Nursing Points

General

1. Heart Murmurs
   1. Causes
      1. Valves stiff and open (blood flows through)
      2. Valves not completely closed -> insufficiency (backflow of blood)
   2. Locations are heart where the heart is directing the blood
      1. Aortic -> right
      2. Pulmonic -> left
      3. Mitral -> midclavicular left
      4. Tricuspid -> bottom sternum
   3. Systolic murmurs -> during contraction
      1. Sound = s1 -> swoosh -> s2
      2. Aortic stenosis
         1. Hear = harsh, loud, rough
         2. Caused by calcification of valves and rheumatic fever
      3. Mitral insufficiency
         1. Hear = loud, blow
         2. Caused by MI, rheumatic heart disease
   4. Diastolic murmurs -> during filling
      1. Sound = s1 -> s2 -> swoosh
      2. Mitral stenosis
         1. Hear = rumble
         2. Caused by calcification
      3. Aortic insufficiency
         1. Hear = blow
         2. Caused by systemic HTN and rheumatic heart disease