35 Questions
What is the sac that surrounds and protects the heart called?
Pericardium
Which direction best describes the flow of blood through the heart?
Right atrium right ventricle pulmonary artery lungs pulmonary vein left atrium left ventricle
What is meant by atrial kick in the context of the heart's anatomy and physiologic functioning?
A boost in blood volume caused by atrial contraction
What can be inferred from the findings of an S3, a soft murmur at the left midsternal border, and a venous hum when auscultating a 7-year-old child?
The findings can all be normal in a child.
What is the significance of a soft murmur at the left midsternal border when auscultating a 7-year-old child?
It is likely to be a normal finding in a child.
What is the most probable interpretation of a venous hum when a 7-year-old child is standing?
It is a common and normal finding in healthy children.
Where is the correct location to palpate the apical impulse in a healthy adult?
Fifth left intercostal space, medial to the midclavicular line
In which pattern should the stethoscope be moved for correct technique in auscultating heart sounds?
Rough Z pattern from the base of the heart across and down, then over to the apex
What is likely the cause of an irregular rhythm in a 16-year-old patient, with a rate that speeds up on inspiration and slows on expiration?
Sinus arrhythmia, normal in young adults and children
Which sound marks the start of systole and is louder than S2 at the apex of the heart?
S1 coinciding with the carotid artery pulse
How should the nurse further assess a sound occurring after S2 at the second left intercostal space?
Watch the patient's respirations while listening for the effect on the sound, as it could be a split S2
Where would the nurse expect to notice an innocent or functional murmur during a cardiac assessment on a 4-year-old child?
Second or third left intercostal space
During which phase of the cardiac cycle does atrial contraction occur?
Diastole
What is the function of the atrial kick in the cardiac cycle?
Pushing the last 25% of blood into the ventricles
When does the second heart sound occur?
With the closure of semilunar valves
Which valve closes slightly later in a normal cardiac cycle?
Tricuspid valve
Which structure serves as the pacemaker of the heart?
Sinoatrial (SA) node
What is the sequence of the electrical stimulus in the cardiac cycle?
SA node, AV node, bundle of His, bundle branches
What does elevated jugular venous pulsation at 45 degrees indicate?
Elevated pressure related to heart failure
In a newborn, where can blood flow into the left side of the heart?
Through an opening in the atrial septum
When does the foramen ovale close after birth?
Within the first hour
What happens to arterial blood pressure during pregnancy?
It decreases due to peripheral vasodilatation
When does blood pressure drop to its lowest point during pregnancy?
During the second trimester
Which of the following is a major risk factor for heart disease?
Elevated serum cholesterol
What is an expected change in blood pressure due to aging?
Increase in systolic blood pressure
What is a characteristic of paroxysmal nocturnal dyspnea?
Shortness of breath at night aggravated by lying down
What should the nurse auscultate for when assessing carotid arteries in a patient with cardiovascular disease?
Bruits
What does a blowing, swishing sound over the carotid artery with a stethoscope bell indicate?
Blood flow turbulence, suggesting a valvular disorder
What does forceful movement of the chest along the sternal border during inspection of the precordium suggest?
Right ventricular hypertrophy
What may difficulty sleeping and waking up breathless indicate in a 45-year-old man?
Paroxysmal nocturnal dyspnea, indicative of heart failure
What should the nurse collect data regarding to assess for major risk factors of coronary artery disease?
Elevated serum cholesterol
What are signs of heart disease in infants during feeding?
Dyspnea, diaphoresis, and fatigue
What should the nurse avoid doing when assessing carotid arteries to prevent an artificial bruit?
Compressing the artery
What is a blowing, swishing sound over the carotid artery with a stethoscope bell indicative of?
Blood flow turbulence, suggesting a valvular disorder
What does a forceful movement of the chest along the sternal border suggest during inspection of the precordium?
Right ventricular hypertrophy
Study Notes
Cardiac Cycle and Heart Sounds
- Atrial contraction during diastole can be felt as a palpitation
- Atrial kick is the pressure exerted against the atria during ventricular contraction
- Atria contract at the end of diastole, pushing the last 25% of blood into the ventricles
- The second heart sound is loudest at the base of the heart and occurs with the closure of semilunar valves
- The tricuspid valve closes slightly later than the mitral valve in a normal cardiac cycle
- The sinoatrial (SA) node is the pacemaker of the heart
- The electrical stimulus of the cardiac cycle follows the sequence: SA node, AV node, bundle of His, bundle branches
- Elevated jugular venous pulsation at 45 degrees indicates elevated pressure related to heart failure
- In a newborn, blood can flow into the left side of the heart through an opening in the atrial septum
- The foramen ovale closes within the first hour after birth
- During pregnancy, arterial blood pressure decreases due to peripheral vasodilatation
- Blood pressure drops to its lowest point during the second trimester of pregnancy
Assessment of Cardiovascular Health
- A 70-year-old man exhibits a blood pressure of 140/100 mm Hg, heart rate of 104 beats per minute, and a split S2 heart sound, indicating an expected increase in systolic blood pressure due to aging.
- Paroxysmal nocturnal dyspnea, which occurs with heart failure, is characterized by shortness of breath at night and is aggravated by lying down.
- Major risk factors for heart disease include elevated serum cholesterol, elevated blood pressure, diabetes, obesity, smoking, and low activity level.
- In infants, signs of heart disease during feeding include dyspnea, diaphoresis, and fatigue.
- When assessing carotid arteries in a patient with cardiovascular disease, the nurse should auscultate for bruits and avoid compressing the artery to prevent an artificial bruit.
- A blowing, swishing sound over the carotid artery with a stethoscope bell indicates blood flow turbulence, suggesting a valvular disorder.
- Forceful movement of the chest along the sternal border during inspection of the precordium suggests right ventricular hypertrophy, while an apical impulse at the fourth or fifth intercostal space indicates normal heart function.
- A 45-year-old man experiencing difficulty sleeping and waking up breathless may be exhibiting signs of paroxysmal nocturnal dyspnea, which is indicative of heart failure.
- To assess for major risk factors of coronary artery disease, the nurse should collect data regarding elevated serum cholesterol, elevated blood pressure, diabetes, obesity, smoking, and low activity level.
- Signs of heart disease in infants during feeding include dyspnea, diaphoresis, and fatigue.
- When assessing carotid arteries, the nurse should auscultate for bruits and avoid compressing the artery to prevent an artificial bruit.
- A blowing, swishing sound over the carotid artery with a stethoscope bell indicates blood flow turbulence, suggesting a valvular disorder.
Test your knowledge of the cardiac cycle, heart sounds, and assessment of cardiovascular health with this quiz. Explore key concepts such as atrial contraction, heart murmurs, risk factors for heart disease, and signs of heart disease in infants and adults.
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