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1. Identify the importance of listening over all four heart valves every time doing a cardiac assessment.
2. Recognize the significance of S3 and S4 heart sounds.
3. Distinguish between systolic and diastolic murmurs.

1. Cardiac Assessment
1. Correct auscultation of heart tones & location of heart valves
2. Abnormal and extra heart tones - discuss and listen to examples!
1. Differentiate between normal and abnormal tones
2. S3
3. S4
4. Summation Gallop
5. Pericardial rub
6. Clicks
7. Murmurs
1. Classification of murmurs
2. Systolic murmurs
3. Diastolic murmurs
4. Continuous murmurs
3. Heart failure - recognizing the assessment changes expected with each
1. Right-sided heart failure
2. Left-sided heart failure
3. Mixed heart failure.
4. Cor Pulmonale
5. Learn what diagnosis just moved into second place for cause!
4. Assessing chest pain
1. Many thing that aren't heart can cause chest pain
2. What clues during your assessment can help you decide what is this patients symptom origin?

Cyndi Zarbano, MSN-Ed, CCRN, CMSRN, LNC, has been a nurse for nearly 30 years specializing in intensive care. She earned her legal nurse consultant training through the Vickie Milazzo Institute in 2008 and has worked on nearly 250 cases for various boards of nursing. She has worked with attorneys on pre-corrective action and with nurses to meet consultation requirements to fulfill corrective action guidelines.

Additionally, Cyndi has worked as a legal nurse consultant responsible to analyze medical records, determine merit, assist with client interviews, attend medical appointments, locate testing experts, complete chronologies, review billing for accuracy, provide deposition/jury question development, and assist in court strategy development. Cyndi is a renowned national seminar speaker having spoken for numerous companies since 2008, including her own, Clinical Review Consultants. She works for Mayo Clinic in Minnesota continuing her passion for bedside nursing in critical care. Speaker Disclosures:
Financial: Cynthia Zarbano is the owner of Clinical Review Consultants and has an employment relationship with Mayo Mankato. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Cynthia Zarbano has no relevant non-financial relationships.

For U.S. and Canadian customers, CE is available for $10 USD per participant. International CE rates may vary; please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion will be emailed, faxed or mailed to participants completing the post-test/evaluation and paying the CE fee.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 9/27/2019
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 1.0 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 1.0 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 1.2 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

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Other Professions
This self-study activity qualifies for 1.0 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Nurses, Nurse Practitioners, Clinical Nurse Specialists