HA Lab Case Study Wk 9 Assessing Heart and Neck Vessels PDF

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Health Assessment Case Study Heart and Neck Vessels Week 9...

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Case Study, Chapter 21, Assessing Heart and Neck Vessels A Black 50-year-old female client is admitted to the health care facility with mitral valve prolapse. The client states that a week ago she became dizzy and began to perspire while at work. She was working at the computer in her office on a major project that was due that day. The client attributed the episode to the stress and anxiety she was experiencing from finishing the project, so she put a cold wet towel around her neck and continued working. The next day, she woke up with a headache and felt a little tightness in her chest. She took an aspirin, and the symptoms subsided. The client became alarmed today when the tightness in her chest felt more like a pain. The client’s presenting symptoms include fatigue, headaches, and sharp chest pains. VS: BP 160/90 mm Hg, HR 110 beats/min, RR 24 breaths/min, Temp. 98.0° F (36.7°C), Pulse Ox 96%, skin is warm; the nurse notes the client is perspiring. Her weight is 30 lb over what it should be. She gives a history of having a murmur since she was little but that it never caused her any problems. She takes cholesterol and blood pressure–lowering medications daily. (Learning Objectives: 2, 5) Questions: a. What are conditions that contribute to turbulent blood flow or heart murmurs? Conditions that contribute to turbulent blood flow or heart murmurs are increased blood velocity, structural valve defects, valve malfunction and abnormal chamber openings.

b. What are three techniques used to assess the precordium and heart sounds? Inspection, palpation and auscultation. Position yourself on the client’s right side, do not auscultate through a gown, elevate patient 30 degrees and concentrate on systematically moving the stethoscope from left to right across the entire heart area from the base to the apex or from the apex to the base. c. Based on these symptoms and history, what is the correct landmark for auscultation of heart sounds in this client? The correct landmark for auscultation of heart sounds in this client are across the entire heart area due to the murmur. Most precisely the second ICS at he left sternal border. Use the diaphragm and the bell in all areas because murmurs have a variety of pitches. Also auscultate with the client in different positions. d. What kind of heart sounds may be heard in this client? Heart sounds heard in this client would be a swishing sound caused by turbulent blood flow. e. When teaching this client about coronary heart disease (CHD), which risk factors are important for the nurse to emphasize? Smoking, stress excessive alcohol consumption diet and nutrition, obesity and overweight, hypertension and physical inactivity. f. If the client asks the nurse if the murmur she has is causing the symptoms, how should the nurse respond? There may not be enough red blood cells carrying oxygen to the rest of the body....