Assessing Clients with Cardiac Disorders Exercise Use the following health history questions and leading statements,

, categorized by functional health patterns, with a family member, friend, or client. Identify areas for focused physical assessment based on findings from the health history. Assessing Cardiac Function Health PerceptionHealth Management Have you ever had any cardiovascular problems (such as angina, heart attack, high blood pressure, or valvular disease)? If so, describe these problems. How were these problems treated (diet, medications, surgery, exercise)? Do you have a history of rheumatic fever, scarlet fever, or strep throat infections? Describe. Have you ever had tests to evaluate the function of your heart (such as electrocardiograms, stress tests, cardiac catheterization)? Describe. What medications are you currently taking (aspirin, blood pressure medications, beta-blockers, calcium channel blockers, digitalis, diuretics, anticoagulants, others)? How often do you take them? Do you smoke or chew tobacco? If so, how much and for how long? Do you drink alcohol? If so, what type, how much, and for how long? Are you able to manage your activities of daily living and work independently? Describe. NutritionalMetabolic Describe your usual diet in a 24-hour period. How often do you eat eggs or fatty foods? Have you had a recent weight gain or loss? Explain. How much salt do you use on and in your food? How often do you eat out? What do you usually order? Elimination Have you had any changes in your normal bowel or bladder elimination? Explain. Has a heart problem interfered with your normal bowel or bladder elimination? Explain. ActivityExercise Describe your normal activity and exercise in a 24-hour period. Has there been a change in your ability, energy level, or strength to perform your usual activities of daily living (such as bathing, cooking, walking, driving, shopping, socializing)? Explain. Do you have shortness of breath with certain activities? If so, what are they? How long do the breathing problems last? What do you do to relieve them? Do you feel tired during the day? When? What do you do when you feel tired? Have you noticed any changes of color of your skin? For example, has it become flushed, dusky, or pale? Have you had any swelling in your feet or legs? Where and how much? Do resting and putting your feet up relieve it? Describe any cough you have had. Is it a dry or a congested cough? If you cough up mucus, what color is it? How long have you had the cough? Have you ever experienced numbness or tingling, dizziness or light-headness, or palpitations? Describe. Have you ever or do you now need to use oxygen? SleepRest How long do you sleep each night? Do you feel rested after sleeping? Does your cardiovascular problem interfere with your rest and sleep? Describe. Do you ever feel short of breath when you are resting or sleeping? Does this feeling wake you up if you are asleep? How many pillows do you sleep on?

CognitivePerceptual Describe any chest pain you have experienced. When did it occur? Where was the pain located (below the breastbone, in the arm or neck)? On a scale of from 0 to 10 (with 10 being the worst pain possible), rate the pain and describe it (for example, burning, crushing, stabbing, squeezing, pressing, heavy, tight). What were you doing when the pain began? Were you engaging in an activity, or were you at rest)? Did it begin gradually or suddenly? How long did it last? Did you have any other symptoms with the pain, such as nausea and/or vomiting, sweating, racing heart, pale skin color, palpitations? What made the pain worse? What did you do to try to relieve the pain? Did this help? Do you have any leg pain when you walk or exercise? How far can you walk before the pain begins? Does resting relieve the pain? Self-PerceptionSelf-Concept Has a problem with cardiovascular function affected how you feel about yourself? Explain. Has a problem with cardiovascular function affected how you feel about your normal life? Are you able to do what you feel is important for yourself and for others who are important to you? RoleRelationship Do you have a family history of high blood pressure, coronary artery disease, high cholesterol, obesity, or diabetes? Has a problem with cardiovascular function affected your role in the family? Explain. Has a problem with cardiovascular function affected your interactions with others in your family, with friends, at work, or in social activities? Has a problem with cardiovascular function affected your ability to work? Explain. SexualityReproductive Have your usual sexual activities been altered by cardiovascular problems? Explain. Do you ever have chest pain during sexual activity? How long does the pain last? What do you do? Describe how having cardiovascular problems has made you feel about yourself as a man or woman. Have you ever been given information on how to alter the pace of and use less strenuous positions during sexual activity? If so, do you use the information? CopingStress How stressful do you view your life-style on a scale of from 0 to 10 (with 10 being extremely stressful)? What factors seem to cause the most worry or stress for you? How often do you feel stressed during the day? Do you have chest pain or shortness of breath when you feel stressed? Describe what you do to cope with stress. Who or what will be able to help you cope with stress from this health problem? ValueBelief What is most important to you in your life? Are there significant others, practices, or activities that help you cope with impairments from this health problem? Explain. Do you restrict or eat certain foods based on your religious and or cultural beliefs and background? How do you perceive the future with this health problem?