Heart and Neck Vessels

Question 1

What can tightness in chest/pain mean?

Answer 1

Angina: occurs when heart’s vascular supply cannot keep up with metabolistic demands

Question 2

Why is it important to note location of chest pain?

Answer 2

Can be caused by pulmonary, musculoskeletal or gastrointestinal

Question 3

What are some chest pain characteristics or feelings?

Answer 3

Crushing, stabbing, burning, vise-like

Question 4

What can a clenched fist mean?

Answer 4

Characteristic of angina

Question 5

What are some associated symptoms of chest pain?

Answer 5

• Diaphoresis (sweating)
• Cold sweats
• Pallor, greyness
• Palpations (feeling of heart skipping)
• Dyspnea (shortness of breath)
• Nausea
• Tachycardia
• Fatigue

Question 6

What do we need to know if patient has dyspnea on exertion?

Answer 6

Exactly what amount of activity causes shortness of breath

Question 7

What is paroxysmal dyspnea?

Answer 7

Unexpected shortness of breath

Question 8

What kinda of dyspnea comes and goes?

Answer 8

Constant/intermittent dyspnea

Question 9

What kind of dyspnea is affected when lying down?

Answer 9

Recumbent Dyspnea

Question 10

What kind of dyspnea occurs while sleeping?

Answer 10

Paroxysmal nocturnal dyspnea

Question 11

When does paroxysmal nocturnal dyspnea occur? Explain how

Answer 11

With heart failure. When lying down, it increases intrathoracic blood and the weakened heart heart cannot accommodate increased load

Question 12

What do most patients experience when they have paroxysmal nocturnal dyspnea?

Answer 12

Awakening after 2 hours with feeling of needing fresh air

Question 13

What is orthopnea?

Answer 13

Need to assume upright position to breath. Note number of pillows used

Question 14

What is hemoptysis and when does it usually occur

Answer 14

• coughing up blood

- Pulmonary disorder or mitral stenosis

Question 15

Why do we ask about when the fatigue occurs, or whether there has been a recent change in energy level

Answer 15

• Fatigue from decreased cardiac output is worse in the evening
• Fatigue from anxiety and depression is present all day or worse in morning

Question 16

Pertaining to the heart/neck vessels, what can blue/ashen facial skin mean?

Answer 16

Cyanosis/pallor occurs with myocardial infarction or low cardiac output

Question 17

Edema is ______ when caused by heart failure

Answer 17

Dependent

Question 18

Why do we ask what time of day the edema occurs

Answer 18

Cardiac edema is worse in the evenings and better in mornings because legs were elevated all night

Question 19

What causes unilateral edema? Bilateral?

Answer 19

• Unilateral: local vein cause

- Bilateral: Cardiac

Question 20

What is nocturia? Who does it occur in?

Answer 20

Excessive urination at night, occurs with heart failure in patients who are ambulatory during the day

Question 21

What does recumbency at night promote?

Answer 21

Fluid reabsorption and excretion

Question 22

What information do we need to obtain for cardiac risk factors?

Answer 22

• 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

Question 23

Why would an older adult not be compliant with medication or treatments?

Answer 23

Side effects or lack of finances