HEART AND NECK VESSELS

Arellano, Mark Adrian Quiamco, Jade

Clemente, Rameses Serrano, Joshua Kyle
Lim, Kay Lyn Tabangcura, Vane Mae
Montezon, Trisha
 HISTORY OF PRESENT HEALTH
CONCERN
QUESTION
Are you experiencing any chest pain (angina pectoris)?
Can you point to roughly where the pain is? When does
the pain usually occur? Does the pain radiate elsewhere–
perhaps to the left shoulder and arm?
Have you been or are you experiencing any difficulties in
breathing–specifically shortness of breath? Have you been
experiencing coughing or wheezing fits recently? Are
these fits accompanied with red-tinged sputum or phlegm?
Is the client cyanotic?
RATIONALE/QUESTIONS
May be indicative of coronary heart disease (CHD),
wherein the myocardium (heart muscles) is not supplied
with sufficient amounts of blood resulting in angina
pectoris
May be indicative of congestive heart failure, specifically
peripheral congestion–wherein the pumping efficiency of
the left side of the heart diminishes to such an inadequate
level that oxygen-rich blood flowing from the lungs backs
up into them. This results in fluid accumulating in the
lungs (pulmonary edema).
 HISTORY OF PRESENT HEALTH
CONCERN

QUESTION RATIONALE/QUESTIONS

Have you experienced any swelling or edemas,
particularly on your legs?
May be indicative of congestive heart failure, specifically
peripheral congestion. The accumulated fluids seep into
the tissue, resulting in peripheral edemas. Peripheral
edemas are much more noticeable and are usually found
in the legs.

Have you noticed your heartbeat to be irregular or May be indicative of arrhythmia, a disorder that refers to
uneven? irregularities in a person’s heartbeat (i.e., abnormal heart
rhythm).
 PERSONAL HEALTH HISTORY

QUESTION RATIONALE/QUESTIONS

Do you have an allergy? It helps healthcare providers optimize medication therapy,

decrease the incidence of adverse drug reactions.

Are you currently on medication? It is important in preventing prescription errors and

consequent risk to patients.
 PERSONAL HEALTH HISTORY

QUESTION RATIONALE/QUESTIONS

Have you been diagnosed with a heart disease prior this
assessment?
Heart diseases often have overlapping symptoms (e.g.,
angina pectoris, SOB) and may contribute to the
development of congestive heart failure. By knowing if a
client has been diagnosed with a heart disease, healthcare
providers are able to address the client’s present health
concerns effectively and immediately.
 FAMILY HISTORY

QUESTION RATIONALE/QUESTIONS

Do you have a family member who happens to have heart
diseases?
When health care providers are aware of the patient's
family history, they may reduce the risk of sickness and
prevent it as early as possible with suitable measures, as a
patient with this genetic background has a high chance of
developing the disease.

What was the reason of your relative's death and how old Knowing the cause of death or the condition of a family
was he or she when they died? member's death might lead to the discovery of diseases
that the family may have suffered from.
 LIFESTYLE AND HEALTH PRACTICES
QUESTION
Do you smoke and/or drink alcohol-based
beverages? If so, how many packs of cigarettes and
bottles can you ingest?
Do you follow a healthy diet?
RATIONALE/QUESTIONS
Smoking and too much of alcoholic drinks has a high risk of
causing damage to the body's arterial walls. This can lead to
carotid artery disease, which might be caused by atherosclerosis,
where a plaque builds up, which causes the arteries to be
narrowed, blocking the flow of blood.
Having an unhealthy diet, such as consuming foods that are
heavy in salt, saturated fat, and sugar, can increase the risk of
heart disease, such as the development of high cholesterol and
blood pressure, wherein it can lead to coronary heart disease as
well.
 LIFESTYLE AND HEALTH PRACTICES

QUESTION RATIONALE/QUESTIONS

Do you participate in any physical activity People who are mostly overweight or obese, as well as those who live
or exercise? an inactive lifestyle, are at a higher risk of developing dyspnea, or
shortness of breath, wherein the muscles become weaker and there is a
lack of oxygen.

How often do you stress out about your Stressing about personal matters can trigger cardiac problems such as
personal work? ischemia, wherein there is an inadequate supply of oxygen and blood,
which can lead to myocardial infarction or heart attack.
TOOLS NEEDED FOR PHYSICAL
ASSESSMENT

Gloves Stethoscope Small pillow

Watch w/ second hand Centimeter ruler Penlight

Glass of water
 INSPECTION
ASSESSMENT NORMAL
Jugular veins The normal mean jugular venous
pressure, determined as the vertical
distance above the midpoint of the
right atrium, is 6 to 8 cm H2O.
ABNORMAL
Jugular vein distention occurs when
the pressure inside the vena cava
increases and appears as a bulge
running down the right side of a
person's neck.
 INSPECTION

ASSESSMENT NORMAL ABNORMAL

Vein inspection The veins looks normal and is not Redness, swelling and bulging in the
visible at 45° inclination. veins.

Skin color The skin does not present any bluish discoloration of the skin, lips,
discoloration. and nail beds and indicates decreased
perfusion and oxygenation.
 AUSCULTATION

ASSESSMENT NORMAL ABNORMAL

Aortic Lub Dub Sound (S1 and S2) Murmur sounds (S3 and S4)

Brachial Pulse for Blood Pressure 120/80 or lower Elevated to Hypertensive Systolic 120
or higher; Diastolic 80 or higher.
 PALPATION
ASSESSMENT NORMAL ABNORMAL

Precordium Gentle tapping of apical impulse Double systolic impulse, sustained thrust
throughout systole

Carotid Artery Smooth, relatively fast outward movement, Altered amplitude of pulse peak, a distortion of
pulse peaks about one-third of the way through the upstroke or downstroke
systole.

Thyroid gland Soft, smooth, symmetrical, and non-tender Presence of nodules, enlargement, swelling,
asymmetrical
 ABNORMALITIES

Abnormal Arterial and Pressure Waves:

A. Small Weak Pulse - The pulse seems faint and tiny because the blood pressure has diminished. Increased
peripheral resistance, as in exposure to cold and severe heart failure, is one of the causes.

B. Large Bounding Pulse - The blood pressure in the lungs has risen, and the pulse has a powerful and
bounding motion. During the rise and fall, the peak may appear to be fleeting.

C. Pulsus Alternans The rhythm is rather consistent, the pulse's amplitude fluctuates from beat to beat. Only
sphygmomanometer can tell the difference between stronger and weaker beats