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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

Stable Angina

Chest Pain with Exertion

Relieved within 15 Minutes

ST Depression

Nitroglycerin

Up to 3 Doses q 5 Minutes

Rest

Antiplatelet Medication

CABG

Angioplasty

2 mins

Unstable Angina

Chest Pain with Rest or Exertion

Limits ADLs

> 15 Minutes

Less Likely Relieved by Nitroglycerin

ST Depression

Fatigue

Acute Coronary Syndrome (ACS) Treatment

Emergency Treatment

2 mins

Pain Assessment

Acute Pain

Chronic Pain

Onset

Provoking or Palliative

Quality

Radiation

Severity

Timing

Subjective Findings

Objective Findings

Reassessment of Pain

2 mins

ECG Interpretation

Rate

Rhythm

P Waves

Upright, Rounded, Before Every QRS

PR Interval (< 0.20 seconds)

Normal QRS (< 0.12 seconds)

2 mins

Cardiac Catheterization

Fluttering Sensation

Contrast Media

NPO 6-12 Hours

Bed Rest

Assess Circulation

Assess for Bleeding

Monitor Vital Signs

2 mins

Cholesterol Lab Values

LDL (Low Density Cholesterol)

< 100 mg/dL

HDL (High Density Cholesterol)

> 40 mg/dL Males

> 50 mg/dL Females

Total Cholesterol

< 200 mg/dL

1 min

Metabolic Syndrome

Dyslipidemia

Central Obesity

Insulin Resistance

Hypertension

Increased C-Reactive Protein (CRP)

Increased Fibrinogen

Increased Risk Cardiovascular Disease

1 min

Coronary Artery Bypass Grafting (CABG)

ST-Segment Elevation Myocardial Infarction (STEMI)

Cardiovascular Disease (CAD)

Uncontrolled Angina

Internal Mammary Artery

Saphenous (Leg) Vein

Transient Limb Edema

Closely Monitor Patients

Venous Thromboembolism (VTE) Prophylaxis

Incentive Spirometer

2 mins

Myocardial Infarction Assessment

Substernal Chest Pain

Crushing or Dull Sensation

Arm, Jaw, and Neck

> 20 Minutes

Unrelieved by Nitro

Palpitations

Diaphoresis

Fear of Impending Doom

Nausea and Vomiting

Shortness of Breath

Monitor for Arrhythmias

2 mins

Myocardial Infarction Diagnosis

12 Lead ECG

ST Elevation

Q Wave

T Wave Inversion

Troponin T and I

CK-MB

Early ECG

Cardiac Stress Test

2 mins

Myocardial Infarction Interventions

Morphine

Oxygen

Nitrates

Aspirin

Thrombolytics (tPA)

Cardiac Catheterization

Stent Placement

Angioplasty

Coronary Artery Bypass Grafting (CABG)

Decrease Modifiable Risk Factors

Resuming Activity (Physical, Sexual)

2 mins

Evolution of Myocardial Infarction and Complications

Arrhythmia

Fibrinous Pericarditis

Papillary Muscle Rupture

Interventricular Septum Rupture

Ventricular Pseudoaneurysm

Ventricular Free Wall Rupture

True Ventricular Aneurysm

Dressler Syndrome

Left Ventricular Failure

2 mins

Nitroglycerin

Decreases Preload

Angina

Up to 3 doses q 5 mins

Headache

Hypotension

Viagra (Sildenafil)

Assess Blood Pressure

Protect From Light

Use Glass Bottle and Special Tubing

Gloves for Applying Topically

2 mins

Hypertension Medications

Diuretics

ACE Inhibitors

Angiotensin Receptor Blockers (ARBs)

Beta Blockers

Dihydropyridine Calcium Channel Blockers

2 mins

Beta Blockers

"-olol" suffix

Decreases Heart Rate and Contractility

Decreases Peripheral Vascular Resistance

Decreases Renin Release

Hypertension

Heart Failure

Angina Pectoris

Asthma and Heart Block Patients

Assess Blood Pressure and Heart Rate

Masking Signs of Hypoglycemia

Do Not Stop Abruptly

2 mins

Beta Blocker Antidote

Glucagon

29 secs

Cardiovascular Effects of Beta-Blockers

Cardiac Myocytes and Vasculature

Decrease cAMP

Decreases SA and AV Node Conduction Velocity

Lower Blood Pressure

Decrease O2 Consumption

Decreases Mortality Post-MI

2 mins

Systemic Effects of Beta-Blockers

Respiratory

Bronchoconstriction

Metabolic

Decreased Insulin

Decreased Glycolysis and Lipolysis

Eye

Reduces Intraocular Pressure

1 min

Calcium Channel Blockers (Verapamil and Diltiazem)

