NU-664B Week 5 Assignment 2: Cardiac Annotated Study Guide
Week 5 Assignment 2: Cardiac Annotated Study Guide
Due: Sunday, 5 February 2023, 11:55 PM
Done: Make a submission
Value: Complete/Incomplete (100 points is Complete and 0 is Incomplete)

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Due: Day 7
Grading Category: Other Assignments
Overview
In this assignment, you will complete the following Annotated Study Guide. The study guide is based on the content from this module and is to be completed as you go through your learning material for this module.
It is strongly suggested that you complete this assignment to better prepare for upcoming assignments and exams. This tool will make a handy reference as you go forward in your practice and career.
Instructions
- Download the Cardiac Annotated Study Guide (Word) before you begin your week’s assigned geriatric assessment assigned readings.
- Review the study guide for topics that will be of particular importance during your reading, and type notes from your reading into the guide to annotate it.
- Save your final file with your name and assignment title, then follow the instructions to submit your study guide file.
- Use this study guide for yourself to study for the course exams and to review for your boards.
Please refer to the Grading Rubric for details on how this activity will be graded.
To Submit Your Assignment:
- Select the Add Submissions button.
- Drag or upload your files to the File Picker.
- Select Save Changes.
Submission status
| Submission status | Submitted for grading |
|---|---|
| Grading status | Graded |
| Time remaining | Assignment was submitted 2 days 11 hours early |
| Last modified | Friday, 3 February 2023, 12:37 PM |
| File submissions | |
| Submission comments | Comments (0) |
Annotated Study Guide for Cardiac Murmurs
Instructions
Each of the cardiac topics you are responsible for knowing have been collected in the readings for the module and study guide. To help recall and master this material, you will annotate each topic in this study guide with notes, thoughts, and/or images as you perform the required readings at the start of this week. There will be prompts, but do not consider yourself constrained by these, as long as each topic is annotated in some way.
Cardiac Murmurs
Timing
- Heard longer than heart sounds
- Palpate the carotid arterial pulse
- Systolic, diastolic, or continuous
Intensity of Sound
- Crescendo grows louder, decrescendo gets softer, crescendo-decrescendo, plateau
Location
- Where does the sound originate from?
- Listen to all areas- aortic, pulmonic, tricuspid, mitral
Radiation
- Where does the sound radiate to?
- Think about direction of the blood flow
Intensity
- Graded from I to VI
- Grade I – very faint
- Grade II- faint but heart immediately, louder than grade II
- Grade III- Moderately loud
- Grade IV- loud, thrill
- Grade V- heard with stethoscope partly off chest, thrill
- Grace VI- heard with stethoscope off chest, thrill
- Loud murmurs can have a thrill
Pitch
- What does it sound like- high, medium, low
Quality
- Musical, blowing, harsh, clicking, blowing
Position & Maneuvers
- Is there a change with position- sitting
- Is there a change with respiration
- Valsalva or standing will decrease murmurs except for hypertrophic cardiomyopathy & mitral valve prolapse
Extra Sounds
- S3 is associated with CHF
- S4 is associated with LVH
Systolic Murmurs
- Mitral regurgitation, aortic stenosis
- Benign murmurs
Mitral Regurgitation
- Heard at 2nd ICS right side of the sternum
- Radiates to neck
- Harsh & noisy murmur
- Mid-systolic ejection murmur
Diastolic Murmurs
- Mitral stenosis, aortic regurgitation
- Diastolic murmurs are abnormal
- Heard at the apex
- Low pitch rumbling murmur
- Opening snap
- Little radiation
- Can be caused by rheumatic heart disease
- Heard at 2nd ICS right of sternum
- High pitched blowing murmur, decrescendo
Mitral Valve Prolapse
- S2 click followed by a systolic murmur
- Loud & musical
- May be at higher risk for embolism, TIA, AF
- Diagnosed with echo & Doppler
Continuous Murmurs
- Begin during systole and continue into diastole
- Pericardial friction rub- scratching / scraping
- Patent Ductus Arteriosis (PDA)- machinery like, harsh
- Mammary souffle- heard during late 3rd trimester / lactation
- Where will you expect to hear mitral valve prolapse?
- Describe the sounds of aortic stenosis.
- Name 2 diastolic murmurs.
- What is the most common murmur?
- What is the expected location to hear mitral regurgitation?
Matching
Match the intensity of the murmur to the Grade
Head with stethoscope not touching chest, thrill present Grade II
Loud, accompanied by a thrill Grade VI
Very faint, not heard if the person changes position Grade I
Usually readily heard, slightly louder, heard in all positions Grade III
Loud but not accompanied by a thrill Grade IV
Can be heard with stethoscope barely on chest, thrill present Grade V

