Flashcards in Cardio Flash Cards 2 Deck (65)
What things are you asking for in a cardiac health history?
Activity level, lifestyle choices, chest pain, palpitations, shortness of breath, and edema
What things are you focusing on in the activity level portion of the assessment?
current activity level, amount of exercise (daily, weekly, monthly), lack of exercise (preference vs. inability), pain, and sudden onset of changes in tolerable activity level
What are some lifestyle choices that you should ask in heart?
smoking, caffeine intake, alcohol use & # of drinks, and prescription or illicit drug use
How do you calculate pack history?
number of packs per day X number of years smoked
What kind of things do you ask about chest pain?
chronic/acute onset, onset & duration, aggravating relieving factors, quality, radiation to shoulder jaw, back, and neck
What do women typically complain of ?
Upper back pain rather than chest pain
What are the types of pain?
pressing, viselike, severe, and ripping
What do you assess in palpitations?
unpleasant awareness of heartbeat, described as skipping, racing, fluttering, pounding; may be due to anxiety; may be acute or chronic; associated symptoms, and aggravating or alleviating factors
What is dyspnea?
difficulty with inspiration or expiration. Sudden onset may be due to pulmonary embolism, pneumothorax (lung collapse) or anxiety
What is orthopnea?
Difficulty breathing when lying down. May be due to congestive heart failure (CHF)
What is paroxysmal nocturnal dyspnea?
Difficulty breathing and awakening during sleep. May be due to heart failure or asthma
What is a cough?
Can be productive or non-productive. May indicate congestive heart failure or coexisting pulmonary infection
What is edema?
Excessive fluid in interstitial space
What is dependent edema?
Located in feet or ankles. May be due to CHF or vascular insufficiency, norm in preggers, may have darkening around ankles, and presences of sores that don?t heal on lower extremities
What is periorbital edema?
edema in tissues surrounding eyes ( rarely a normal finding), may be due to renal or liver failure, or pre-eclampsia in preggers
What parts of the body are included in a heart assessments, besides the heart?
eyes, neck, chest, arterial pulses, venous return, blood pressure, heart rate, and pulse pressure
What do you assess in the neck?
right jugular vein pressure to estimate central venous pressure ( not used in infants and children < 12)
What do you assess in the chest?
inspection of chest wall, auscultation of sounds, palpations for PMI, or thrills
What does a peripheral arterial pulse tell you?
indicates degree of perfusions, apical pulse and radial pulse comparison
What does the peripheral venous system indicate?
Degree of return of flow to heart
What does the carotid pulse assessment tell you?
circulation to head and neck, bruits may be detected by listening w/ stethoscope.
What must you never do when palpating the carotid?
NEVER palpate both carotids at once!
In the examination of the neck, what are you assessing in the Jugular Venous Pressure?
right atrial pressure, central venous pressure, right ventricular end pressure, and easy noninvasive low-tech assessment tool for use in outpatient settings
What does a change in JVP indicate?
fluctuations in volume status, right and left ventricular function, tricuspid and pulmonic patency, pericardial pressure, and arrhythmias
What does a low JVP indicate?
hypovolemia (blood loss or extreme dehydration)
What does an elevated JVP indicate?
heart failure, pulmonary hypertension, tricuspid stenosis, and pericardial compression
What is the appropriate JVP Procedure?
raise bed/head to 30*, turn pt head to the left to view the RIGHT side, place a centimeter ruler upright on the sternal angle, identify the highest point of pulsation in the jugular vein, place a card/tongue blade horizontally from the top of the jugular vein to the ruler, make a right angle, and measure the distance above the sternal angle in centimeters. Normal is 3 to 4 cm elevation
What are the surface landmarks for Cardio?
Midsternal line- MSL, Midclavicular Line-MCL, Anterior axillary line-AAL, and Midaxillary line-MAL
Blood flows through the heart from _ to _
Right to Left