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Primary Care PT > Screening of the Cardiovascular and Pulmonary Systems > Flashcards

Screening of the Cardiovascular and Pulmonary Systems Flashcards

1
Q

cardiopulm systems checklist

A
  • Dyspnea
  • Cough (duration, positional, productive, sputum)
  • Palpitations
  • Syncope
  • Sweats
  • Edema
  • Cold distal extremities
  • Skin discoloration
  • Open wounds/ulcers
  • Clubbing of the nails
  • Wheezing, stridor
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2
Q

dyspnea

A

difficult/uncomfortable breathing
Often associated with chronic heart and lung disease
• Can be related to activity, exertion, or body position

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3
Q

orthopnea/recumbent dyspnea

A

eased when sit/stand/prop

possible causes
Congestive heart failure
Mitral valve disease
Rarely: Severe asthma, Emphysema, Chronic bronchitis
Neurologic diseases
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4
Q

platypnea/sitting upright dyspnea

A

eased when recumbent

possible causes
Status postpneumonectomy
Neurologic diseases
Cirrhosis (intrapulmonary shunts)
Hypovolemia
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5
Q

Trepopnea/multiple dyspnea

A

eased in side lying

possible causes
- congestive heart failure

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6
Q

dyspnea screening questions

A

 When did the shortness of breath (SOB) begin?
 Did the SOB begin suddenly or slowly over time?
 Do you wake up suddenly at night with severe SOB (paroxysmal
nocturnal dyspnea)?
 Do you know why the SOB started?
 Is the SOB constant?
 Does SOB occur with exertion only? At rest? Or when in certain
positions, such as lying flat (orthopnea) or when sitting up
(platypnea)?

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7
Q

cough

A

– pulmonary or cardiovascular concern
• Nocturnal may indicate heart failure, side effect of medications
• Chronic if 3 weeks or longer
• Most common causes: smoking, allergies, postnasal drip
• Yellow, red/bloody, green sputum suggest pathology

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8
Q

screening questions for cough

A

 What is the duration?
 What is the cause (from the patient’s perspective)?
 Is it constant and persistent or intermittent?
 Is the cough related to position or posture?
 Is it a productive cough (including color and odor of sputum)?
 Is there pain accompanying the cough?
 Associated symptoms (dyspnea, items from the general health checklist)?

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9
Q

Palpitations

A
  • Described as “fluttering, jumping, pounding, irregular, skipping”
  • Follow-up questions about frequency and duration
  • Associated symptoms: chest pain, syncope, lightheadedness, dyspnea
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10
Q

Syncope

A
  • Sudden loss of consciousness  loss of postural tone  spontaneous recovery
  • Causes: reduced blood flow to brain, metabolic or psychogenic origin
  • Increase >70yrs…increased fall risk
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11
Q

Sweats/diaphoresis

A
  • Common with acute myocardial infarction
  • Pain/tightness into L UE, jaw, neck, epigastric, midthoracic regions
  • Diaphoresis + described pain pattern = increased concern
  • Elevated concern if risk factors for cardiac disease
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12
Q

edema/cold distal extremities/skin discoloration

A
  • Peripheral edema and tissue changes
  • Observed at any point during assessment
  • Associated with many serious pathologies:
  • Venous insufficiency
  • Congestive heart failure
  • Deep vein thrombosis (DVT)
  • Pulmonary hypertension
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13
Q

Screening questions for adema

A

 What was the onset of the edema (slow versus fast)?
 Is it related to dependent limb position?
 Is it related to time of day—morning versus end of the day?
 Are there any other associated symptoms or signs, e.g., pain, cyanosis, jaundice,
redness of the limb(s), clubbing of the nails, cough?

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14
Q

Exam findings for edema/cold extremities/skin discoloration

A
  • Confirmation via palpation and/or observation of limb
  • Findings: pitting edema, local tenderness, altered skin temperature, color variance
  • Circumferential measurements for edema
  • Unilateral edema marked by difference of 1+cm above ankle or 2+cm at midcalf
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15
Q

Open wounds/ulcers

A

vascular compromise
diabetes
infections
skin cancer

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16
Q

clubbing of the nails

A
  • Distal phalanx appears rounded and bulbous
  • Nail plate is convex-shaped
  • Abnormality associated with:
  • Chronic hypoxia
  • Lung cancer
  • Cystic fibrosis
  • Congenital heart defects
  • Graves disease
  • Overactive thyroid
17
Q

wheezing/stridor

A
  • Abnormal respiratory sounds
  • Audible to ear
  • Wheezing is high-pitched noise, due to partial airway obstruction
  • Stridor is high-pitched sound due to obstruction of larynx or trachea
  • Additional signs of general and pulmonary distress
  • Auscultation to identify sounds, see if position change affects sounds
18
Q

wheezing/stridor screening questions

A 
 Have you noticed this noise?
 Do you know why the sound exists?
 How long has it been present?
 How often does it occur?
 What are the precipitating factors (e.g., odors, food, animals, exertion, emotions)?
 Are there any associated symptoms?
19
Q

hypertension symptoms

A
  • Facial flushing
  • Headaches
  • Altered vision
  • Dizziness
  • Nosebleeds
  • Shortness of breath
  • Chest pain
  • Unsteady, “rubbery” legs
  • Feeling “faint”, syncope
20
Q

orthostatic hypotension symptoms

A

lightheadedness
unsteady legs
feeling faint

management:
- lie down
- ankle pumps
modify standing activities
- notify medical personnel as needed
21
Q

atherosclerosis risk factors

A

Age
- Men ≥45 years old Women ≥55 years old
Family History
- Myocardial infarction, coronary revascularization, or
sudden death before:
• 55 years in father/other male first-degree relative
• 65 years in mother/other female first-degree relative
Cigarette Smoking
- Current smoker or recently quit (within previous 6 mo)
Physical Inactivity
- ≤90 min/wk mod intensity or ≤150 min/wk light intensity
Obesity
- Body mass index ≥30 kg/m2
Hypertension
- Systolic ≥140 mm Hg and/or diastolic ≥90 mm Hg on BP
- based on an average of ≥2 readings obtained on ≥2
- occasions or taking antihypertensive medication
Dyslipidemia
- Low-density lipoprotein (LDL) ≥130 mg/dL or
- High-density lipoprotein (HDL) <40 mg/dL
Diabetes
- Fasting plasma glucose ≥126 mg/dL

22
Q

Congestive heart failure symtoms

A
  • Increased fluid retention
  • Weight gain
  • Dependent pitting edema
  • Increased fatigue with activity
  • Distention of the jugular veins
Management
• Pharmaceutical intervention
• Dietary modifications
• Healthy lifestyle
• Regular medical assessment/follow-up

Primary Care PT (10 decks)

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