Slows AV Conduction

Angina Pectoris

Arrhythmias

Essential Hypertension

Bradycardia

Hypotension

Constipation

Peripheral Edema

Gingival Hyperplasia

Medication Education

2 mins

Cardiac Enzyme Evaluation: Creatine Kinase CK-MB

Skeletal or Cardiac Muscle Injury

Onset: 4-8 Hours

Peak: 12-24 Hours

Return to Normal: 2-3 Days

1 min

Cardiac Enzyme Evaluation: Myoglobin

Skeletal or Cardiac Muscle Injury

Onset: 1 - 4 Hours

Peak: 12 Hours

Return to Normal: 24 Hours

Elevation After 24 Hours: Reinfarction

2 mins

Cardiac Enzyme Evaluation: Troponin

Cardiac Muscle Injury

Detection in Blood: 4 Hours

Peak: 24 - 36 Hours

Return to Normal: 5 - 14 Days

Most Specific for Cardiac Muscle

Treat Aggressively

2 mins

Bile Acid Resins

Hyperlipidemia

Bile Acid Reabsorption Prevented

Decrease LDL

Colestipol (Colestid)

Cholestyramine (Questran)

Colesevelam (Welchol)

GI Distress

Cholesterol Gallstones

Decreased Absorption of Fat-soluble Vitamins

2 mins

Statins

Rhabdomyolysis

Hepatotoxicity

HMG-CoA reductase inhibitors

Decrease LDL

Decrease Triglycerides

Increase HDL

2 mins

Atorvastatin (Lipitor)

-statin Suffix

HMG-CoA Reductase Inhibitors

High Cholesterol

Hepatotoxicity

Rash

Rhabdomyolysis

Myopathy

Monitor Liver Enzymes

Administer at Bedtime

Avoid Grapefruit

2 mins

Vitamin B3 - Niacin (Nicotinic Acid)

Decreases Triglycerides

Decreases LDL

Increases HDL

Dyslipidemia

Pellagra

Diarrhea

Dermatitis

Dementia

Flushing

GI Distress

Hepatotoxicity

2 mins

High Blood Pressure Response

Atria Release Atrial Natriuretic Peptide

Vasodilation

Antagonizes Aldosterone

Na+ and Water Excreted

1 min

Primary Hypertension Risk Factors

Excessive Alcohol Consumption

High Sodium Diet

Dyslipidemia

Obesity

People of African Descent

Advanced Age

Vitamin D Deficiency

Reduced Nephron Number

Diabetes

Lack of Physical Activity

2 mins

Hypertension Assessment

Essential Hypertension

Secondary Hypertension

Headache

Vision Changes

Nosebleed (Epistaxis)

Chest Pain

Syncope (Fainting)

Average 2 Sets, 2 Minutes Apart

After 2 or More Visits (within 1-4 weeks)

Take BP Both Arms

Common in African Americans

2 mins

Supine Hypotension (Vena Cava Syndrome)

Compression of the Vena Cava and Descending Aorta

Hypotension

Dizziness

Tachycardia

Decreased Renal Perfusion

Decreased Uteroplacental Perfusion

Side-lying Position

2 mins

Alteplase

Tissue Plasminogen Activator

Thrombosis

Bleeding

Intracranial Hemorrhage

Internal Hemorrhaging

Minimize Bleeding

Monitor for Shock

Aminocaproic Acid

2 mins

Venous Thromboembolism (DVT) Assessment

Venous Wall Inflammation caused by Thrombus

Tenderness

Edema

Warmth

Asymmetry

Could be Asymptomatic

Monitor for Pulmonary Embolism

58 secs

Blood Pressure Classification (JNC 7)

Normal

Systolic (<120)

Diastolic (< 80)

Prehypertension

Systolic +20 (120-139)

Diastolic +10 (80-89)

Stage 1 Hypertension

Systolic +20 (140-159)

Diastolic +10 (90-99)

Stage 2 Hypertension

Systolic + > 20 (160)

Diastolic + > 10 (100)

