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Importance of Proper Cardiac Assessment

Heart disease is the number 1 killer in the United States. That's why it is so important to know the pertinent cardiac assessment parameters. The major elements of the cardiac exam should include observation, palpation and, most importantly, auscultation.

The evaluation of the cardiovascular system focuses on the heart, but should also include an assessment for disease in the arterial system throughout the body or other factors that can relate to cardiac problems. Keep in mind that an appropriate evaluation requires a broad assessment. Coexistent types of cardiac pathophysiology and varied severity in symptomatology can make assessment difficult for the nurse. However, the ability to recognize symptoms, assess their severity, and determine when the patient status is changing is essential to prevent poor outcomes and frequent hospital readmissions. These actions are the responsibility of the nurse and expected within the scope of practice.

A nurse, in almost every care setting, will encounter patients with some degree of heart disease manifestation. The nurse or health care provider must provide a careful and thorough evaluation of the assessments needed to give proper reporting to the physician. Honing assessment skills aids in recognition of both subtle and overt symptoms and behaviors which may indicate patient compromise. A nurse, with proper education, training, and assessment skills can perform nursing duties that promote and protect the health and well-being of each patient.

Key Points to remember –
  • The origins of cardiac disease and how it pertains to the course of care.
  • Methods of cardiac assessment from the health care provider and how it needs to be reported.
  • Laboratory and diagnostic testing relating to the cardiac system.
  • Hypertensive heart disease can be detected by a clinical examination, ECG, and other cardiac imaging devices.
  • The level of systolic and diastolic blood pressure are directly related to coronary artery disease symptoms, both morbidity and mortality.
  • The ECG/EKG monitoring system today still remains the “gold standard” method for detecting LVH despite its relative lack of sensitivity.
EKG monitoring is becoming more common in inpatient and outpatient care settings as well as emergency and critical care areas. Nurses and other healthcare professionals are responsible for cardiac patients including monitoring and interpreting cardiac dysrhythmias. They must develop critical thinking skills required to quickly and accurately identify potentially life threatening conditions.

Risk factors associated with cardiovascular disease would include such things as cigarette smoking, elevated blood pressure, elevated serum total (and LDL) cholesterol, low serum HDL cholesterol, diabetes mellitus, advancing age, predisposing risk factors, obesity, abdominal obesity, physical inactivity, family history of premature coronary heart disease, ethnic characteristics, psychosocial factors, conditional risk factors, elevated serum triglycerides, small LDL particles, elevated serum homocysteine, elevated serum lipoprotein(a), prothrombotic factors (eg, fibrinogen), and inflammatory markers (eg, C-reactive protein).

Risk reduction involves intervention in areas such as smoking cessation, treatment of hypertension, treatment of lipid disorders, management of diabetes, weight reduction, and exercise prescription.

Cardiac assessment education will aid in reduction of hospital readmissions and improve the level of care that is being provided in all healthcare settings.


Pedagogy Education Inc. offers two courses that will improve the acuity of cardiac assessment techniques. Author Patricia Schmehl takes great pride in providing the highest quality of education for cardiac assessment and her class, “Critical Thinking in Cardiac Assessment”, provides the basic tools and knowledge needed in proper cardiac assessment. Author Kevin Stansbury takes great pride in providing the highest quality of education for cardiac assessment through EKG recognition and his class, “EKG Recognition”, provides the tools and knowledge needed for cardiac assessment through EKG monitoring.

Pedagogy Blog by Catheryn Peplinski, MBA, RT (R) (M), RDMS, is our Director of Operations and author of Pedagogy online continuing education courses.

Catheryn Peplinski, MBA, RT (R) (M), RDMS, is Director of Operations at Pedagogy Inc. in Troup, Texas. She has earned her Master’s Degree in Business Administration from University of Phoenix, and has a degree in Radiology from Ferris State University. Catheryn is licensed in multiple modalities of Radiology, specializing in High-Risk Obstetrics and genetic testing with over 28 years of experience in diagnostic medicine, education, and management.

Her background includes management and development of clinical practices, education, health care provider in multiple diagnostic procedures, laboratory procedures, surgical assisting, protocol development, accreditation processes, operations, author, and editing/publishing with Pedagogy Inc. She has taught medical students the skills of ultrasound, as well as to nursing staff and radiology and ultrasound students. Catheryn has successfully produced educational material for continuing education and student development. Catheryn has a deep passion to help others with strong beliefs in service oriented philosophies to give to those less fortunate.

She has been blessed with the opportunity to participate in a medical mission trip to Guatemala with her children to gain the appreciation of field medicine and sharing of their talents. She has written multiple news articles and blogs for Pedagogy as well as an infusion based class for Radiology Nursing Professionals.

Posted: 7/18/2013 10:10:05 AM
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