Patient Assessment - Cardiac

Question 1

Practice OPQRST Hx for chest pain.

Answer 1

Onset:

• Is it sudden or gradual?
• How did it begin?
• Where were you when it started?
• What were you doing at the time?

Provocation:

• What brought on the pain?
• Was it related to exertion or were you sitting/resting?
• Does anything make the pain better or worse?

Quality:

Describe the pain.

• Is it sharp, dull, heavy, squeezing, crushing?

Radiation:

• Does the pain travel anywhere else? Does the pain radiates down your arm, up your neck, or Into your back?

Severity:

• Rate the pain/discomfort on a scale of 1/10.

Timing:

• When did the pain start?

Question 2

Define:

Paroxysmal Nocturnal Dyspnea

Answer 2

Shortness of breath that awakens the patient from their sleep.

Question 3

Define:

Orthopnea

Answer 3

Shortness of breath while lying down.

Question 4

Define:

syncope

Answer 4

Temporary loss of consciousness.

Question 5

What medical conditions are commonly prescribed with digitalis?

Answer 5

• CHF
• Atrial flutter
• Atrial fibrillation
• SVT

Question 6

What type of medication ends with “lol”?

Answer 6

beta-blockers

Eg. Atenolol, Bisoprolol, Metoprolol, Labetalol, Carvedilol, Nadolol.

Question 7

What are the functions of beta blockers?

Answer 7

• Decrease the HR.
• Decrease the contractility of the heart.
• Decrease the blood pressure.

Question 8

What is the funtion of diuretics?

Answer 8

It makes the kidneys excrete more sodium and water than usual.

It is used in patients with CHF or hypertension.

Question 9

What are the functions of calcium channel blockers?

Answer 9

• Prevents coronary artery spasm.
• Decreases cardiac contraction.

Question 10

Define:

orthostatic hypertension

Answer 10

An increase in blood pressure from sitting vs. supine.

Question 11

What is the sound of a normal heart?

Answer 11

“lub” “dub”

This signifies S1 and S2.

Question 12

What are the two abnormal heart sounds?

Answer 12

“da” “bla”

This signifies S3 and S4.

Question 13

When S1 heart sound is auscultated, what are you hearing?

Answer 13

Closure of tricuspid and mitral valves.

Question 14

When S2 heart sound is auscultated, what are you hearing?

Answer 14

Closure of the pulmonic and aortic valves.

Question 15

When S3 heart sound is auscultated, what are you hearing?

Answer 15

• Young adults: rapid filling of the ventricle
• Older adults: heart failure

Question 16

When S4 heart sound is auscultated, what are you hearing?

Answer 16

Turbulent filling from ventricular stiffening.

It is very rare and heard just before S1.

Question 17

Define:

pulsus paradoxus

Answer 17

It is characterized by a drop in systolic BP during inhalation.

>10 mmHg

Question 18

Define:

pulsus alternans

Answer 18

A difference in the palpable strength of the heart beat.

Question 19

Define:

pulse pressure

Answer 19

The difference between diastolic and systolic pressure.

Question 20

What conditions can result in different blood pressures between each arm?

Answer 20

• Stroke
• Aortic aneurysm

Question 21

How often should vital signs be obtained for critical and non-critical?

Answer 21

• critical: 5 minutes
• non-critical: 15 minutes