The First Step is
Heart Inspection I 1/7
Heart Inspection I 2/7
Position and Comfort Level
Heart Inspection I 3/7
Heart Inspection I 4/7
Skin color and condition
Heart Inspection I 5/7
Heart Inspection I 6/7
Dyspnea, Orthopnea
Difficult or labored breathing
Breathing is easier in an upright position. “How many Pillows”
Heart Inspection I 7/7
Carotid Arteries
Carotid Assesment Step 1/3
Inspection; located inbetween the Trachea an the sternomastois muscle (should not be visible)
Carotid Assesment Step 2/3
Palpation; palpate each artery soflty, one at a time. Feel for contour and amplitude. Smooth with a rapid upstroke and slower downstroke. Should have a normal grade of 2.
Carotid assesment 3/3
Auscultation; place bell of stethoscope at: 1. the angle of the jaw. 2. midcervical area 3. Abse of teh neck. Instruct patient to hold breath, you should hear nothing.
After corotid inspection is…
Jugular assesment
Inspection:Look for Central venous pressure. Pt should be in supine postion, have pt turn thier head and watch thier JV distend. look for regular pulsations.
After the Jugular vein you assess
The Pericordium (part 1)
When first assessing the pericordium we first
Inspect/ palpate the following: Thrills, Chest wall pulsations, Heave or lift, Apical Impulse.
Pericordium Assesment 1/4
Thrills: Vibration staht signify turbulent blood flow
Pericordium Assesment 2/4
Chest Wall Pulsations: pulsations of the wall not always visible. should be located in the same area as the apical pulse.
Pericordium Assesment 3/4
Heave or lift: abnormal pulstaion at the left sternal border or apex. sign of an ventricular hypertrophy
Pericordium Assesment 4/4
Apical Impulse: located at the same spot as apical pulse. ( patient may need to be rolled onto side). ask pt. to exhale and hold it. Note Location Size Amplitude and Duration
Pericordium (part 2)
INSPECTION (but really auscultation)
Heart inspection II 1/4
THE “Z”, APe To Man: locate the aortic pulmonic Tricuspid Mitral areas.
The “Z”
Heart inspection II 2/4
Locate APICAL PULSE. Assess for rate rhythym and quality
Heart inspection II 3/4
S1/S2 S1:best heard at apex S2: Best heard at the base.
Heart inspection II 4/4
Check for pulse deficits = radial – apical. suggests weak contraction of ventricles.