Hypertensive Crisis

Systolic > 180

Diastolic > 110

4 mins

Venous Thromboembolism (DVT) Interventions

Anticoagulants

Prevention Education

Frequent Ambulation

Leg Exercises

Compression Stockings or SCD's

Avoid Nicotine and Oral Contraceptives

Surgery

1 min

Pulmonary Embolism Causes

FAT BAT Mnemonic

Fat

Air

Deep Vein Thrombosis (DVT)

Bacteria

Amniotic Fluid

Tumor

Hypercoagulable

Central Venous Lines

Immobilized

1 min

Pulmonary Embolism Assessment

Shortness of Breath (SOB)

Pleuritic Chest Pain

Tachypnea

Hemoptysis

Hypoxemia

Sudden Death

52 secs

PT/PTT Lab Values

Prothrombin Time (PT)

10-14 seconds

Activated Partial Thromboplastin Time (PTT or aPTT)

25-35 seconds

1 min

INR Lab Value

0.8-1.2 Normal Range

Warfarin

2.0-3.0

1 min

Varicose Veins Assessment

Increased Venous Pressure

Incompetent Valves

Telangiectasias

Small Reticular Veins

Dilated and Tortuous Veins

1 min

Varicose Veins Interventions

Laser Therapy

Sclerotherapy

Removal of Saphenous Vein

Avoid Prolonged Standing

Elastic Compression Stockings

2 mins

Superficial Thrombophlebitis

IV Catheter Irritation

Erythema

Cord-like Vein

Edema

Remove IV Catheter

Elevate

Warm Compress

Rotate Sites Q3 Days

Aseptic Technique

2 mins

Chronic Venous Insufficiency (Venous Stasis Ulcer) Assessment

Venous Stasis Ulcer

Uneven Edges

Dull Persistent Pain

Medial Malleolus

Necrotic

Normal Pulses

Lower Leg Edema

Bronze-Brown Pigmentation

Warm

Pruritus

2 mins

Chronic Venous Insufficiency (Venous Stasis Ulcer) Interventions

Frequently Elevate Legs

Avoid Standing/Sitting for Long Periods of Time

Elastic Compression Stockings

Bilayer Artificial Skin

Daflon

Wound Dressings

Proper Foot and Leg Care

2 mins

Hydrochlorothiazide HCTZ

Inhibits Reabsorption NaCl and H₂O

Edema

Mild to Moderate Hypertension

Hypokalemia

Hyponatremia

Dehydration

Hyperglycemia

Gout

Sulfa Allergy

Pregnancy and Breastfeeding

1 min

Loop Diuretics

Thick Ascending Limb of Loop of Henle

Inhibits Na+-K+-2Cl-

Sulfa Drug

Furosemide

Lasix

Ototoxicity from Rapid Injection

Gout

Dehydration

Hypocalcemia

Hypokalemia

Orthostatic Hypotension

2 mins

Loop Diuretic Education

Furosemide (Lasix)

Heart Failure

Pulmonary Edema

Acute Renal Failure (ARF)

Edema

Notify the provider of weakness, dizziness, or muscle cramping

Increase Potassium Intake

Check BP Daily

Daily Weights and Monitor IandOs

1 min

K+ Sparing Diuretics

CHF and Hypertension

Hypokalemia

Hyperaldosteronism

Collecting Tubule

Spironolactone

Competitive Aldosterone Receptor Antagonist

Amiloride and Triamterene

Block Na+ Channels

Hyperkalemia

Gynecomastia

2 mins

Spironolactone (Aldactone)

Inhibition of Aldosterone

Potassium Retention

Hypertension

Edema

Heart Failure

Hyperkalemia

Endocrine Effects

Avoid Potassium Supplements

2 mins

Angiotensin-Converting Enzyme (ACE) Inhibitors

"-pril" Suffix

Block Renin Angiotensin-Aldosterone System (RAAS)

Hypertension

Heart Failure

Dry Non-productive Cough

Hypotension

Dizziness

Possible Hyperkalemia

Angioedema

Slowly Change Position

Do Not Stop Abruptly

2 mins

NSAIDs

Anti-inflammatory

Analgesic

Fever

Closure of Patent Ductus Arteriosus

Reversible Inhibition of COX-1 and COX-2

Block Prostaglandin Synthesis

Interstitial Nephritis

Gastric Ulcer

Renal Ischemia

1 min

Prazosin (Minipress)

-osin suffix

Selective Alpha-1 Receptor Blocker

Hypertension

Benign Prostatic Hyperplasia (BPH)

