Heart, Lungs, and Peripheral Vessels

Respiratory Assessment Subjective Data

Cough, shortness of breath, chest pains, history of infections, smoking history, and environmental exposure (work environment, harsh chemicals, smoke, etc)

Inspection of Respiratory System

Shape and configuration, patient's facial expression, LOC, Skin color/condition, and quality of respirations (effort, symmetry, accessory muscle usage.)

Auscultation of Respiratory System

Evaluate Bilaterally as well as anterior and posterior sides

One full breath at each location, deciphering if normal or abnormal sounds (adventitious sounds)

When assessing a person with breast tissue that may interfere with ausculation, displace breast tissue as necessary

Adventitious Sounds

Any abnormal respiratory sounds. Crackles (rales), Wheezing, or Rhonci

Auscultatory Areas Respiratory System (Posterior)

Auscultatory Areas Respiratory System (Anterior)

Pulmonary Function Measurement

Incentive Spirometer (Inhalation Exercise)

Pulse Oximeter (Hemoglobin Saturation)

6-Minute Walk Test (6MWT)

Cardiac Blood Flow

1. superior and inferior caval veins

2. rt atrium

3. tricuspid valve

4. rt ventricle

5. pulmonic valve

6. pulmonary artery

7. lungs

8. pulmonary veins

9. lt atrium

10. mitral valve

11. lt ventricle

12. aortic valve

13. aorta

14. body

Cardiac Conduction

SA node: "pacemaker" intrinsic rate of 60-100 bpm

AV node: 40-60 bpm

Purkinje Fibers: 20-40 bpm

Rhythmicity

Regular generation of an action potential by the heart's conduction system

Automaticity

The ability of the heart to generate and conduct electrical impulses on its own.

Auscultatory Areas

APE To Man: Aortic, Pulmonic, Erb's point, Tricuspid, Mitral

Lower Extremity Arteries

Lower Extremity Veins

Arteries in the Arm

Peripheral Vasculature: Arteries

- Delivers oxygen + nutrients

- High-pressure

- Accessible to Examination: Temporal, Carotid, Brachial, Radial, Femoral, Popliteal, Dorsalis Pedis, Posterior Tibial

Peripheral Vasculature: Veins

- More veins than arteries

- Goes back to the heart by returning mostly deoxygenated blood and its waste products

- Low Pressure System

Inspection and Palpation of Peripheral Vasculature: Upper Extremities

- Lift the person's hands in your hands, inspect color, temperature, texture, and turgor

- Note the presence of lesions, edema, orc lubbing

- Check capillary refill

- Radial and brachial pulse (grade-amplitude)

Inspection and Palpation of Peripheral Vasculature: Lower Extremities

- Uncover Legs; DO NOT uncover genitalia

- Assess for Edema

- Skin

- PT and DP Pulses (Can use doppler)

- Monofilament Test

Edema

Abnormal accumulation of fluid in interstitial spaces of tissues.

Pneumothorax

Air in the pleural cavity caused by a puncture of the lung or chest wall