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NURS 3715- Clinical Integration III- Week One Exam
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NURS 3715- Clinical Integration III- Week One Exam...
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NURS 3715- Clinical Integration III- Week One ExamWhere are the 5 areas of the heart?
- aortic valve: 2nd ICS: Rt sternal border
- pulmonic valve: 2nd ICS left sternal border
- Erbs point: 3rd ICS left sternal border
- tricuspid valve: 4th ICS left sternal border
- Mitral valve: 5th ICS left MCL (also where PMI is palpated)
What are contraindications to obtaining a blood pressure?
Extremity when IV fluids are infusing, ateriovenous shunt or fistula, or a breast or
axillary surgery has been performed. Also, don't apply the cuff to an extremity with
trauma.
What should you do if a patient's blood pressure is high?
Repeat measurement in opposite extremity and compare the measurements. Have
another nurse repeat BP in 1-2 min. If still high assess for associated signs and
symptoms, report to charge nurse and implement orders from provider.
What to do if BP low?
Place patient in supine position, limit activity, assess, report to charge nurse, and
implement orders.
What is a special consideration with critically ill patients, or those with peripheral
vascular disease, when taking BP?
Compare readings in both arms, both legs, or all four extremities. If using upper
extremities, use the pressure that is higher.
, What is systole?
Ventricular contraction of the heart forces blood into the aorta. This is the first sound.
What is diastole?
When the ventricles relax, blood left over in the arteries always pushes on the arterial
walls with a small pressure. This is the origin of the fifth sound.
Pulse pressure
Difference between systolic and diastolic pressure.
Position of pt's arm when blood pressure is taken
Pt should be seated or supine; forearm should be positioned at a level equal to the heart
with palm facing upwards. Feet should be flat on the floor without crossing legs.
To what should the BP cuff be inflated?
30mmHg above the patient's normal value.
What do the BP sounds sound like w/ peds?
They are hard to hear in kids due to low frequency and amplitude. Use the bell and the
4th Korotkoff sound (muffled) represents the diastolic pressure.
What is pseudohypertension?
The presence of arteriosclerosis related to decreased vessel elasticity leads to inability
of the BP cuff to adequately compress arteries, thus providing elevated systolic
pressure readings.
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