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Assessment Techniques for the Cardiovascular system

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Dame Elysabeth

on 14 September 2016

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Transcript of Assessment Techniques for the Cardiovascular system

gordon functional health pattern
activity & exercise
Respiratory system

Cardiovascular system

Musculoskeletal system
Assessment of this functional health pattern

includes the assessment of 3 major body systems:

Blood studies
Radiological studies
Electrocardiographic studies
Diagnostic studies
Vital signs
Respiratory system
Cardiovascular system
Musculoskeletal system
Physical examination
Subjective
Interview/ history
Identify cardiovascular risk factors
Identify previous illness or surgery
Identify medications required for maintenance
Identify symptoms being experienced
Personal habits (nutrition, smoking, alcohol, exercise and stress)
Age
Gender
Hereditary
Elevated BP
Elevated serum cholesterol
Cigarette smoking
Obesity
Glucose intolerance
Diabetes
Elevated fibrinogen
cardiac risk factors
How many flights of stairs can you climb without stopping?
Would you describe any chest pain or distress that you ever have.
How is your blood pressure?
How often do you wake at night to void?
How does your body feel during exercise?
Do you know your blood levels of cholesterol and triglycerides are
Interview Questions
shortness of breath
cough
tire easily
recent changes in energy level
smoke
exercise
skin changes on arms or legs
heart gallops
shortness of breath while lying flat
swelling
data subjective and Objective
History and interview
Typical daily activities
Exercise
Leisure activities
Limitations to daily activities
Activity tolerance
Strategies to overcome limitations
Risks to activity intolerance
Level of ability to provide self care
Left ventricular hypertrophy
Cocaine use
Personality factors


Protective Factors:
Elevated HDL
Exercise
Estrogen
Moderate alcohol use

Data Subjective
Chest Pain
Palpitations
Dyspnea
Cough
Dizziness
Syncope
Intermittent claudication
Nocturia
Edema
Orthopnea
Common Cardiovascular Signs and Symptoms
inspection
General
Detailed
Pulse; blood pressure
Peripheral vascular assessment
Precordium
General Appearance
Behavior
Posture and gait
Hygiene and grooming
Skin
General
Hands and nails
Lower extremities
Inspection
Skin and mucous membrane
color
edema
nail beds
petechiae
Precordium
Identify landmarks
Thorax: size, shape, and symmetry
Pulsations
Peripheral vascular
Pulses– (more on the following slides)
Capillary refill
Symmetry- always compare side to side
Precordium
Atrial impulse
Lifts/heaves/ thrill- other chest movements other than atrial impulse
PALPATION
Palpate Arterial Pulses
Brachial artery
Carotid artery
Femoral artery
Radial artery
Popliteal artery
Posterior Tibial artery
Dorsalis Pedis artery

Compare side to side/ upper to lower
Rate
Rhythm
Contour
Amplitude (force)
: graded 0 to 4
Palpate Arterial Pulses
4= bounding
3= full, increased
2= expected
1= diminished
0= absent; not palpable
Heart sounds
S1 and S2
S3 and S4
Murmurs
Vascular bruits
Clicks and snaps
Pericardial rubs

Also auscultation of the carotid arteries using the bell of the stethoscope.
Listen for turbulance/ blowing/ swishing. Auscultation of carotid
Auscultation
Pulse oximetry
Vital signs including JVP/CVP
Chest X-Ray
Echocardiography
- stress echocardiogram
- transesophageal

Blood examination
(Hb, platelets, WWC), HCt, cholesterol; cardiac (injury) markers
Other assessment tools and diagnostics
--Nuclear Imaging
Thallium or cardiolite stress test
PET scan (Positron emission tomography)
Coronary angiogram/catheterization
MRI
Stress Tests
Dobutamine
Persantine (nuclear medicine)
Other assessment tools and diagnostics
Activity Intolerance
Anxiety
Decreased Cardiac Output
Fatigue
Fluid Volume Excess
Knowledge Deficit
Self- Care Deficit
Ineffective (Peripheral) Tissue Perfusion
Health Seeking Behaviors
Effective individual therapeutic regimen management
NURSING DIAGNOSIS
Activity and Exercise Pattern
Activity and Exercise Pattern
Activity and Exercise Pattern
Assessment Techniques for the Cardiovascular system
Assessment techniques for the Cardiovascular System
INSPECTION
Fundamentals of nursing assessment
ACTIVITY AND EXERCISE


References
Daniels, R. (2004). Nursing Fundamentals: Caring and Clinical Decision Making. USA Delmar Learning.

Herdman, T.H & Kamitsuru, S. (Eds). (2014). NANDA International Nursing Diagnosis Definitions and Classification 2015-2017. Oxford: Wiley Blackwell

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