Cardiovascular Assessment N232

Inspect Precordium

stand on the right side of the patient and visually examine the left chest over the heart for any visible pulsations lifts or abnormal movement I am inspecting the precordium for visible pulsations

Palpate Thrills and Heaves

place the palm or ulnar surface of your hand over the chest wall and gently feel for vibrations or lifting sensations that may indicate turbulent blood flow or heart enlargement I am palpating for thrills and heavesPMI

Auscultate S1 and S2

place the diaphragm of the stethoscope firmly on all five cardiac areas in order and listen for normal lub dub sounds and rhythm I am auscultating all five cardiac areas using the diaphragm for S1 and S2

Heart Rate and Rhythm

keep the diaphragm at the apical area and listen carefully to determine if the rhythm is regular and rate is normal I am assessing heart rate and rhythm at the apical area

Auscultate S3 S4 and Murmurs

use the bell lightly over all five cardiac areas to listen for low pitched abnormal sounds such as extra heart sounds or murmurs I am auscultating all five areas with the bell for S3 S4 and murmurs

Left Lateral Position

assist the patient into a left side lying position and place the bell at the apex to better hear low pitched heart sounds I am positioning the patient in the left lateral position to auscultate the apex

Leaning Forward Position

have the patient sit up and lean forward slightly while placing the diaphragm over the aortic and pulmonic areas to assess for murmurs I am having the patient sit up and lean forward to auscultate the aortic and pulmonic areas00