Nightmares

Orthostatic Hypotension

Tachycardia

Priapism / Inhibition of Ejaculation

Nasal Congestion

First Dose Effect

Administer at Bedtime

2 mins

Clonidine

Alpha-2 Agonist

Hypertensive Urgency

Attention Deficit Hyperactivity Disorder (ADHD)

Tourette Syndrome

Opioid Withdrawal

CNS Depression

Respiratory Depression

Hypotension

Rebound Hypertension if Abrupt Cessation

2 mins

Hydralazine (Apresoline)

Severe Hypertension

CHF

Reduced Afterload

Pregnancy

Vasodilates Arterioles

Drug-induced Lupus

Reflex Tachycardia

Hypotension

Combined with Diuretic and Beta Blocker

1 min

Minoxidil (Loniten, Rogaine)

Vasodilates Arterioles

Severe Hypertension

Baldness

Reflex Tachycardia

Blood Volume Expansion

Hypertrichosis

Pericardial Effusion

Rash

Give with Beta Blocker and Diuretic

2 mins

Angiotensin II Receptor Blockers (ARBs)

Ends in "-sartan"

Blocks Angiotensin II Receptor

Hypertension

Angioedema

Renal Artery Stenosis

Pregnancy

1 min

Arterial Ulcer Assessment

Absent or Decreased Pulses

Intermittent Claudication

Sharp Pain

Dependent Rubor

Well Defined Edges

Over Bony Areas

Smooth, Shiny Skin

Toes, Heels, Lateral Lower Legs

Cool

2 mins

Arterial Ulcer Interventions

Saline Dressing

Structured Exercise Programs

Fibrinolytics

Antiplatelet Medication

No Caffeine, Nicotine

Surgery

1 min

Peripheral Artery Disease (PAD)

Atherosclerosis

Intermittent Claudication

Pain with Exercise

Paresthesias

Arterial Ulcers

Critical Limb Ischemia

Amputation

Ankle-Brachial Index (ABI)

2 mins

Amputation

Trauma

Peripheral Vascular Disease

Diabetes Complications

Gentle Handling

Surgical Tourniquet at Bedside

Prevent Contractures

Frequent Inspection

Compression Bandages

Phantom Pain

Mirror Therapy

2 mins

Heparin (Unfractionated)

Suppresses Coagulation

Deep Vein Thrombosis (DVT)

Pulmonary Embolism

Hemorrhage

Heparin-Induced Thrombocytopenia (HIT)

Monitor aPTT

Preferred (Safe) During Pregnancy

Protamine Sulfate

2 mins

Heparin Induced Thrombocytopenia (HIT)

5-10 Days After Heparin Exposure

Heparin-Platelet Factor 4 Complex

Autoantibodies Form Against Complex

Heparin-Platelet Factor 4-Antibody Complex Binds Platelets

Platelet Aggregation

Procoagulant Release

Thrombocytopenia

Serotonin Release Assay (SRA)

Stop Heparin, Start Direct Thrombin Inhibitor

2 mins

Warfarin (Coumadin)

Inhibits Clotting Factors

Atrial Fibrillation

Venous Thrombosis

Pulmonary Embolism

PT/INR Levels

Observe for Bleeding

Pregnancy

Vitamin K and Fresh Frozen Plasma

Prolonged Therapeutic Onset

Maintain Same Diet

2 mins

Warfarin Antidotes

Vitamin K

Fresh Frozen Plasma

59 secs

Ticlopidine (Ticlid)

ADP Receptor Antagonist

Irreversibly Inhibits Platelet Aggregation

Thrombotic Event Prevention

Neutropenia

Thrombotic Thrombocytopenic Purpura (TTP)

GI Distress

Rash

Withhold Before Surgery

Monitor Blood Count

2 mins

Clopidogrel (Plavix)

ADP Receptor Antagonist

Prevent Platelet Aggregation

Acute Coronary Syndrome (ACS)

Prevention of Thrombotic Events

Bleeding

Thrombotic Thrombocytopenic Purpura (TTP)

Pancytopenia

Abdominal Pain

Withhold Before Surgery

2 mins

Enoxaparin (Lovenox)

Inhibits Clotting Factors

Factor Xa

Clot Formation Prevention

Heparin Induced Thrombocytopenia (HIT)

Bleeding

Medication Education

Subcutaneous Injection

2 Inches from Umbilicus or Incisions

Protamine Sulfate

2 mins

Abciximab and Tirofiban (GP IIb/IIIa Inhibitors)

IIb/IIIa Receptor Inhibitors

Inhibits Platelet Aggregation

Thrombotic Event Prevention

Acute Coronary Syndrome (ACS)

