Palpate Cardiac Valves IRL?

Published

Do nurses palpate all cardiac valves with their head-to-toe assessment every time in the real world?

Up Vote Up Vote ×
Do nurses palpate all cardiac valves with their head-to-toe assessment every time in the real world?

Palpate as in feel for them or auscultation as in listen for heart sounds and murmurs? Big difference.

Up Vote Up Vote ×

Palpate as in feel for them. My head-to-toe assessment from my school says, "palpate over valve sites"

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

To be honest, I've never palpated over the valve sites in the 10 years I've been a nurse, nor did I learn how to palpate them in school.

In the real world of nursing, ain't nobody got time for that.

Up Vote Up Vote ×
To be honest, I've never palpated over the valve sites in the 10 years I've been a nurse, nor did I learn how to palpate them in school.

In the real world of nursing, ain't nobody got time for that.

Thank you so much, TheCommuter!!

Up Vote Up Vote ×

I have never seen any of our nurses do that nor have I heard anyone talking about it. Maybe on a cardiac floor, but I highly doubt if they are doing it.

Up Vote Up Vote ×
To be honest, I've never palpated over the valve sites in the 10 years I've been a nurse, nor did I learn how to palpate them in school.

In the real world of nursing, ain't nobody got time for that.

Nor I in 30+ years. I'm not sure what the point of trying to palpate valve sites would be.

Up Vote Up Vote ×
Specializes in ICU, LTACH, Internal Medicine.

The point is to feel so-called "thrill", also named "kitty's purring". You can feel blood flows this way if you are experienced enough and, importantly, patient is thin enough (either a young child or very much cachectic adult ). Sort of the very poor man's doppler.

Even in places where physical exam is still taught the good ol' fashioned way, valves palpation is not practiced that much, and for daily nursing exam it is absolutely poitless, even if one somehow got time for that, which is never going to happen.

Up Vote Up Vote ×

You could assess the PMI -- that's "point of maximum impulse/impact," as in, "Is the heart so enlarged that you can feel it banging right through the chest wall?" Sometimes good to know.

Up Vote Up Vote ×
Specializes in ICU, LTACH, Internal Medicine.

"Heart banging through the chest" is not about enlarged heart but about hyperkinesis of left ventricle, which can be enlarged or not, and its function may be altered or not. It may be symptom of a dozen of things (compensated aortic stenosis, pheochromocytoma, hyperthyroid/thyroid storm, HTN urgency/emergency, cocaine/meth toxicity and overdose of dig, to name just a few). The common thing is that it is well accessible on rather thin patients.

The physical enlargement of "heart" (or, rather, left ventricle) is accesed by percussion of left cardiac border. It must be, depending on the patient's body type, at left mid-clavicular line or an inch to the left at most. Percussion on anterior axillary line means enlargement of the left ventricle or displacement, usually of the whole mid-mediastinum (like in tension pneumothorax on the right side).

Up Vote Up Vote ×
Specializes in 15 years in ICU, 22 years in PACU.

I'm curious as to what school on this planet is teaching cardiac valve palpation to nursing students.

Up Vote Up Vote ×

I have never heard that but I did learn the auscultation points for the valves? I don't get what palpating them would do. Most sick people are overweight anyways so it seems pointless

Up Vote Up Vote ×
+ Join the Discussion