Okay, okay, okay. I'm in the last semester of school and seem to have not gotten down something I thought is really simple. It is the idea of, when documenting, what is heart sounds vs heart rhythm.
Heart sounds can be normal or abnormal, and heart rhythms can be regular or irregular, according to my school's teachings. Now, when they say, are the heart sounds normal or abnormal, I'm thinking, the actual question is: are there any murmurs, s3, s4, or out of sync beats (like an extra beat that you'd hear with a.fib or something)? If yes, then the heart sounds are abnormal, if no, then they are normal.
For heart rhythm, I'm thinking the question behind it is, is the beat steady. If we have an s3, but the beat is steady and constant, then the rhythm is regular. If, for example, we have a 3rd degree heart block, then of course the rhythm is irregular.
Is this correct? And if I'm not correct, what is the difference between Sound vs Rhythm with an example. Because my teaching was describing it to me in a way that made it sound like they were basically the same thing, making one of the categories redundant...
Also, if you can give examples of, Normal Heart Sounds with an Irregular Rhythm, and also Abormal Heart Sounds with a Regular Rhythm, that would be sweeeeet.
Specializes in Medical-Surgical/Float Pool/Stepdown.
made me say this:
I stand by my assertion that S3 and S4 are not extra valve noises, and the lub-dub (properly called S1 and S2) are not the result of the ventricles squeezing and delivering a pulse, and my subsequent correction of those misapprehensions.
I really, really, didn't want the OP to go away with confusion on that, as his/her instructor had already given enough reason for confusion.
Either way, I meant that you should feel a pulse while being able to hear the heart beating...if you are always so eloquent in all of your online typings (with the years of practice that you've had on AL) then kudos to you. Could have been easily clarified...and in a more professional way but no skin off my back, this is the internet after all. No one has to be polite or professional to each other. In a world of spell check and trying to type on my phone I would have asked for clarification before sending that reaction. Probably one of the main reasons nurses stop posting here...
I agree, it does seem obvious, but I'm not sure you read my entire post... For clarification purposes, would you call a.fib normal heart sounds as GrnTea did? Because my teacher wouldn't, but I would. Now I'd like your opinion as it seems according to my quote, that you wouldn't consider it normal sounds. This is where I'm confused, and seemingly other people too.
Thanks a ton!
The lub dub is the sound made when the valves close and you hear the blood hitting the closed valve.
So yes, as Green Tea said, they are normal sounds, just abnormal rhythm. Remember, sound does not equal rhythm, they are two separate things you are assessing together. Listen over the 4 points, aortic, pulmonic, triscuspid, mitral: about 2nd intercostal, A to right of sternum, P to left of sternum, then down to T left of sternum at about 5th intercostal, M at 5th mid clavicular line (apical area). These spots let you hear that valve louder than the others. S1 tends to be louder at T&M, S2 louder over A&P. It takes a lot of skill and practice to truly hear if one of those valves is leaking (murmur) louder than the others, which is why we just say if the murmur is systolic or diastolic, not which valve.
Listen over the mitral or apical area, to count apical pulse. This should correspond to a palpated radial pulse; what you are feeling for is to see if every beat you hear actually produces a palpable pulse at the wrist. If the heart is very irregular, sometimes the chambers don't have time to fill with enough blood to push a pulse down the arm.
AJJKRN
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Either way, I meant that you should feel a pulse while being able to hear the heart beating...if you are always so eloquent in all of your online typings (with the years of practice that you've had on AL) then kudos to you. Could have been easily clarified...and in a more professional way but no skin off my back, this is the internet after all. No one has to be polite or professional to each other. In a world of spell check and trying to type on my phone I would have asked for clarification before sending that reaction. Probably one of the main reasons nurses stop posting here...