Cardiovascular Assessment
Why this is important
This learning plan will give you a foundation for assessment of the client with cardiac or peripheral vascular problems. Clients who have been admitted with cardiac problems often signal a change in condition with the addition of abnormal heart sounds. Any client who has impaired circulation or procedures performed which affect peripheral circulation must have frequent CMS checks.
What you will learn to do
Perform a basic cardiovascular assessment
Knowledge and skills you will learn along the way
This learning plan addresses the following learning objectives to help you master the competency:
a. Define key terms.
b. Locate each of the heart valves and determine the direction of blood flow through the heart.
c. List pertinent questions to ask a patient in order to collect subjective data regarding the cardiovascular system.
d. Determine normal heart rate and rhythm.
e. Identify normal S1 and S2 heart sounds.
f. Locate standard anatomic locations for assessing heart sounds.
g. Describe a systematic approach for assessing heart sounds.
h. Describe correct utilization of the stethoscope with differentiation of the bell and diaphragm.
i. Explain the implications of abnormal heart sounds (e.g. S3, S4, murmur).
j. Identify normal cardiac assessment findings when patients have prosthetic valves or pacemakers.
k. Describe characteristics of a murmur.
l. Differentiate apical impulse, retractions, lifts, heaves, pulsations, bruits and thrills.
m. Describe the components of a peripheral vascular assessment.
n. Locate each of the peripheral pulses.
o. Explain how the 0-4+ scale is used to measure amplitude of peripheral pulses.
p. Explain how a doppler device is used to detect peripheral pulses.
q. List the steps in testing Homan's sign.
r. Explain how the 0-4+ scale is used to measure degree of edema.
s. Explain the components of a CMS check.
t. Distinguish between normal and abnormal findings.
u. Describe developmental and cultural differences to take into consideration.
v. Explain how to properly document findings.
Learning Activities
a. PREVIEW the Performance Standards and Learning Objectives for this competency outlined above.
b. READ Jarvis pages 455-470, 473-486 (Heart and Neck Vessels), and chapter 20 (Peripheral Vasculature)
c. VIEW or READ a presentation on cardiovascular assessment
d. LISTEN to different heart sounds
e. VIEW a demonstration of cardiac assessment and CMS checks
f. PRACTICE cardiac assessment, Doppler assessment, and CMS checks with a peer
Assessment Activities
a. DEMONSTRATE satisfactory completion of performance check off
b. DOCUMENT findings of cardiovascular assessment on flowsheet and/or written narrative note submitted to instructor for evaluation
c. DEMONSTRATE ability to apply knowledge by completing an exam.