1c Health Assessment

What is the main job of the cardiovascular system?

Maintain perfusion, deliver oxygen/nutrients, and remove waste.

The heart needs adequate blood volume + contractility to pump effectively.

Memory phrase: Fluid + squeeze = perfusion.

What are the 4 chambers, and what does each side of the heart do?

RA = receives blood returning to the heart.
RV = sends blood toward the lungs.
LA = receives blood returning from the lungs.
LV = sends blood through the aorta to the body.

Memory phrase: Right → lungs. Left → body.

What are the 4 valves and where are they located?

Tricuspid = RA → RV
Pulmonic = RV → lungs
Mitral = LA → LV
Aortic = LV → aorta/body

Valves act as one-way doors that prevent backflow.

Memory phrase: T → P → M → A.

What is the complete path of blood through the heart?

Body → RA → Tricuspid → RV → Pulmonic → Lungs → LA → Mitral → LV → Aortic valve → Aorta → Body.

Memory phrase: Body → Right → Lungs → Left → Body.

Valve order: T → P → M → A.

AV valves vs. semilunar valves?

AV valves = Tricuspid + Mitral → between atria and ventricles.

Semilunar valves = Pulmonic + Aortic → between ventricles and great vessels.

Memory phrase: AV = T&M; SL = P&A.

What structures make up the heart’s electrical conduction system?

SA node, AV node, Bundle of His, bundle branches, and Purkinje fibers.

Electrical impulses cause the heart muscle to contract.

Memory phrase: SA/AV → His → Branches → Purkinje.

What does an ECG do?

Records the heart's electrical activity.

Can detect arrhythmias, heart attack, and other abnormalities.

Where is the Point of Maximal Impulse (PMI), and why is it important?

5th intercostal space, midclavicular line.

It is the apex of the heart, the site for the apical pulse, and the mitral area.

Normal diameter is <2.5 cm.

Displaced left or enlarged PMI may indicate cardiac enlargement.

Memory phrase: PMI = 5th ICS + MCL + Mitral.

What causes S1 and S2, and where are they heard best?

S1 = mitral + tricuspid close → “lub” → louder at mitral/tricuspid areas.

S2 = aortic + pulmonic close → “dub” → louder at aortic/pulmonic areas.

Normal heart sound will be “lub, dub, lub, dub,” and so on.

Use the diaphragm.

Memory phrase: S1 = AV close; S2 = semilunar close.

What are S3 and S4?

Low-pitched extra heart sounds that can be pathologic.

Use the bell to hear them.

Extra heart sounds are abnormal like swoosh, dub or lub, dub, dub, you only want to hear lub, dub

Memory phrase: Extra low sounds = bell.

Murmur vs. thrill vs. bruit?

Murmur = blowing/swooshing sound from turbulent blood flow in the heart.

Thrill = palpable vibration over the precordium from turbulent flow.

Bruit = swooshing sound from turbulent flow in a blood vessel.

Memory phrase: Murmur = heart hear; Thrill = heart feel; Bruit = vessel hear.

What can cause a heart murmur?

Increased blood-flow velocity, valve defects/malfunctions, or abnormal chamber openings such as ASD/VSD.

Murmurs may be benign or pathologic.

What is a heave/lift and what can it indicate?

A forceful outward movement of the chest wall.

May indicate ventricular enlargement.

Memory phrase: Heave = enlarged ventricle pushing outward.

How should the carotid arteries be assessed?

Palpate gently one at a time.

Assess rhythm and strength.

For auscultation, listen with the bell for a bruit while the patient briefly holds their breath.

Memory phrase: Carotids = one at a time.

How do you assess the jugular vein, what is abnormal, what does it indicate?

Observe at about 30°.

No bulging/distention should be present above 45°.

JVD at 45° or greater suggests right-sided heart failure.

Memory phrase: JVD = Right-sided failure.

What is congestive heart failure (CHF)?

The heart cannot pump enough blood to meet the body's needs → poor circulation + fluid overload.

Left-sided failure = fluid in lungs.

Right-sided failure = fluid in body.

Memory phrase: Left = lungs; Right = rest.

What findings suggest a DVT?

Usually unilateral:

Pain
Swelling
Redness
Warmth

A clot can travel to the lungs and become life-threatening.

Memory phrase: One hot, red, swollen, painful leg = DVT.

What is atherosclerosis, and how does it relate to CAD?

Atherosclerosis = plaque buildup → arteries become thick/stiff.

CAD = coronary arteries become narrowed or blocked → can cause MI.

Memory phrase: Plaque → narrowing → less blood → heart attack risk.

What symptoms should make you think of a cardiac or vascular problem?

Chest pain, palpitations, dizziness, shortness of breath, fatigue, edema, varicose veins, and claudication.

Claudication = leg pain from too little blood flow during activity.

What is the pulse-strength scale?

3+ = bounding
2+ = expected/normal
1+ = diminished
0 = absent

Memory phrase: 2+ = normal. Nurs2144 Lecture Week 10 - Card…

What peripheral pulses should you know?

Radial
Brachial
Femoral
Popliteal
Posterior tibial
Dorsalis pedis

Memory phrase: Arm → groin → knee → ankle → foot.

What is a pulse deficit?

Difference between the apical heartbeat heard and radial pulse felt.

It means some heartbeats are not effectively reaching the peripheral arteries.

Apical pulse should be counted for 60 seconds.

What findings suggest poor peripheral perfusion?

Pallor, cyanosis, cool skin, weak/absent pulses, delayed capillary refill, skin ulcers, or clubbing.

Memory phrase: Pale + cool + weak pulse = poor perfusion.

What is normal capillary refill?

Less than 2 seconds.

It assesses circulation to the extremities.

Memory phrase: Cap refill <2 sec. Nurs2144 Lecture Week 10 - Card…

How do you assess extremity temperature?

Use the back of your hands.

Cool extremities may indicate poor perfusion.

What does Allen’s test assess?

Blood flow to the hand.

Occlude radial + ulnar arteries → release ulnar artery → color should return within 3–5 seconds.

Memory phrase: Allen = hand circulation, 3–5 sec.

What are the 3 layers of the heart?

Epicardium = outer protective layer.
Myocardium = muscular middle layer.
Endocardium = thin inner layer.

Memory phrase: E-M-E = outer → muscle → inner.

What features are used to describe a heart murmur?

iming, location where it is loudest, shape, intensity, and quality.

It may crescendo (get louder) or decrescendo (get softer).

Memory phrase: When? Where? Shape? How loud? What quality?

What cardiovascular changes are noted with pregnancy and aging?

Pregnancy = blood volume increases about 40–50%, which can contribute to weight gain/swelling.

Older adults = arteries become stiffer from calcification, systolic BP tends to rise, and the left ventricular wall becomes thicker.

What are the 5 cardiac auscultation sites and where are they?

Aortic = 2nd ICS, right sternal border
Pulmonic = 2nd ICS, left sternal border
Erb’s point = 3rd ICS, left sternal border
Tricuspid = 4th–5th ICS, left sternal border
Mitral = 5th ICS, left midclavicular line

Listen in a rough Z pattern from base → apex.

Memory phrase: A-P-E-T-M.

How can DVTs be prevented?

Early ambulation, frequent leg movement/exercises, avoid prolonged immobility, stay hydrated, use compression devices/stockings if ordered, and give anticoagulants if prescribed for high-risk patients.

Memory phrase: Move, hydrate, compress, anticoagulate.

Also remember: once a DVT is suspected, do not massage the leg, because the clot could dislodge and travel to the lungs.

This prevention part is outside your professor’s slide deck, but it is standard nursing knowledge and fits the test topic she listed.