Heart and Neck Vessels Flashcards
What can tightness in chest/pain mean?
Angina: occurs when heart’s vascular supply cannot keep up with metabolistic demands
Why is it important to note location of chest pain?
Can be caused by pulmonary, musculoskeletal or gastrointestinal
What are some chest pain characteristics or feelings?
Crushing, stabbing, burning, vise-like
What can a clenched fist mean?
Characteristic of angina
What are some associated symptoms of chest pain?
- Diaphoresis (sweating)
- Cold sweats
- Pallor, greyness
- Palpations (feeling of heart skipping)
- Dyspnea (shortness of breath)
- Nausea
- Tachycardia
- Fatigue
What do we need to know if patient has dyspnea on exertion?
Exactly what amount of activity causes shortness of breath
What is paroxysmal dyspnea?
Unexpected shortness of breath
What kinda of dyspnea comes and goes?
Constant/intermittent dyspnea
What kind of dyspnea is affected when lying down?
Recumbent Dyspnea
What kind of dyspnea occurs while sleeping?
Paroxysmal nocturnal dyspnea
When does paroxysmal nocturnal dyspnea occur? Explain how
With heart failure. When lying down, it increases intrathoracic blood and the weakened heart heart cannot accommodate increased load
What do most patients experience when they have paroxysmal nocturnal dyspnea?
Awakening after 2 hours with feeling of needing fresh air
What is orthopnea?
Need to assume upright position to breath. Note number of pillows used
What is hemoptysis and when does it usually occur
- coughing up blood
- Pulmonary disorder or mitral stenosis
Why do we ask about when the fatigue occurs, or whether there has been a recent change in energy level
- Fatigue from decreased cardiac output is worse in the evening
- Fatigue from anxiety and depression is present all day or worse in morning
Pertaining to the heart/neck vessels, what can blue/ashen facial skin mean?
Cyanosis/pallor occurs with myocardial infarction or low cardiac output
Edema is ______ when caused by heart failure
Dependent
Why do we ask what time of day the edema occurs
Cardiac edema is worse in the evenings and better in mornings because legs were elevated all night
What causes unilateral edema? Bilateral?
- Unilateral: local vein cause
- Bilateral: Cardiac
What is nocturia? Who does it occur in?
Excessive urination at night, occurs with heart failure in patients who are ambulatory during the day
What does recumbency at night promote?
Fluid reabsorption and excretion
What information do we need to obtain for cardiac risk factors?
- Elevated cholesterol levels
- Elevated BP
- Random plasma glucose level value >11.1 mmol/L
- Known diabetes mellitus
- Obesity
- Cigarrete smoking
- Low activity level
- Postmenopausal
- Length of any hormone replacement theory
Why would an older adult not be compliant with medication or treatments?
Side effects or lack of finances
