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1. Analyze 6 extra heart sounds and distinguish what they mean when you hear them.
2. Assess the difference between systolic and diastolic murmurs, as well as clues to expected assessment finding with each.
3. Analyze 5 adventitious breath sounds and understand the clue and common causes for their occurrence.
4. Evaluate voice sounds to confirm pulmonary pathology.

Cardiac Assessment Skills

• Extra Heart Sounds
• S2 Splits
• S3
• S4
• Summation Gallops
• Mechanical Clicks
• Pericardial friction Rubs

• Heart Murmurs
• 4 Systolic Murmurs
• 3 Diastolic Murmurs

Pulmonary assessment

• Adventitious Breath Sounds
• Wheezes
• Rales
• Rhonchi
• Stridor
• Pleural Friction Rubs
• Using Vocal Fremitus to Confirm Pathology
• Bronchophony
• Whispered Pectoriloquy
• Egophony

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, a CE test is available for $9.99 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 may 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.

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.

Continuing Education Information
NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after passing the online post-test (80% passing score) and completing the evaluation). Instructional methods will include PowerPoint, didactic lecture, and others. Continuing Education Information: Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Program content is reviewed periodically per accrediting board rules for currency and appropriateness for credit. Credit approvals are subject to change. 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. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact info@pesi.com or 800-844-8260 before purchase. Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of your profession. 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 profession's standards. For Planning Committee disclosures, please see statement above. For speaker disclosures, please see the faculty biography.

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Nurses, Nurse Practitioners, and Clinical Nurse Specialists
This self-study activity consists of 2.0 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from this self-study activity and contact your state board or organization to determine specific filing requirements.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 2.0 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 2.0 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 2.0 self-study contact hours. Please email cepesi@pesi.com with your license number, include the title, speaker name and date. 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 2.0 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