Percutaneous Coronary Intervention (PCI)

Bleeding

Expensive

Combination Drug Therapy

2 mins

Abdominal Aortic Aneurysm (AAA) Assessment

Atherosclerosis

Bruit

Pulsation in Abdomen

Abdominal or Lower Back Pain

Tearing Pain

Ultrasound

Rupture

Shock

Surgical Repair

1 min

Abdominal Aortic Aneurysm Rupture

Acute Tearing Pain

Pulsatile Abdominal Mass

Grey Turner Sign

Cullen Sign

Hypovolemic Shock

Diagnosis by Clinical Impression

Emergent Surgical Intervention

Poor Prognosis

3 mins

Bleeding Precautions

Hard Foods

Aspirin Products

Blowing Nose Forcefully

Straining During BMs

Enemas or Rectal Suppositories

Pads and Monitor Menstruation

Soft-bristled Toothbrush

Electric Razor

Limit Needle Sticks

Smaller Needle Size

3 mins

ECG: Sinus Tachycardia

> 100 bpm

Regular

Present, Upright, Every QRS

< 0.20 seconds

< 0.12 seconds

Treat Underlying Cause

2 mins

ECG: Sinus Bradycardia

< 60 bpm

Regular

Present, Upright, Every QRS

< 0.20 seconds

< 0.12 seconds

Atropine

1 min

ECG: Atrial Fibrillation

Variable Rate

Irregular Rhythm

No P Wave

No PR Interval

QRS < 0.12 Seconds

1 min

ECG: Atrial Flutter

Variable

Regular or Irregular

Saw Tooth, Multiple Before Every QRS

Non-measurable

< 0.12 seconds

2 mins

Parts of an ECG

P Wave

Atrial Depolarization

QRS Complex

Ventricular Depolarization

T Wave

Ventricular Repolarization

2 mins

Cardiopulmonary Resuscitation (CPR) for Adults

Scan Scene

Activate Emergency Response System

Check For Breathing (Max 10 Seconds)

Open Airway

Compressions: 2 Inches Deep (100-120 Compressions/Min)

Airway: Ensure Airway is Still Open

Breathing: Administer 2 Rescue Breaths

Repeat C-A-B Sequence (30:2) Until Help Arrives

3 mins

Magnetic Resonance Imaging (MRI)

Internal Body Images

Detects Variations of Soft Tissues

No Metal Objects

No Pacemakers

Contrast is Non-Iodine

Safe During Pregnancy

Long Procedure

Antianxiety Medications

2 mins

Heart Failure Interventions

Echocardiogram

Invasive Hemodynamic Monitoring

High Fowler's Position

Oxygen

Advanced Airway

Diuretics

Beta Blockers

Angiotensin II Receptor Blockers (ARBs)

ACE Inhibitors

Digoxin (Lanoxin)

Pacemaker

2 mins

Lidocaine

Blocks Na+ Channels

Ventricular Arrhythmia

Anesthetic

Paresthesias

Seizures

Respiratory Depression

Drowsiness

Anesthetic Effects Extended with Epinephrine

1 min

Phenytoin (Dilantin)

Blocks Na+ Channels

Tonic-clonic Seizures

Ataxia

Nystagmus

Sedation

Gingival Hyperplasia

Purple Glove Syndrome

Hirsutism

Rash

Anemia

Individualized Dosing

2 mins

Amiodarone

Class III Antiarrhythmic (K+ Channel Blocker)

Decreases SA and AV Node Conduction

Inhibits Cytochrome P450

Supraventricular Tachycardia with Heart Failure

Ventricular Tachycardia

Hepatotoxicity

Pulmonary Fibrosis

Bradycardia

Heart Block

Thyroid Disorders

Blue/Gray Skin Deposits

Corneal Deposits

3 mins

Atropine

Muscarinic Antagonist

Bradycardia

Increased Exocrine Secretions

Smooth Muscle Spasms

Tachycardia

Dry Mouth

Urinary Retention

2 mins

Digoxin (Lanoxin)

Increases Inotropy

Heart Failure

Atrial Fibrillation

Bradycardia

Fatigue

Heart Block

Heart Rate Below 60

Hypokalemia

Monitor for Toxicity and Visual Changes

Digibind

2 mins

Acute Digoxin Toxicity

Hyperkalemia

Cholinergic (Nausea, Vomiting, Diarrhea)

