1
Q
Cardiovascular Signs for Physician Referral
A
- when pt has a combination of systemic s/s at presentation
- women with chest or breast pain who have a +family history of breast cancer or heart disease
- palpitation in any person with history of sudden death, more than 6 episodes in a min, or lasting several hours w/ s/s of pain, SOB, fainting, light headedness
- anyone who cannot climb a single flight of stairs without feeling moderately winded (dyspnea) or awakens at night (PND) or experiences SOB when laying down (orthopnea)
- a pt who is neurologically unstable as a result of recent CVA/TBI/SCI etc that experiences new arrhythmia
2
Q
Cardiac Pts should be sent back to their physician under which situations?
A
- nitroglycerin tablets do not relieve angina
- pattern of angina changes are noted
- obnormally severe chest pain with n/v
- anginal p! radiates to jaw or L arm
- anginal p! is not relieved by rest
- upper back feels abnormally cool, sweaty or moist to touch
- develops progressively worsening dyspnea
- individual with previous coronary artery stent experiences chest p!
- demonstrates greater than 40 mmHg difference in pulse pressure (SBP-DBP)
- pt reports “doubt” in their current condition
3
Q
Potential Red Flags for Cancer Screening
A
- Age>50
- Previous h/o CA or bilateral carpal tunnel syndrome, joint pain of unknown rheumatic cause
- Anyone with back, pelvic, groin, or hip pain accompanied by abdominal complaint, palpable mass
- Recent weight loss of 10% of total body weight within 2 weeks
- Shoulder, back, hip, pelvic sacral pain accompanied by changes in b/b
- Hip or groin pain reproduced by heel strike, hopping test or translation/rotational stress
- Intense pain at night (7 or higher)
- Signs of nerve root compression
- Onset of new neurological deficits
- Growing mass (p!ful or p!less) that continues to grow in size
- disproportionate relief of pain from aspirin
12.
4
Q
Cancer - Red Flags in Women vs. Men
A
Women
- any woman with chest, breast, axillary, or shoulder pain of unknown cause especially over the age of 40
- Prolonged or excessive menstrual bleeding or breakthrough bleeding
Men
- Any man with hip, groin, SI or additional presence of sciatica with previous history or prostate cancer
