Card 1101 M3

Identifying the correct patient, physical examination, and physical appearance.

BMI = weight(kg)/height(cm)²

Vital signs are the measurement of the body's basic functions. Blood pressure is not one of them. The only vital signs of the body are: Temperature, pulse, and respiration.

• Patient's history can include:
• 1. Known medical conditions;
• 2. Age;
• 3. Sex;
• 4. Family history;
• 5. Prescribed meds;
• 6. Over the counter meds;
• 7. Illegal drugs;
• 8. Stress factors;
• 9. New symptoms;
• 10. Old symptoms;
• 11. Current concerns;

The NYHA functional classfication is a functional and therapeutic classification used to prescribe the proper physical activity for a cardiac patient.

• The classification has four classes:
• Class I-No limitations; suffer no symptoms when doing normal activity.
• Class II-Slight, mild limitation of activity; comfortable with rest or mild activity;
• Class III-Marked limitation of activity; comfortable with rest only.
• Class IV-Patient limited to complete rest; Any activity causes discomfort; Symptoms occur even at rest;

"Air hunger" or SOB that is normal for that level of exertion.

• Causes:
• LV failure
• Mitral stenosis
• COPD or Asthma

Sensation of pain, pressure or tightness in chest. The main cause is Ischemic (general term for organ) Heart Disease.

• Chest discomfort with the following characteristics:
• Central location;
• radiation to arm, neck, and/or jaw;
• a sqeezing, tightness, pressure sensation;

• Types:
• Typical exertional angina
• Atypical angina

Palpitations are defined as an awareness (or sensation) of an irregularity in cardiac pulsation, a throbbing or rapid or fluttering rhythm.

Syncope is defined as transient loss of consciousness due to inadequate blood flow to the brain. It usually results from cardiac or neurological conditions. Common causes of syncope include:

• seizure disorders
• vasovagal syncope (the simple faint)
• cardiac dysrhythmias such as ventricular tachycardia
• complete heart block

• Two types:
• -Effort syncope is one of the defining events in patients with valvular aortic stenosis
• -Vasovagal syncope usually occurs when the patient is physically or emotionally uncomfortable

Irritation somewhere in the upper or lower respiratory tract.

Peripheral edema (i.e., extensive amount of tissue fluid in peripheral body tissues) is most commonly the result of venous insufficiency. It is usually a late finding in patients with left ventricular failure, and signals the onset of right ventricular failure. On physical exam the patient has elevated jugular venous pressure.

Peripheral cyanosis is a bluish color of the patient's fingers or toes as the result of decreased blood flow to the skin secondary to vasoconstriction. It is not associated with clubbing, and is commonly caused by shock or exposure to cold.

Central cyanosis involves the entire body. It is the result of abnormal saturation of venous blood during its pulmonary transit or right-to-left cardiac shunts. Fingers and toes are often clubbed -- that is, lateral and longitudinal curvature of the nails accompanied by soft tissue enlargement.

Examination of pulse, and pulmonary auscultation.

Frequency, intensity, quality, and duration.

Adventitious sounds are sounds that are heard over and above the normal or abnormal breath sounds. Adventitous means "extra" or "added".

• Normal
• Vesicular-
• Bronchial
• Broncovesicular

• Abnormal
• absent
• Diminished
• Abnormally located