Friend, I am so glad you’re here! We are just rockin’ and a rollin’ on this nursing head-to-toe assessment study guide. Today we are talking all about how to assess the cardiac system. And let me just tell you, I think the cardiac system is just about the best thing ever. So bear with me if I get a bit carried away with excitement!
Before you dive into physically assessing your patient, there are a few questions to ask first. These questions will help you get a better understanding of the patients history and presenting problem. They will also allow you to focus your assessment based on their primary needs and get to the root of the problem faster.
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Ask them about why they are there. Most patients have more than one medical issue, so make sure to ask what their primary concern is. You will also ask about their other medical concerns later, but you need to know their primary one first.
A few good presenting problem questions are:
1. What brought them into your facility?
2. What symptoms do they have?
3. Are they currently in any pain?
4. How long have those symptoms been going on?
5. Is there anything that makes those symptoms worse or relieves them?
6. Are they taking any medications or supplements for these symptoms?
The next section of questions is directed toward their personal history. This includes all of the other medical issues they have. These questions are important for you to understand some possible risk factors the patient may have for cardiovascular problems. The patients responses also help direct what you teach them. For example, if your patient smokes and eats foods high in sodium, you can educate them on the benefits of quitting smoking and eating foods low in sodium.
Common personal history questions include:
7. Do you smoke, use alcohol or other drugs?
8. How often do you exercise?
9. What exercise activities do you usually do and for how long?
10. Describe what you typically eat for breakfast, lunch and dinner. (Pay special attention to foods high in salt, sugar and fat)
11. Have you had any heart surgeries in the past?
12. How would you describe your current level of stress?
13. How would you describe your stress level over the previous year?
14. Describe your typical day, whether at work or doing other activities. (Pay special attention to safety concerns such as extended driving and the patient complains of having fainting spells).
One difference between assessing the other body systems and the cardiac system is the emphasis we place on family history. Mostly because we know that family history has a significant impact on our patient’s cardiovascular health and wellbeing.
You will want to ask these primary questions regarding the patients family history:
15. Does anyone in your family (who is living) have heart disease or any other cardiovascular issues?
16. What are their ages?
17. Has anyone in your family passed away from cardiovascular disease?
18. At what age did they pass away?
By asking these questions, we can get a better sense of the patients risk factors for cardiovascular disease, such as blood clots and coronary artery disease.
Physical Assessment Questions
The final set of questions are all about the patient’s physical symptoms. Personally, I like to ask these questions as I am physically assessing the patient because the physical assessment helps jog my memory. For example, if I am assessing their legs, I will ask if they ever have any leg swelling.
I will list out the common physical assessment questions here, but I encourage you to play around with your assessment pattern and flow. This will help you figure out where in the assessment process these questions make the most sense for you.
Some good physical assessment questions are:
19. Do you ever experience chest pain?
20. Do you ever have a hard time catching your breath?
21. Do you ever feel like you don’t have energy, are lethargic or fatigued?
22. Do you ever feel your heart pounding or racing?
23. Do you ever have swelling in your legs or feet?
24. Do you ever have wounds, especially on your feet and buttocks?
25. How long does it usually take for a wound to heal?
As always with physical assessment questions, ask when the problem started, how severe it is, what causes it and what relieves it.
By now you’re probably wondering how in the world you will remember all of these questions the next time you’re at clinical. Girrrrl (cue sassy finger snap), that’s what you’ve got me for!
Have you claimed your FREE Cardiac Assessment Cheat Sheet yet?
Be sure to come back next week as we dive into the physical assessment portion of the cardiovascular nursing assessment.
Catch ya later, girlfriend!
Until then, comment below and tell me what your favorite nursing subject is. Mine is cardiac…big time. 🙂
Comerford, K. C., & Hodgson, B. E. (2013). Assessment made incredibly easy. Ambler, PA: Lippincott Williams & Wilkins.