Diagnostic testing and imaging studies family history

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diagnostic testing and imaging studies. family history. Patient-centered care: determine information relative to patient history for: NutritionSmokingAlcoholExerciseMedicationAdditional History:Infants, Children and Pregnant WomenInfantsMaternal health: How was mother’s health during pregnancy?Feeding pattern: Any cyanotic changes during nursing or crying?Growth and activity: Meeting developmental outcomes? Children Growth and activity: Meeting developmental outcomes?Evidence of any chest pain? History of respiratory infections Significant family history—genetic abnormalities Pregnant women HTN during pregnancy?Associated clinical symptoms—proteinuria, weight gain, edema?Experiencing faintness or dizziness? Additional History for Aging AdultMedical historyReview presence of comorbidities.Medication profile historyRx or OTC Aware of side effectsCompliance with therapyEnvironmentImpact on ADLsPreparation and EquipmentPreparationTo evaluate carotid arteries, a person can be sitting. To assess jugular veins and precordium, the person should be supine with head and chest slightly elevated.Ensure woman’s privacy by keeping her breasts draped.EquipmentMarking penSmall centimeter rulerStethoscope with diaphragm and bell endpiecesAlcohol wipe to clean endpieceNeck Vessels: Palpation and AuscultationPalpate carotid arteryPalpate only one carotid artery at a time to avoid compromising arterial blood to brain.Feel contour and amplitude of pulse, normal strength 2+.
Findings should be same bilaterally Auscultate carotid artery.Assess for presence of carotid bruit. avoid compressing the artery which can create an artificial bruit.Keep neck in neutral position and lightly apply stethoscope atangle of jaw, midcervical area, and base of neck.Neck Vessels: Inspection Inspect jugular venous pulse.From jugular veins you can assess central venous pressure (CVP) and judge heart’s efficiency as a pump.Position a person supine anywhere from a 30- to a 45-degree angle, wherever you can best see pulsations.Estimate pressure.Observe for possible distention.Characteristics of jugular versus carotid pulsations Differentiate between: location, quality, respiration, palpable, pressure, and position of patient Neck Vessels: Vascular StructurePrecordium Inspect anterior chest.Arrange tangential lighting to accentuate any flicker of movement.Observe for any possible pulsations.Palpate apical impulse: note location, size, amplitude and duration. Palpate across precordium to assess for any possible pulsations.Precordium AuscultationIdentify auscultatory areas associated with valves.Sound radiates with blood flow direction; valve areas are:Second right interspace: aortic valve areaSecond left interspace: pulmonic valve areaLeft lower sternal border: tricuspid valve areaFifth interspace at around left midclavicular line: mitral valve area
Note rate and rhythm: describe characteristicsIdentify S1and S2.

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