NRSG 3323 Lecture Notes - Lecture 5: Peripheral Artery Disease, Palpation, Undressed
1 Dec 2017
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Lab skills: practice obtaining a cv assessment health history, practice cv physical assessment using lab guide provided, 16-4 obtaining an ecg. The patient must be properly undressed and in a gown for this examination. Tangential lighting (a method of directing light from an adjustable lamp at a right angle to the area being observed) will make pulsations and slight movements more visible. The examination room must be quiet to perform adequate auscultation. Make sure room and stethoscope are warm. General sequence for cardiac exam includes inspection, palpation and auscultation. Apical impulse (pmi): 4th ics (children) or 5th ics mcl (adults). May not be seen due to breast tissue or muscle. Abnormal: strong pulsation such as heaves or lifts. (strong visible movement of. Abnormal: strong pulsation or absent. (may indicate stenosis) At 45 degree angle, pulsations are normally visible bilaterally and equal.
