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fifth intercostal space on the left location of the heart 

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fifth intercostal space on the left location of the heart 

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If pain is better when walking = arterial

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Ultrasound used to detect blood flow in a blood vessel

Very useful when suspected PAD

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Palpate for bitting edema
Temperature bilaterally
Capillary refill
Gout
Listen to tibial dorsal brochial ulna and radial bilaterally

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Parallel the arteries

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Assess pulse bilaterally (radial, brachial, femoral, popliteal(if painful stop), posterior tibialis, dorsalis pedis)

Don’t usually assess ulnar pulse

Rate, rhythm, force

Doppler if pulse not palpable

Edema, pitting, non-pitting

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Obtain information on if older adult has mobility aid, hearing aid or vision problems

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CTEMPS
Color
Temperature
Edema
Movement
Pulse
Sensation

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If pain is better when laying = venous

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Swollen legs at end of day
Pain with acitivity , often aching

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-when assessing carotid arteries of an older adult with cardiovascular disease listen with the bell of the stethoscope to auscultate for bruits
-use caution when palpating and auscultating the carotid artery
-Avoid pressure in the carotid sinus area ( could cause reflex, slowing the heart rate)
-Pressure on carotid can compromise circulation that may already be narrowed by atherosclerosis
-fatigue in evening could be result of decreased cardiac output

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Carries oxygenated blood away from the heart

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Ask about
- leg cramps
- swelling
- any medication
- skin changes
- cold feet/hands

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S1 is louder in the dub where it’s found in the Triscubed and mitral valve (Abical)

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Access temp bilaterally with back of hands

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Cough
Goat
Bloodpressure

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Fatigue

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-safety- positioning, comfort, privacy, ID X2 & intro, consent
-Assess VS first- TPR, BP, O2, sat, pulse
-Apical rate- 30 sec unless abnormal or irregular
-extremities
-neck
-precordium

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Parallels the arteries

Lie closer to the skin surface

Carry deoxygenated blood & waste products from tissues

Low pressure system

Flow via skeletal muscles contraction, intraluminal valves, and pressure gradient by breathing

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Normal grading for arterial pulse is +1

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Order to obtain objective information
1. vitals
2. Extremities
3. Carotid/jugular assessment
4. Pericardium

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Lymphatics: retrieves excess fluid from tissues and returns it to blood stream.

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Dorsalis pedialis, posterior tibialis

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Chest pain

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Ask if they have dyspnea

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S1 is louder than S2 at the apex; S2 is louder than S1 at the base

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right side heart failure could lead to liver/kidney problems/edema in lower extremities

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right side heart failure could lead to liver/kidney problems/edema in lower extremities

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Ask about family history of CVD, hypertension, stroke 

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Ask about family history of CVD, hypertension, stroke 

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Ask if about diet ( if it’s high fat)
Ask about exercise habits
Ask about fatigue
Ask about chest pain

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S1 louder in the tricuspid and mitral sites
S2 louder in the atrial and pulmonic sites
S3, S4 not heard
Heart sounds rhythmic and regular

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Carry deoxygenated blood from tissue to heart

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S1 coincide with the R wave

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S3 and S4 sounds should not be audible

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Leg pain or cramps (swelling, blockages)

Skin changes of extremities (pale legs)

Edema

Lymph node enlargement

Personal habits (sedentary, obesity, genetics, pregnancy, smoking, diet)

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Narrowing of arteries means lower oxygen to extremities

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Carry oxygenated blood

Strong, tough, can withstand higher pressure

More elastic fibres to stretch with systole & diastole

Vascular smooth muscle contracts and dilated to control blood flow

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Precordium is symmetrical, no visible pulsation, no cyanosis
No peripheral edema

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AP 1:1

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Capillary refill in all 20 digits

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Doppler is used to listen for arterial flow of posterior tibial and dorsalis pedis

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Idk