Question

1. Compare the heart sounds S₃ and S₄. Describe how you would assess your patient for each. In relationship to S₁ and S₂, when would you hear these sounds?

2. Patients with both right and left – sided heart failure may present with elevated BNP levels. Explain what a focused respiratory assessment for each would reveal and why the results are different.

3.Discuss how you would assess your patient for right-sided heart failure: explain what you would do (be specific) and what results you would anticipate.

Answer 1

S3 is ventricular gallop which occurs after s2 in increased atrial pressure leading to mitral valve opening.it occurs maily in congestive heart failure.S4 is atrial gallop that occurs when atria contract to pump blood in to left ventricle.it happens mainly in diastolic heart failure.s3 is heard after S2 abd S4 is heard normally after S1.in left sided heart failure there may be pulmonary congestion,causing crackles ,tachypnea,wheezing and blood tinged sputum.and right heart failure mainly arises due to chronic pulmonary disorders and it causes pumping problem in heart.

3.a.assesment includes with history taking.risk factors are assessed..which includes chronic pulmonary conditions,smoking,histry of left sided heart failure

b.physical assesment.

Weight increase by fluid retention

Pitting edema

Jugular venous dustension

Ascites

C.ask for orthopnea and paroxysmal nocturnal dyspnea

d.chest x ray that shows cardiac enlargement,fulffy appearance of pulmonary vessels,fluid collections in pleural space

E blood test BNP AND nt pro Bnp test.

Further assessment can be done with ecg and echo followed by cardiac catheterisation