Health Assessment Quiz 3 PDF

Health Assessment Quiz 3 Cardiovascular Identify the relevant data that is included in a comprehensive health history of the heart and peripheral vascular system (present health status, past medical hx, family hx, problem-based hx) Present Health Status - Chronic Illness (Diabetes, Renal Failure (Ki...

Health Assessment Quiz 3 Cardiovascular Identify the relevant data that is included in a comprehensive health history of the heart and peripheral vascular system (present health status, past medical hx, family hx, problem-based hx) Present Health Status - Chronic Illness (Diabetes, Renal Failure (Kidney), Hypertension)? Allergies? Medications (BP meds, Aspirin, puffers)? Past Health History - Heart Disease or defect? Rheumatic fever (a condition that causes the heart, joints, brain and skin to swell)? Hyperlipidemia (high cholesterol)? Angina (chest pain)? Family History - Diabetes? Heart Disease? Hyperlipidemia (high cholesterol)? Hypertension? Angina? Personal & Psychosocial History - - Exercise? Personality type? Stress management? Relaxation methods? Diet? Alcohol Consumption (how much)? Drugs? Caffeine (how much)? Smoke (how often, what, how much)? #pack years = #packs/day x # of years smoking Problem Based History - OLD CARTS Chest Pains? Shortness of Breath (SOB)? Nocturia? Cough? Fatigue? Leg Cramping? Swelling of feet or ankles? Fainting? Describe the procedure to test for carotid bruits and explain the meaning of a negative test and a positive test Auscultate Carotid Arteries for Bruits: Positive Test (Should not Hear) Bruit- Low pitched “blowing” sounds that indicate the narrowing of the vessels Negative Test (Should Hear) No sound Landmark, identify, understand and auscultate the following areas of the heart: Aortic, Pulmonic, Erb's point, Tricuspid, Mitral (APE to Man) ICS (InterCostal Space), LMCL (Left Midclavicular Line), ICS RSB (Intercostal Space Right Sternal Border), LSB (Left Sternal Border) APE to MAN Aortic - 2nd ICS RSB (Right side, 2 Spaces down) Can lie supine or on side Pulmonic - 2nd ICS LSB (Left side, 2 rib spaces down) Erb’s - 3rd ICS LSB (Left side, 3 rib spaces down) Best to hear for heart Murmurs Tricuspid - 4th ICS LSB (Left side, 4 rib spaces down) Mitral - 5th ICS MLCL (Left middle, 5 rib spaces down) Under the nipple Distinguish between normal and abnormal heart sounds (S1, S2, S3, S4 and a murmur/friction run). Heart Sounds: S1 - “Lub” First Sound, Systole (Contraction), Closing of AV Valves S2 - “Dubb” Second Sound, Diastole (Relax+Refill), Closing of the semilunar valves Splitting of S2- Sounds like gallops (Common in younger population) S3 - Heard after S2, “Ken-tuck-y” (Caused by: Fluid overload) S4 - Heard after S1, “Ten-ness-ee” (Caused by: Ventricle stiffness) Murmur - “Whooshing” Sound. Prolonged and abnormal heart sounds produced by vibrations created when blood flow is altered. Structural abnorms in valves, pulmonary or aortic valves. Systolic Murmur - Most common cause: Incompetent valves or obstruction of blood flow through valves. Diastolic Murmur - Most common cause: Incompetent or narrowed valves. Pericardial Friction Rub - Rubbing sound audible during both S1 + S2, caused by inflammation of the pericardial sac, Sounds like sandpaper rubbing together. Identify normal and abnormal rate and rhythm when auscultating heart sounds. Rate: Normal: (60-100 bpm) Abnormal: Tachycardia - Too Fast Bradycardia - Too Slow Rhythm: Space between beats Regular Irregularly- Same pattern Irregular irregularly- All over the place Identify what is meant by the terms "heave" and a "thrill" Palpate the precordium (chest) for: Heave- feels like the heart is pushing up on your hands Thrill- feels like vibration Health promotion practices that are pertinent to the heart and vascular system - Limiting alcohol+quitting smoking Reducing stress - Eating nutritious foods Good weight Physical activity Landmark and palpate the following pulses: radial, ulnar, brachial, popliteal, dorsalis pedis, posterior tibial and femoral pulses. Radial - Upper wrist, on the left side Brachial - At elbow bend, on the inside Popliteal - Back of leg (knee cap) Dorsalis Pedis - Top of foot between big and 2 toe Posterior Tibial - Inside of your foot, below ankle ball Femoral - Groin area Describe the various measures of edema: 1+ to 4+, and the term "pitting". What do these all mean? Pitting Edema - Caused from built up fluid (ex. Obesity, heart failure, injury, hypertension) 0 - No Pitting edema +1 - Disappears almost immediately +2 - Mild Edema. Disappears 10-25 sec +3 - More than 1 min +4 - Last between 2-5 min (Severe) Neurovascular Assessment Why? - You are assessing to see if the NS and vessels are working properly in limbs. Who is it Done on? - Anyone suspected of having cardiovascular disease, trauma and surgery, diabetes, car accidents, older people, someone in a cast, burns or infections. Normal Findings: Sensation - No numbness or tingling Movement - Able to move fingers and toes Color, Temp, pulses, edema Cap Refill - Gently squeeze tip of finger nail for 5 sec. Should be less than 2 seconds. If greater than 2 seconds its poor perfusion (circulation). 6 P’s to Remember Abnormal Findings in a PV Assessment Pulseless - Assess pulses Pale - Assess color Paresthesia - Abnormal sensation Pain - Assess pain Poikilothermia - cold (assess skin temp) Paralysis - Assess movement. Can they wiggle their toes? Or limbs? Describe the term "tenting" as it relates to skin turgor. What is a normal skin turgor assessment? Tenting - When the skin stays up after performing a skin turgor assessment Skin Turgor Assessment: Pull up a part of skin in the middle of the top of your hand. Should instantly return. If it remains elevated after being pulled up and released it can indicate cardiovascular disease. Describe what you palpate peripheral lymph nodes for; size, warmth, tenderness, consistency and mobility. Abnormal: - Warm to touch, not moveable, enlarged, firm, and tender Describe what normal and abnormal findings are when inspecting and palpating the lymphatic system. Abnormal: Axillary + Breast Nodes - Enlarged node up into the axilla = breast cancer Children commonly have small moveable lymph nodes behind ears, neck, temples, groins Locate and palpate the following lymph nodes: Preauricular - in front of ear Postauricular - Behind ear Occipital - Side/ back of the neck Submandibular - Under Jaw Parotid - Jaw bone Anterior + Posterior Superficial Cervical Chains - Neck Axillary - Under arm (armpit) Epitrochlear - Elbow Popliteal - Behind Knee Inguinal - Iliac Crest Describe your understanding of the terms lymphedema and lymphadenopathy Lymphedema - Tissue swelling from build up of fluid usually drained through the body’s lymphatic system Lymphadenopathy - the swelling of lymph nodes