Cardio #2 Subj Data, Health history, IPPA Flashcards
Subjective Data
Chest Pain
Dyspnea
Orthopnea
Cough
Fatigue
Cyanosis or Pallor
Edema
Nocturia
Past Cardia history
Family Cardiac history
Personal Habits
Onset, Location, Character, Aggravating, and/or relieving factors
Character: Crashing, stabbing, Burning, vise-like
Associated Symptoms: Sweating, ashen gray or pale skin, shortness of breath, nausea or vomiting, racing of heart, heart skips beat.
Chest Pain
cause, onset, duration, affection by position
Does shortness of breath interfere with activities of daily living
Dyspnea
Is the need to assume a more upright position to breathe
Note the exact number of pillows used
Orthopnea
Subjective Data of cough
Duration
Frequency
Type
coughing up sputum (color, odor, blood tinged)
aggravating and/or relieving factors
Subjective data of Fatigue
Onset
relation to time of day
Subjective data of Cyanosis or pallor
Occurs with myocardial infarction or low cardiac output
swelling of legs or dependent body part due to increased interstitial fluid
onset, recent change, relation to time of day, relieving factors, associated symptoms
Edema
occurs with heart failure in the person who is ambulatory during the day
Nocturia
Examples of past cardiac history
Last ECG
Stress ECG
Serum cholesterol measurements
other heart tests?
Example of family cardiac history
Family history of hypertension, diabetes, heart problems, coronary artery disease (CAD) , Sudden death at younger age
Personal habits (cardiac risk factors)
Nutrition
Smoking
Alcohol
exercises
drugs
Additional history for infants
Mother’s health during pregnancy, feeding habits, growth, activity
Additional history for children
Growth, activity, any joint pains or unexplained fever, frequent headaches or nosebleedings, streptococcal infection (tonsillitis)
Additional history for pregnant females
Any high PB during this or previous pregnancies, associated signs (weight gain, proteinuria), dizziness
Additional history for aging adult
Any symptoms of heart diseases (HTN, CAD) or COPD, any recent changes, medications (digitalis), side effects ; environment
what do we inspect for
Skin color (Cyanosis, pallor) and condition
any obvious bulging on anterior thorax at the left
Edema
Orthopnea
what do we palpate
Apical pulse
Location of palpation
One intercostal space (usually 5th ICS) at left MCL
Size from palpation
Normally 1cm x 2cm
Amplitude from palpation
Normally a short gentle tap
Duration during Palpation
Short, normally occupies only first half of systole
What do we ask the client during assesment
To exhale then hold it or turn him to the left side
is used to estimate approximately heart borders and configuration
Recently is displaced by the chest
x-ray or EchoCG
Helps to detect heart enlargment
Percussion (Cardio)
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