HELLO EVERYONE!
I AM JEMS ANDRE RECORBA, BSN1-11 I A PULSATINS WHILE PALPATING THE AORTIC PULMONIC AND
STUDENT NURSE FROM DAVAO DOCTORS COLLEGE AND IN
THIS VIDEO I WILL BE PERFORMING MY RETDEM. IN
ASSESSING THE CARDIOVASCUAR SYSTEM!
CARDIOVASCULAR SYSTEM IS AN ORGAN SYSTEM THAT
PERMITS BLOOD TO CIRCULATE AND TRANSPORT
NUTRIENTS, OXYGEN, CARBON DIOXIDE, HORMONE AND
BLOOD CELLS. IT PROVIDES NOURISHMENT FIGHT DISEASES
STABILIZE TEMPERATURE AND MAINTAIN HOMEOSTASIS.
NOW, REVIEW THE CLIENTS MEDICAL RECORD IF
AVAILABLE. DETERMINE THE SCOPE OF THE ASSESSMENT,
PREPARE THE MATERIALS, THIS INCLIDES, RULES, GLOVES,
PENLIGHT AND STETHOSCOPE. AND THEN GREET THE
CLIENT POLITELY, INTRODUCE SELF, VERIFY CLIENT
IDENTITY AND EXPLAIN THE PROCEDURE AND DONT
FORGET TO PERFORM THE HAND HYGIENE TO DETER THE
SPREAD OF MICRO.
HELLO MAAM, MAY I COME IN? SO ITS IMPORTANT TO ASK
THE CLIENT CONSENT BEFORE ENTERING THE ROOM.
HELLO MAAM, GOODMORNING, I AM JEMS YOUR STUDENT
NURSE FOR TODAY. BEFORE ANYTHING ELSE MAAM, CAN
YOU TELL ME YOUR NAME, BDAY. OKAY THANK YOU! AND
WHAT DO YOU WANT ME TO CALL YOU MAAM? OKAY
MAAM GINA, FOR TODAY I AM GOING TO ASSESS YOUR
CARDIOVASCULAR SYSTEM FOR US TO KNOW IF THERE’S
ANY ABNORMALITIES, IS THAT OKAY WITH YOU? OKAY
THANK YOU!
AS YOU CAN SEE MAAM GINA I HAVE ALREADY CLOSE THE
CURTAINS AND DOORS FOR US TO PROVIDE THE PRIVACY.
BEFORE WE PROCEED MAAM GINA DO YOU HAVE ANY
QUESTIONS/CLARIFICATIONS? OK TNX!
SO NOW, ENSURE THE CLIENTS COMFORT. AND THEN
INQUIRE THE CLIENT IF THERE’S ANY HISTORY OF CARDIAC,
ASK FOR LIFESTYLE HABITS THAT ARE RISK FACTORS OF
CARDIAC PROBLEM.
SO NOW MAAM GINA, DO YOU HAVE ANY PAST HISTORY
ABOUT CARDIAC? HOW ABOUT TO YOUR FAMILY? OK.
YOUR CURRENT LIFESTYLE? OK NICE, THANKS. SO NOW
LET’S PROCEED!!!
FOR NOW, THE FIRST ASSESSMENT IS ASSESSING THE
JUGULAR VEINS AND CAROTID ARTERIES.
FIRST THING TO DO IS, POSITION THE CLIENT TO SUPINE
POSITION WITH THE HEAD OF THE BED ELEVATED BETWEEN
30-45 DEGREES MAKING SURE THAT THE HEAD AND TORSO
OF THE PATIENT IS ON THE SAME PLANE. NEXT IS TURN THE
PATIENT HEAD SLIGHTLY AWAY FROM THE SIDE BEING
EXAMINED.
AND THEN SHINE A TANGENTIAL LIGHT SOURCE ONTO THE
NECK AND SUPRASTERNAL AREA. TO OBSERVE ANY
PULSATIONS. IF DONE ASSESS FOR THE JUGULAR VENOUS
PRESSURE BY LOCATING THE HIGHEST POINT OF THIS
TENSION. NOTE THAT THE JUGULAR VEIN SHOULD NOT BE
DISTENDED BULGING AT 45 DEG.
NOW MEASURE THE VERTICAL DISTANCE IN CENTIMETER
ABOVE THE EXTERNAL ANGLE BY EXTENDING LONG
RECTANGULAR CARD HORIZONTALLY . AND ALSO A
CENTIMETER RULER VERTICALLY FROM THE STERNAL
ANGLE.
NOW FOR THE HEAD OF THE BED MUST BE ELEVATED AT 30
DEGREES SLIGHTLY TURNS THE PATIENTS HEAD TOWARD
THE SIDE BEING EXAMINED AND THEN PALPATE FOR THE
CAROTID ARTERIES. VERY LIKELY TO AVOID BLOCKING
CIRCU. AND VAGAL STIMULATION. THEN PALPATE
INDIVIDUALLY BECAUSE BILATERAL PALPATION OF
CAROTID ARTERIES MAY RESUT CEREBRAL BLOOD FLOW.
FEEL FOR ANY AMPLITUDE OF STROK AND THRILLS
AND THEN USE STETHOSCOPE AND PLACE THE BELL TO THE
OVER THE CAROTID ARTERIES AND LISTEN FOR A BREWEE.
