Heart and Neck Vessels Case Study

1.
Determine if the client is currently experiencing any angina.
2.
Auscultate the apical pulse for 1 minute.
3.
Encourage the client to describe his chest discomfort.
4.
“At what time of day do you feel most fatigued”
5.
How the client’s spiritual beliefs impact his health care expectations.
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6.
-Dietary need.
-Herbs or purgatives used.
7.
Help the client to a supine position on the bed with his chest exposed.
8.
-Left midclavicular line.
-5th intercostal space.
9.
-Right sternal border.
-2nd intercostal space.
10.
Roll half-way to his left side.
11.
Chest x-ray, Echocardiogram.
12.
Inch the stethoscope across and down in a “z” pattern.
13.
S1 and S2 heart sounds.
14.
Palpate the carotid artery pulse.
15.
Document this normal finding on the initial assessment record.
16.
Systolic murmur.
17.
Note how easily the murmur is heard by gradually lifting the stethoscope.
18.
Repeat auscultation across the chest using the bell of the stethoscope.
19.
Use the bell of the stethoscope to continue listening at the apical site.
20.
Check for jugular vein distention.
21.
-Remove the client’s pillow and turn his head away slightly.
-Place the Client in a Semi-Fowler’s position.
22.
Document the level at which the pulsation is observed.
23.
Palpate one artery and then palpate the artery on the opposite side.
24.
Move the bell of the stethoscope up the right side of the neck to the mid-clavicular area.
25.
-Onset of an S3 heart sound.
-Observed jugular vein distention.
-Client’s subjective report of dyspnea.
26.
-Assessment
-Recommendation
-Situation
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