Cardiovascular Assessment

Question 1

Health History

Answer 1

Consist of:
1. History of Present Illness
2. Past Medical History
3. Family History

Question 2

History of Present Illness

Answer 2

Ask about:
1. Orthopnea
2. Dyspnea
3. Easy fatigability
4. Growth Delays
5. Squatting
6. Edema
7. Frequent occurrences of pneumonia

Parents may report:
1. Diaphoresis
2. Delayed gross motor development
3. Cyanosis
4. Tachypnea

Question 3

Past Medical History

Answer 3

Assess for:
1. Problems occurring at birth
2. Frequent infections
3. Chromosomal abnormalities
4. Prematurity
5. Autoimmune disorders
6. Use of medications (corticosteroids)

> Assess mother’s pregnancy, labor and delivery history
Assess status of the neonate at birth
Assess maternal use of medication (illicit or OTC drugs and alcohol); exposure to radiation; presence of hypertension; maternal viral illnesses

Assess Risk Factors:
1. Family History of heart disease or CHD
2. Hyperlipidemia
3. Diabetes Mellitus
4. Obesity
5. Inactivity
6. Stress
7. High-cholesterol diet

Question 4

Inspection

Answer 4

1. Color of skin, noting cyanosis
2. Inspect skin for edema
   > In infants, peripheral edema occurs in the face, then the pre sacral region and then the extremities
   > Edema of the lower extremities is characteristic of right sided heart failure in older children
3. Clubbing (fingers and toes)
   > First sign is softening of the nail beds followed by rounding of the fingernails, followed by shininess and thickening of the nail ends
4. Temperature
5. Respirations
6. Neck for JVD
7. Note abdominal distention

Question 5

Palpation

Answer 5

1. Palpate radial or brachial pulse
2. Palpate femoral pulse
3. Note:
   > Tachycardia
   > Bradycardia
   > Rhythm irregularities
   > Diminished peripheral pulses or thready pulse
4. Palpate abdomen for hepatomegaly (sign of right-sided HF)

Question 6

Auscultation

Answer 6

1. Apical pulse for a FULL MINUTE
2. Heart sounds
3. BP in both upper and lower extremities