NEXT TO ASSESS IS TH EPRECORDIUM OR HEART. THE FIRST
THING TO DO IS TO BEGIN WITH THE GENERAL INSPECTION
CHEST WALL, LOOK FOR ANY PULSATIONS, SYMMETRY
MOVEMENTS. NEXT INSPCT FOR PRECORDIUM FOR
TRICUSPID AND ETHICAL AREA.
NOW, PALPATE FOR HIPS AND OR LIFTS USING THE PALM R
HOLD THE FINGER PADS OBLIQUELY AGAINST THE CHEST .
THEN PRESS THE BALL OF THE HAND S FIRMLY AGAINTS
THE CHEST WALL. FILLS FOR ANY VIBRATORY SENSTATION.
NEXT IS PALPATE THE IMPULSES USING THE FINGER PADS
OBLIQUELY ON THE AORTIC PULMONIC AND APICAL AREA.
NEXT IS THE APPICAL IMPULSE USING 2-3 FINGERS PADS.
FOR FINER ASSESSMENT USE 1 FINGER ONLY TO CONFIRM
THE PULSE. IF UNABLE TO FEEL, REPOSITIONED THE
PATIENT TO ROLL PARTLY TO THE LEFT SIDE AND PALPATE
AGAIN. IF UNABLE ASK THE CLIENT TO EXHALE FULLY
VACINATED. AND HOLD FOR A MOMENT. NEXT TO PALPATE
IS THE EPIGASTRIC AREA.
NOW THE NEXT STEP TO DO IS TO ASSESS THE HEART RATE
AND RHYTHM OF THE PATIENT BY PLACING THE
DIAPHRAGM OF THE STETH... THEN REPEAT THE STEPS WITH
THE PATIENT FACING ON THE LEFT SIDE AND ALSO SUPINE
SITTING POSITION. AND ASK TO INHALE/EXHALE AND
HOLD!!!
FOR NOW IS TO INSPECT THE ARMS AND LEGS OKAY? CAN I
SEE YOUR HAND SIR? (INSPECT) THE TEMP. IS NORMAL, SKIN
COLOR IS CONSISTENT. CHECK FOR ANY ABNORMALITIES
ALSO THE NAILS CHECK!!!!! NEXT IS TO ASSESS THE RADIAL
PULSE, THEN THE ULNAR, AND THEN BRACHIAL PULSE. OK
GOOD, YOUR PULSES MADAM GINA IS GOOD AND STRONG.
NOW I AM GOING TO PERFORM THE ALLEN TEST WHICH IS
DONE TO TEST THE PATENCY OF THE CLIENT ULNAR AND
RADIAL ARTERY. ASK THE CLIENT TO CLOSE/OPEN THE
HAND AND SQUEEZE IT AFTER. OK TNX
NEXT WE WILL PROCEED TO THE LOWER EXTREMITIES.
(CHECK EVERYTHING!!!!!) THE COLOR IS CONSISTENT, THE
HAIR IS EVEN. THE TEMP.IS WARM, THERE IS NO ANY
ULCERATIONS, VARICOSITIES AND PALPATING FOR
FIRMNESS. EVERYHTING IS GOOD! NOW IS TO PALPATE THE
PULSE FIRST IS THE POPLITEAL PULSE, CAN YOU PLEASE
RAISE YOUR KNEE FOR ME? OK!!!! NEXT IS THE DORSALIS
PULSE, BOTH ARE GOOD AND REGULAR RHYTHMS, NOW
FOR THE POSTIDEAL, BOTH ARE GOOD! NOW FOR THE
CAPILLARY REFILL, OK GOOD! NORMAL
NOW SIR WE WILL PROCEED TO THE HOMANS TEST WHICH
IS A PROCEDURE TO ASSESS DEEP VEINS. NOW MADAM, CAN
YOU PLEASE STAND AND WALK FOR ME? OK TNX
NOW MADAM GINA WE ARE DONE ASSESSING EVERYTHING,
AND NOW I AM GOING TO SUMMARIZE THE RESULTS....
UPON AUSCULTATION OF YOUR NECK EVERYTHING IS
NORMAL, I DIDN’T HEARD ANY SWISHING. NO THRILLS
NOTED AND YOUR JUGULAR VENOUS IS AT 6CM WITH THE
BED ELEVATED AT 30 DEG. WHICH IS GOOD! AND ALSO TO
YOUR CHEST OR TO YOUR ACCORDION THE MOVEMENT IS
SYMMETTRICAL. NO RETRACTIONS , THRILLS. THE HEART
RATE IS 75 BPM WHICH IS REGULAR. NOW FOR YOUR
UPPPER AND LOWER EXTREMITIES THE RESULT IS
SYMMETRICAL, NO EDEMA, SKINS IS WARM CAPILLARY
REFILL IS GOOD, THE RADIAL PULS, ULNAR AND BRACHIAL
PULSES ARE STRONG AND VERY GOOD. NEXT IS FOR THE
ALLEN TEST THE RESULT IS GOOD WHILE THE LEGS IS GOOD
ALSO, NO SWELLING ATROPHY . THE DORSALIS AND
POSTERIOR TIBIAL PULSES ARE NICE AND NORMAL,
STRONG. OVERALL THE CARDIOVASCULAR SYSTEM IS
GOOD AND NORMAL. I SUGGEST THAT CONTINUE BEING
HEALTHY AND DO EXERCISE REGULARY MAINTAIN A
PROPER EATING, OKAY? THANKS!!1 DO YOU HAVE ANY
QUESTIONS? OK THANK YOU.....AND DONT FORGET TO
PERFORM HAND HYGIENE!!!