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Exam 3 NURS 630 (cardiac, mental health, MS, HA, metabolic) questions with correct answers
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Exam 3 NURS 630 (cardiac, mental health, MS, HA, metabolic) questions with correct answers
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Exam 3 NURS 630 (cardiac, mental health, MS, HA,metabolic) questions with correct answers
• Murmur grading:
o Grade I: Correct Answer-Barely audible; heard faintly after a period of
attentive listening
• Murmur grading:
o Grade II: Correct Answer-Soft but easily audible
• Murmur grading:
o Grade III:
o Grade IV: Loud, present over widespread area; no thrill Grade V:
Loud, audible with stethoscope barely on the chest; precordial thrill
present
o Grade VI: Heard without stethoscope (rare) Correct Answer-
Moderately loud; no thrill
• Murmur grading: o Grade IV: Correct Answer-Loud, present over
widespread area; no thrill
• Murmur grading:
Grade V: Correct Answer-Loud, audible with stethoscope barely on the
chest; precordial thrill present
• Murmur grading:
,o Grade VI: Correct Answer-Heard without stethoscope (rare)
• Innocent murmurs
• Important questions to ask? Correct Answer-- Any shortness of breath
with exercise?
- Any dizziness or syncope with exercise?
- Any family history of sudden cardiac death?
murmur work up and restrictions Correct Answer-- Cardiac consultation
- Echocardiogram
- No sports participation until work-up completed
pathalogic murmur •Characteristics and things to ask Correct Answer--
Radiation
- Diastolic
- Grade > IV
- Interferes with S1 and/or S2
- Increases with sitting or standing
- Unequal femoral and/or radial pulses
- Displaced PMI
- Abnormal history
innocent murmur characteristics and things to ask Correct Answer-- No
radiation
,- Systolic
- Grade <III
- Does not interfere with S1 & S2
- Decreases with sitting and standing
- Equal femoral and radial pulses
- Normal PMI
- Normal history and physical exam
innocent murmurs herard in what % of children and if unsure do what?
Correct Answer-• 50%
refer
Grade </=2 intensity* Correct Answer-- Short systolic duration.
Minimal radiation. Musical or vibratory quality. Softer intensity when
the patient is sitting compared with when the patient is supine. Not
present when standing.
• Pathologic Murmursrefer to pediatric cardiologist when a child has?
Correct Answer-o A murmur in a child with a syndrome associated with
Congenital Heart Defect (trisomy 21)
o Any diastolic murmur
o Any systolic murmur associated with a thrill
o Pansystolic murmurs Continuous murmurs that cannot be suppressed
o Systolic clicks
o Opening snaps
, o Fixed splitting of the second heart sound not associated with bundle
branch block
o An accentuated S2 S4 gallops
o Not positional Grade III/ VI or higher
o Harsh quality
o Atrial septal defect: May have a soft, mid systolic murmur at ULSB
with wide-split heart sounds
• Diagnostic Studies for murmurs Correct Answer-o Chest xray; ECG,
ECHO, CBC
ASD Correct Answer-• Increased pulmonary blood flow
• Opening in septum between atria, between left and right atria
• Foramen ovale
• Results in right venticular hypertrophy
• Fatigue, delayed growth, CHF
• Soft, mid systolic murmur
• Diagnosis: echo, chest x-ray (mild cardiomegaly), ECG
and corrected by surgical closure or patch
PDA (patent ductus arteriosus) Correct Answer-• Ductucs arteriosus
fails to close
• Blood flows from aorta to pulmonary artery
• Increased blood flow to lungs
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