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Cardiovascular assessment

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Cardiovascular assessment. Objectives. At the end of session the student will be able to: 1. Review cardiovascular anatomy and physiology. 2. Identify landmarks for cardiovascular assessment. 3. Identify major techniques for cardiovascular assessment. - Inspection. - Palpation.

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objectives
Objectives

At the end of session the student will be able to:

1. Review cardiovascular anatomy and physiology.

2. Identify landmarks for cardiovascular assessment.

3. Identify major techniques for cardiovascular assessment.

- Inspection.

- Palpation.

- Auscultation.

4. Identify assessment techniques for peripheral vascular system.

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General Considerations

  • The patient must be properly undressed and in a gown for this examination. .
  • The examination room must be quiet to perform adequate auscultation. .
  • Observe the patient for general signs of cardiovascular disease (finger clubbing, cyanosis, edema, etc.).
landmarks for cardiovascular assessment
Landmarks for cardiovascular assessment

1. Sternum

2. Clavicles

3. Ribs

inspection
Inspection

1. Position the client.

2. Inspect the client’s face, lips, ears and scalp.

3. Inspect the jugular veins.

4. Inspect the carotid arteries.

5. Inspect the client hands and fingers, legs.

6. Inspect the chest, abdomin.

palpation
Palpation

1. Palpate the chest in the five key landmarks.

2. Palpate the client’s carotid pulses.

3. Palpate for hepatojugular reflux.

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Auscultation

  • Position the patient supine with the head of the table slightly elevated.
  • Always examine from the patient's right side. A quiet room is essential.
  • Listen with the diaphragm at the right 2nd intercostal near the sternum (aortic area).
  • Listen with the diaphragm at the left 2nd intercostal near the sternum (pulmonic area).
  • Listen with the diaphragm at the left 3rd, 4th, and 5th interspaces near the sternum (tricuspid area).
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Listen with the diaphragm at the apex (mitral area).
  • Listen with the bell at the apex.
  • Listen with the bell at the left 4th and 5th intercostal near the sternum.
  • Have the patient roll on their left side.
    • Listen with the bell at the apex.
    • This position brings out S3 and mitral murmurs.
  • Have the patient sit up, lean forward, and hold their breath in exhalation.
    • Listen with the diaphragm at the left 3rd and 4th intercostal near the sternum.
    • This position brings out aortic murmurs.
  • Record S1, S2.
  • Auscultate the carotid arteries.
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S 1 “lub” is caused by closing of the mitral and tricuspid valves.
  • S 2 “dub” is caused by closing of the aortic and the pulmonic valves.
assessing the peripheral vascular system
Assessing the peripheral vascular system

1. Blood pressure.

2. Palpate peripheral pulses and compare both sides of the body.

* Rate and Rhythm.

* Volume and Character.

3. Inspect for presence of edema.

references
References

1. Lynm S.Bickley Bates’ guide to Physical examination and history taking. 7th ed (1999) Lippincott

2. John F Munro, Lan W Campbell. Macleod’s clinical examination. 10th ed (2000)

3. Lina K.Sims Health assessment in nursing (1995) by Addison – Wesley publishing company.