The findings from an assessment of a 70-year-old patient with ...

[tth]

The findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. The nurse knows that this finding indicates:
 
  a. Decreased fluid volume.
  b. Increased cardiac output.
  c. Narrowing of jugular veins.
  d. Elevated pressure related to heart failure.

Question 2

Which of these statements describes the closure of the valves in a normal cardiac cycle?
 
  a. The aortic valve closes slightly before the tricuspid valve.
  b. The pulmonic valve closes slightly before the aortic valve.
  c. The tricuspid valve closes slightly later than the mitral valve.
  d. Both the tricuspid and pulmonic valves close at the same time.

[jojobee318]

Answer to Question 1

ANS: D
Because no cardiac valve exists to separate the superior vena cava from the right atrium, the jugular veins give information about the activity on the right side of the heart. They reflect filling pressures and volume changes. Normal jugular venous pulsation is 2 cm or less above the sternal angle. Elevated pressure is more than 3 cm above the sternal angle at 45 degrees and occurs with heart failure.

Answer to Question 2

ANS: C
Events occur just slightly later in the right side of the heart because of the route of myocardial depolarization. As a result, two distinct components to each of the heart sounds exist, and sometimes they can be heard separately. In the first heart sound, the mitral component (M1) closes just before the tricuspid component (T1).

[tth]

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[ttt030911]

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