SAS 14

• The students will study and read Chapter 14 of their book about Auscultatory Sounds.
• Heart Murmurs are discussed in the Student Activity Sheet for Health Assessment (Lecture) for BS Nursing / First Year, Session # 1, Lesson Title: The Cardiovascular System (Part 3).
• The tracker is used to track the progress of the work done and the work that remains.
• The AL strategy of Turn and talk involves students turning to their talk partner/s to find out, summarize, clarify, share ideas, point of view or opinions.
• The rationale for the lesson wrap-up is to mark the session as completed in the tracker.
• Upon completion of this lesson, the nursing student can: Obtain an accurate history of the cardiovascular system; Appropriately prepare and position the patient for cardiovascular examination; Inspect, palpate, and auscultate the jugular veins, carotid arteries, and the precordium to evaluate cardiovascular status; Discuss risk factors for coronary heart disease; Discuss risk reduction and health promotion strategies to reduce coronary heart disease.
• Materials for this lesson include a book, pen and notebook, and an index card/class list.
• References for this lesson are Bates’ Nursing Guide to Physical Examination and History Taking (Second Edition) by Beth Hogan-Quigley, Mary Louise Palm, and Lynn Bickley.
• A midsystolic murmur begins after S1 and stops before S2, with brief gaps audible between the murmur and the heart sounds.
• A pansystolic (holosystolic) murmur starts with S1 and stops at S2, without a gap between murmur and heart sounds.
• When a patient has a constant blood pressure reading of 150/100, lifestyle modifications and drug therapy are advised.
• Intensity is influenced by the thickness of the chest wall and the presence of intervening tissue.
• The optimum body mass index that people should maintain is between 18.5 and 24.9.
• Tomatoes must be recommended to a patient who has hypertension.
• Diabetes, history of cardiovascular disease, obesity, and physical inactivity are modifiable risk factors for coronary heart disease.
• Lifestyle medication for a patient at risk for cardiovascular disease includes teaching about eating a balanced diet and avoidance of fast food and processed food.
• Having regular aerobic exercises is a part of lifestyle medication for a patient at risk for cardiovascular disease.
• A midsystolic murmur has a shape of a plateau.
• A client with three or more of the findings of metabolic syndrome is likely to have metabolic syndrome.
• Complete cessation of smoking is a part of lifestyle medication for a patient at risk for cardiovascular disease.
• The intensity of a crescendo-decrescendo murmur remains the same throughout.
• Excessive use of seasonings on food can contribute to the worsening hypertension of a patient.
• A late systolic murmur usually starts in mid- or late systole and persists up to S2.
• An early diastolic murmur starts immediately after S2, without a discernible gap, and then usually fades into silence before the next S1.
• A middiastolic murmur starts a short time after S2 and may fade away or merge into a late diastolic murmur.
• A late diastolic (presystolic) murmur starts late in diastole and typically continues up to S1.
• The shape or configuration of a murmur’s shape is the most difficult for a novice to determine.
• Find the location where the murmur is heard in terms of the intercostal space and its relation to the sternum, the apex, or the midsternal, the midclavicular, or one of the axillary lines.
• Intensity of a murmur is usually graded on a 6-point scale and expressed as a fraction, where the numerator describes the intensity of the murmur wherever it is loudest; the denominator indicates the scale you are using.