How To: Perform a cardiovascular exam on a patient

The key to being a good doctor is great patient care and thoroughness, and those are exactly the skills you will learn in this video lesson, as you learn to perform a cardiovascular examination on your patient. This is a great, step-by-step resource for the proper examination procedure. Every medical student should know these techniques, and nursing students could benefit from this knowledge, too. Every cardiovascular exam should include inspection of the pulse, blood pressure, carotid pulsations, precordium, and diaphragm. There's even a section on learning to use a stethoscope. See the full procedure.

Preparation:
* Position and gown patient
* ALWAYS stand to patient's right side

Inspection:
* Inspect ankles for signs of edema
* Identify carotid and jugular pulse

Pulse and Blood Pressure:
* Note vital sign values
* Measure pulse and blood pressure if no values are reported or if values are abnormal

Special Consideration — Irregular Pulse:
* Measure up to a minute

Carotid Pulsations:
* Observe pulsations in neck
* Palpate one side at a time
* Note amplitude and contour

Special Consideration — Auscultation for Bruits:
* Place diaphragm or bell over each carotid artery
* Ask patient to hold their breath momentarily

The Precordium:
* Observe for precordial movement
* Identify apical pulse visually
* Palpate apical pulse/PMI
* Palpate for extra movement

Auscultation with the Diaphragm:
* Auscultate aortic area (R 2nd IS)
* Auscultate pulmonic area (L 2nd IS)
* Auscultate tricuspid (L sternal border)
* Auscultate mitral area (PMI)

Auscultation with the Bell:
* Auscultate mitral area (PMI)
* Auscultate other areas as time permits

Go to OPETA for the rest of the written instructions, including the special considerations for S3 and Mitral Murmurs, Jugular Venous Pressure, and Aortic Insufficiency.