Module 2: Cardiovascular Assessment - Nursing Skills Theory 3

Vocabulary-style flashcards covering the subjective and objective components of a focused cardiovascular nursing assessment, including heart sounds, landmarks, and neck vessel evaluation.

Subjective Data

Information collected during the assessment process by asking the patient about chest pain, dyspnea, orthopnea, cough, fatigue, color (cyanosis, pallor), nocturia, cardiac history, personal habits, and medications.

Objective Data

Information gathered through physical assessment of the heart, neck vessels, and periphery, ideally performed with the patient's chest exposed and comparing extremities bilaterally.

Precordium

The area of the chest that directly covers the heart, major vessels, and thorax.

Apical impulse (PMI)

Also known as the point of maximum impulse, it is palpated at the midclavicular line in the $5^{th}$ intercostal space (ICS) using the fingertips.

Thrill

A continuous vibration similar to a purring cat’s throat, palpated using the proximal portion of four fingers; the most common cause is aortic stenosis.

Thrust (Heave or Lift)

A palpable pulsation that lifts the heel of the hand with each heartbeat; it occurs at the left sternal border with right ventricular hypertrophy and at the apex with left ventricular hypertrophy.

S1

The first heart sound, characterized as a low, dull "lub" sound caused by blood movement through valves and chambers.

S2

The second heart sound, characterized as a higher pitched, short "dub" sound.

S3

An extra heart sound that sounds like "lub-dub-ee"; it may indicate dilated, weak, or "floppy" ventricles, and is associated with systolic heart failure or volume overload.

S4

An extra heart sound heard just before S1 that sounds like "dee-lub-dub"; it indicates blood pushing into a noncompliant or "stiff" ventricle, often due to chronic hypertension or diastolic heart failure.

Aortic Landmark

The auscultation site located at the right $2^{nd}$ intercostal space.

Pulmonic Landmark

The auscultation site located at the left $2^{nd}$ intercostal space.

Erb's point

The auscultation site located at the left $3^{rd}$ intercostal space where both S1 and S2 can be heard.

Tricuspid Landmark

The auscultation site located at the lower left sternal border in the $4^{th}$ intercostal space.

Mitral Landmark

The auscultation site located at the left $5^{th}$ intercostal space, medial to the midclavicular line.

Murmurs

Extra heart sounds described as blowing or swooshing, caused by rough and forceful blood flow from valve abnormalities or backflow.

Diaphragm (Stethoscope)

The part of the stethoscope used to auscultate the five landmark locations to identify rhythm and normal S1 and S2 sounds.

Bell (Stethoscope)

The part of the stethoscope used to listen for extra heart sounds (S3 and S4), murmurs, and carotid bruits.

Distended jugular vein

An abnormal finding characterized by bulging on the side of the neck, which can indicate right sided heart failure or fluid overload.

Bruit

A blowing, swishing sound caused by turbulent blood flow through a narrowed artery, identified by auscultating the carotid artery with the bell while the patient holds their breath.

Carotid Sinus

An area in the upper half of the carotid artery that should not be compressed during palpation, as it can cause a decrease in heart rate, decrease in BP, and syncope.