Blurry Yellow Green Vision with Halo of Light

Arrhythmia

Bradycardia

Prolonged PR interval

Decreased QT

Scooping on EKG

T Wave Inversion

2 mins

Digoxin Toxicity Treatment

Activated Charcoal

Slowly Normalize K+

Digibind (Anti-Digoxin Fab)

Magnesium Sulfate

Lidocaine

Cardiac Pacing

2 mins

Epinephrine (Adrenaline)

Alpha and Beta Agonist

Anaphylaxis

Primary Open Angle Glaucoma (POAG)

Bleeding

Cardiac Arrest

Tachycardia

Hypertension

Tremors

Insomnia

Multiple Strengths

2 mins

Types of Heart Failure

Left Sided

Pulmonary Congestion

Right Sided

Peripheral Edema

High Output

Unable to Meet Metabolic Needs

1 min

Left Heart Failure Assessment

Pulmonary Congestion

Pink Frothy Sputum

Wheezing or Crackles

Dyspnea with Exertion

Cough

Fatigue

Tachycardia

Weak Peripheral Pulse

S3, S4 Heart Sounds

1 min

Right Heart Failure Assessment

Jugular Venous Distention (JVD)

Peripheral Edema

Hepatosplenomegaly

Nocturia

Weight Gain

Ascites

Fatigue

1 min

Endocarditis Assessment

Infection of Inner Layer and Valves

Fever

Fatigue

New or Changed Murmurs

Roth's Spots

Splinter Hemorrhages

Janeway Lesions

Osler's Nodes

Heart Failure

Embolization

2 mins

Endocarditis Interventions

IV Antibiotics

4-6 Weeks

Anticoagulants

Good Hygiene

Closely Monitor

Antibiotic Prophylaxis

Dental Procedures

Invasive Procedures

1 min

Acute Pericarditis Causes

Idiopathic

Infection

Trauma

Cardiac

Myocardial Infarction

Autoimmune Diseases

Uremia

Tumor

Radiation

2 mins

Acute Pericarditis Assessment

Pericardial Sac Inflammation

Sharp Chest Pain

Increased with Inspiration

Pain Decreased by Leaning Forward

Pericardial Friction Rub

Diffuse ST-Elevation

T Wave Inversion

Fever

May Be Asymptomatic

Cardiac Tamponade

2 mins

Acute Pericarditis Interventions

Treat Underlying Disorder

Antibiotics

Colchicine + NSAIDs

Corticosteroids

Place Patient Upright with Head of Bed at 45°

Pericardiocentesis

Pericardial Window

2 mins

Aortic Stenosis

Age-related Calcifications

Bicuspid Aortic Valve

Crescendo-decrescendo Murmur

Systolic Murmur

Ejection Murmur

Ejection Click

Radiates to Carotids and Apex

Pulsus Parvus et Tardus

Syncope

Helmet Cells

2 mins

Mitral Stenosis

Murmur Follows Opening Snap

Late Diastolic Murmur

Enhanced by Expiration

Low-Pitched Rumbling

Dilation of Left Atrium (LA)

Recurrent Attacks of Rheumatic Fever

2 mins

Tricuspid Regurgitation

Holosystolic

Blowing Murmur

Radiates to Right Sternal Border

Enhanced by Inspiration

1 min

Mitral Regurgitation

Holosystolic

Blowing Murmur

Loudest at Apex

Radiates toward Axilla

Louder by Squatting

Hand Grip

Expiration

1 min

Aortic Regurgitation

Diastolic Murmur

Immediate High-pitched

Blowing Murmur

Wide Pulse Pressure

Water Hammer Pulse

Head Bobbing

Pulsating Nail Bed

Can Cause Austin Flint Murmur

1 min

Syphilis

Treponema pallidum

Painless Chancre

Rash on Palms and Soles

(Generalized) Lymphadenopathy

Condylomata Lata

Asymptomatic

Aortitis

Neurosyphilis

Gummas

Penicillin

Jarisch-Herxheimer Rash

3 mins

Cardiac and Circulation Assessment

Inspect General Appearance

Inspect Chest

Note Location of Apical Impulse

Percuss Chest Wall

Auscultate Heart Sounds: S1, S2, S3, S4

Auscultate for Pericardial Friction Rub and Murmurs

Assess Skin, Fingernails and Toenails

Check Carotid Artery and Jugular Vein

Palpate Skin for Temperature, Texture, Turgor

Check Capillary Refill Time

Palpate Arterial Pulses Bilaterally

5 mins

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