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Cardiovascular SystemMedical Surgical Nursing

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Which heart sound can be a clue of left side ventricular failure, volume overload, mitral, tricuspid or aortic regurgitation or hypertension?
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S3-heard in early diastole, a galloping sound
Which heart sound can be a clue of a condition increasing vascular resistance like left ventricular hypertrophy, aortic stenosis, hypertension, or CAD?
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S4-heard in late diastole
What position is it best for a patient to be in when listening for a pericardial friction rub?
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Sitting, leaning forward and at the end of expiration.
Which part of the heart is it easiest to hear a pericardial friction rub?
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At the apex, during S1 or S2
Heaves are usually caused by...
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Left Ventricular Hypertrophy
Which part of the heart should you listen to (base or apex?) to best hear the aortic and pulmonic areas?
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The base (top)
Which part of the heart should you listen to (base or apex?) to best hear the tricuspid and mitral areas?
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The apex (bottom)
S1 indicates closure of the _______ valves.
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AV valves (tricuspid/mitral)
S2 indicates closure of the _______ valves.
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Semilunar (aortic/pulmonic)
Systole or Diastole? S1
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Beginning of systole
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Systole or Diastole? S2
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Beginning of diastole
The diaphragm of the stethoscope is used to hear which two heart sounds?
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S1 and S2-high pitched
The bell of the stethoscope is used to hear which two heart sounds?
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S3 and S4 (low pitched)
Which position is best for listening to a patient's mitral valve?
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Left Lateral decubitus
What is a pulse deficit and how is it detected?
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A pulse deficit is the difference between the radial pulse rate and apical pulse rate. It is assessed by palpating both at the same time. Two nurses are required if the pulses are very different.
You are listening to a patient's carotid artery. You know the carotid pulse corresponds with ventricular contraction and therefore occurs the same time as what heart sound?
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S1-this can be used to differentiate S1 from S2
You hear a splitting of S2 at the pulmonic area while a patient breathes in. Is this a normal finding?
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Yes
You hear a splitting of S2 at the pulmonic area while a patient breathes out. Is this a normal finding?
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No, this is an abnormal finding
Ventricular gallop is another word for what heart sound?
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S3
Atrial gallop is another name for what heart sound?
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S4
You have a 20 year old male in your clinic. You are assessing his cardiac sounds and hear an S3. Is this a normal finding?
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It can be normal in young adults, it is pathologic when there is mitral valve regurgitation or left ventricular failure
  
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