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
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| 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.
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