Overview
This lecture demonstrates how to perform a focused cardiovascular assessment, including heart sounds, peripheral pulses, and related physical examination steps.
Introduction to Focused Cardiovascular Assessment
- The cardiovascular assessment is performed in a head-to-toe fashion, focusing on heart and peripheral circulation.
- Important to assess heart sounds at all cardiac landmarks.
- Assessment includes checking peripheral pulses in both upper and lower extremities, carotids, abdominal, and possibly renal arteries.
Patient Interview and Preparation
- Begin with patient identification and orientation questions (name, date, location, reason for visit).
- Explain procedure and obtain patient consent.
- Perform hand hygiene before starting the assessment.
Carotid and Heart Assessment
- Palpate carotid arteries one side at a time to assess pulse.
- Auscultate carotid arteries for bruits (abnormal sounds indicating turbulent blood flow), asking patient to hold breath briefly.
- Auscultate heart sounds over appropriate chest landmarks with the patient breathing normally.
Lung and Skin Assessment
- Listen to lung sounds with the stethoscope on the skin, instructing the patient to take deep breaths.
- Inspect the back for redness or pressure areas, ensuring adequate skin care (e.g., offloading with pillows).
Abdominal Assessment
- Auscultate abdominal arteries for vascular sounds.
- Listen to bowel sounds and inquire about recent bowel movements.
- Palpate the abdomen for tenderness and check for bladder distention.
Peripheral Circulation Assessment
- Assess upper extremities: check hand strength, circulation, and peripheral pulses (radial, brachial).
- Assess femoral pulses in the groin area, maintaining patient privacy.
- Assess lower extremity pulses and circulation.
- Evaluate lower limb muscle strength and movement (push/pull against resistance).
- Check for edema (swelling) in the shins.
Conclusion
- Thank patient and explain that assessment is complete.
- Encourage viewing related assessment videos for other body systems.
Key Terms & Definitions
- Focused Cardiovascular Assessment — An in-depth evaluation of the heart and blood vessels.
- Bruit — Abnormal vascular sound heard with a stethoscope over an artery, indicating turbulent blood flow.
- Palpation — Using hands to examine body parts and assess pulses or tenderness.
- Auscultation — Listening to internal sounds, usually with a stethoscope.
Action Items / Next Steps
- Watch additional physical assessment videos on other body systems in the series.
- Practice performing the steps of a focused cardiovascular assessment.