Assess the character (e.g. slow-rising, thready) and volume of the pulse.

A focused assessment of the cardiac system includes a review for common or concerning symptoms: Chest pain—assess location, when it occurs, intensity, type, duration, with or without exertion, radiation, associated symptoms (shortness of breath, sweating, nausea, palpitations, anxiety), and alleviating factors.

Documentation of a basic, normal heart exam should look something along the lines of the following: The external chest is normal in appearance without lifts, heaves, or thrills. PMI is not visible and is palpated in the 5th intercostal space at the midclavicular line. Heart rate and rhythm are normal.

When performing a nursing assessment on the cardiovascular system, you will use palpation and auscultation to assess the carotid arteries for a thrill and a bruit. The thrill is a vibration against your fingers. It can feel like a buzzing or humming under the skin. Use the same method as palpating the carotid arteries.

The most common and most important cardiac symptoms and history are: Chest pain, tightness or discomfort….Associated cough:

• Duration, paroxysms or constant, dry or productive?
• Associations: is it related to chest pains; any fever or shivering fits?
• Sputum: colour, quantity and any haemoptysis?

1. Palpate the radial pulse.
2. Assess for radio-radial delay.
3. Palpate the brachial pulse.
4. Assess for a collapsing pulse.
5. Auscultate the carotid artery.
6. Palpate the carotid pulse.

A focused assessment of the cardiac system includes a review for common or concerning symptoms: Chest pain-assess location, when it occurs, intensity, type, duration, with or without exertion, radiation, associated symptoms (shortness of breath, sweating, nausea, palpitations, anxiety), and alleviating factors.

A thorough cardiovascular assessment will help to identify significant factors that can influence cardiovascular health such as high blood cholesterol, cigarette use, diabetes, or hypertension (CDC, 2011). Therefore, a cardiovascular exam should be a part of every abbreviated and complete assessment.

Heart sounds were recorded by placing the phone on the skin of the chest, using the built-in microphone. In most smartphones, microphones are located on the lower border of the device. Heart sounds can be best heard in the intercostal spaces.

Past medical history Note whether there have been any heart attacks, any history of angina and any cardiac procedures or operations (type and date of intervention and outcome). Previous levels of lipids if ever checked or known. Ask whether there is any history of rheumatic fever or heart problems as a child.

Thrills: These are vibratory sensations felt on the skin overlying the heart, which indicates turbulence; this can be felt in loud murmurs and are necessary for murmur grading.

Objective Assessment The physical examination of the cardiovascular system involves the interpretation of vital signs, inspection, palpation, and auscultation of heart sounds as the nurse evaluates for sufficient perfusion and cardiac output.

Skill Development in the Clinical Setting. Nurses should be able to recognize normal heart sounds and the split of the second sound. Murmurs should be recognized as normal or abnormal. Nurses working in intensive care units and emergency departments require advanced skills in auscultation of heart sounds.

The five landmarks include: A good set of vital signs are important for any patient but especially for a patient with cardiovascular symptoms or complications. Always take a full set of vital signs including blood pressure, heart rate (pulse, apical pulse), respiratory rate and temperature.

The physical examination of the cardiovascular system involves the interpretation of vital signs, inspection, palpation, and auscultation of heart sounds as the nurse evaluates for sufficient perfusion and cardiac output.