NUR 634 Topic 5 DQ 2

Discussion: Practice the physical exam techniques outlined in the topics assigned Bates Physical Examination Videos and write a reflection on the following:

 NUR 634 Topic 5 DQ 2 Assessment Description

Practice the physical exam techniques outlined in the topic’s assigned Bates’ Physical Examination Videos and write a reflection on the following:

Identify three techniques that you learned from the videos.

What aspects of the assigned physical examination are you doing well?

What are you going to focus on for improvement as you practice for the skills check off?

Scholarly resources are not required.

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Resources

NUR 634 Topic 5 DQ 2

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Bates’ Guide to Physical Examination and History Taking

Required

Read Chapters 16-17 in Bates’ Guide to Physical Examination and History Taking.

View Resource

Bates’ Visual Guide: 12-Month Access Card to BatesVisualGuide.com With OSCE Clinical Skills Videos

Optional

View and complete video segments 10.1-10.10 in “Volume 10: Cardiovascular System,” and segments 11.1-11.8 in &#

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https://batesvisualguide.com/

CareOnPoint

Optional

Read “Cardiovascular Disorders,” located in the CareOnPoint? application.

http://app.careonpoint.co

NUR 634 Topic 5 DQ 2 Sample

Cardiovascular physical examination is crucial in assessing diseases of cardiac origin or diseases that present with cardiac symptoms. Bates’ physical examination videos have helped me learn important skills necessary for my current and future practice. For example, I have learned how to access jugular venous pressure (JVP) by examining for jugular vein distension. I have also learned the clinical significance of elevated JVP on right atrial pressures, which is indicative of right-sided heart failure (Byrne, 2021). In addition, I have learned how to perform a good chest inspection, palpation, percussion, and auscultation, how to report normal and abnormal findings of each, and the relevance of the findings in establishing a clinical diagnosis. I have also learned how to palpate and auscultate for different pulses, including the radial, carotid, and aortic pulses (Cook et al., 2021). NUR 634 Topic 5 DQ 2 I have also learned how to report a pulse based on rate, rhythm, symmetry, and character and how to auscultate for a bruit.

I have noted that I can confidently perform certain aspects of a cardiac examination, including inspection, palpation, and percussion. I can confidently inspect the chest for any abnormality and check for cyanosis, pallor, finger clubbing, and edema (Cook et al., 2021). I can also palpate for the apical pulse and identify if it has laterally or medially displaced. Additionally, I can also percuss to identify lateral and superior heart borders. I have also noted I can incorporate a respiratory examination in a cardiac examination as some diseases, such as heart failure, are often associated with pulmonary edema. NUR 634 Topic 5 DQ 2

However, I have noted I am having challenges in auscultation for heart sounds. I can confidently locate the aortic, pulmonary, tricuspid, and mitral valves and auscultate for S1 and S2 heart sounds. However, I cannot correctly identify abnormal heart sounds such as murmurs, S3, S4, and systolic clicks. I am also having difficulties defining the character of pulses based on the volume and waveform (Saugel et al., 2021). As a result, I cannot confidently identify certain conditions, such as aortic stenosis and regurgitation, that present with abnormal pulse waveforms.

NUR 634 Topic 5 DQ 2 References

Byrne, J. (2021). Consultation and clinical assessment of the heart and cardiovascular system. British Journal of Nursing, 30(18), 1066–1072. https://doi.org/10.12968/bjon.2021.30.18.1066

Cook, D. J., Webb, S., & Proudfoot, A. (2021). Assessment and management of cardiovascular disease in the intensive care unit. Heart, 108(5), heartjnl-2019-315568. https://doi.org/10.1136/heartjnl-2019-315568

 Saugel, B., Kouz, K., Scheeren, T. W. L., Greiwe, G., Hoppe, P., Romagnoli, S., & de Backer, D. (2021). Cardiac output estimation using pulse wave analysis—physiology, algorithms, and technologies: a narrative review. British Journal of Anaesthesia, 126(1), 67–76. https://www.bjanaesthesia.org/article/S0007-0912(20)30857-6/fulltext NUR 634 Topic 5 DQ 2