NURSING INTERVIEW GUIDE TO COLLECT SUBJECTIVE DATA FROM THE CLIENT
Questions Findings
Current Symptoms
Have you noticed any color, temperature, or Cold, pale, clammy skin on the extremities and
texture changes in your skin? thin, shiny skin with loss of hair, especially over
the lower legs, are associated with arterial
insufficiency.
Warm skin, edema and brown pigmentation
around the ankles are associated with venous
insufficiency.
do you experience heaviness, an aching Although peripheral venous disease (PVD) is
sensation in your legs aggravated by standing or not as common as PAD, it often occurs with
sitting for long periods, leg edema or varicosities? PAD but can occur in isolation. Symptoms of
PVS include heaviness of legs, aching
sensation in legs aggravated by standing or
sitting for long periods of time, leg edema, or
varicosities.
Do you have any leg veins that are rope-like, Varicose veins are hereditary but may also
bulging or contorted? develop from increased venous pressure and
venous pooling. Standing in one place for long
periods of time also increases the risk for
varicosities.
Do you have any sores or open wounds on your PVD is often associated with delayed wound
legs? Where are they located? Are they painful? healing. Ulcers associated with arterial disease
are usually painful and are often located on the
toes, foot, or lateral ankle. Venous ulcers are
usually painless and occur on the lower leg or
medial ankle.
Do you have any swelling in your legs or feet? At Peripheral edema results form an obstruction of
what time of day is swelling worst? Is there any the lymphatic flow or from venous insufficiency
pain with swelling? from such conditions as incompetent valves or
decreased osmotic pressure in the capillaries.
It may also occur with deep vain thrombosis
(DVT). Risk factors for DVT include reduced
mobility, dehydration, increased viscosity of the
blood, and venous stasis.
Do you have any swollen glands or lymph nodes? Enlarged lymph nodes may indicate a local or
If so, do they fell tender, soft, or hard? systemic infection.
Past History
Do you have any problems you had in the past A history of prior PVD increases a person’s risk
with the circulation in your arms and legs like for a recurrence. Symptoms such as an
blood clots, ulcers, coldness, hair loss, numbness, absence of a prior palpable pulse; cool, pale
swelling, or poor healing? legs; thick and opaque nails; shiny, dry skin; leg
ulcerations; and reduced hair growth signal
peripheral arterial occlusive disease
Have you had any heart or blood vessel surgeries Previous surgeries after the appearance of the
or treatments such as coronary artery bypass skin and underlying tissues surrounding the
grafting, repair of an aneurysm, or vein stripping? blood vessels. Grafts for bypass surgeries are
often taken from veins in the legs.
Family History
Do you, or does your family, have a history of These disorders or abnormalities tend to be
DVT, diabetes, hypertension, coronary heart hereditary and cause damage to blood vessels.
disease, intermittent claudication, or elevated An essential aspect of treating PVD is to identify
cholesterol or triglyceride levels? and then modify risk factors.
Lifestyle and Health Practices
Do you or (did you in the past) smoke or use any Smoking significantly increases the risk for
other form of tobacco? How much and for how chronic arterial insufficiency.
long?
Do you exercise regularly? Regular exercise improves peripheral vascular
circulation and decreases stress, pulse rate,
and blood pressure, decreasing he risk for
developing PVD.
Do you use oral or transdermal (patch) This is a very important question especially for
contraceptives? smokers. Oral contraceptive pill are
contraindicated after the age of 35 if smoking.
Oral or transdermal contraceptives increases
the risk for thrombophlebitis, Raynaud disease,
hypertension, and edema.
Are you experiencing any stress in your life at this Stress increases the heart rate and blood
time? pressure, and can contribute to vascular
disease.
How have with your circulation affected your Discomfort or pain associated with chronic
ability to function? arterial disease and the aching heaviness
associated with venous disease may limit a
client’s ability to stand or walk for long periods.
Do you regularly take medications prescribed by Drugs that inhibit platelet aggravation, such as
your physician to improve your circulation? aspirin and clopidogrel may be prescribed to
increase blood flow. Aspirin also prolongs the
time it takes for blood to clot and us used to
reduce the risks associated with PVD. Client
who fail to take their medications regularly are
at risk for developing more extensive peripheral
vascular problems. These clients require
teaching about their medication and the
importance of taking it regularly.
Do you wear support hose to treat varicose veins? Support stockings help to reduce venous
pooling and increase blood return to the heart.
NURSING INTERVIEW GUIDE TO COLLECT SUBJECTIVE DATA FROM THE CLIENT
Questions Findings
Current Symptoms
Do you experience chest pain? Chest pain can be cardiac, pulmonary,
muscular, or gastrointestinal in origin. Angina
(cardiac chest pain) is usually described as a
sensation of squeezing around the heart; a
steady, severe pain, and a sense of pressure.
It may radiate to the left shoulder and down
the left arm or to the jaw. Diaphoresis and
pain worsened by activity are usually related
to cardiac chest pain.
Does your heart ever beat faster? Tachycardia may be seen with weak heart
muscles, and attempt by the heart to increase
CO.
Does your heart ever skip beats, or have extra Palpitations may occur with an abnormality of
beats? When does this occur and how long the heart’s conduction system (arrythmias) or
does it last? What makes this better or worse? during the heart’s attempt to increase CO by
increasing the HR. palpitations may cause the
client to feel anxious.
Do you experience dizziness? Dizziness may indicate decreased blood flow
to the brain due to myocardial damage.
However there are several other causes for
dizziness such as inner ear syndromes,
decreased cerebral circulation, and
hypotension.
Past History
Have you been diagnosed with heart defect or Congenital or acquired defects affect the
a murmur? heart’s ability to pump, decreasing the oxygen
supply to the tissues.
Have you had rheumatic fever? Acute rheumatic fever and rheumatic heart
disease is a significant public health concern
around the world. Rheumatic carditis
develops after exposure to group A beta
hemolytic streptococci and results in
inflammation of all layers of the heart,
impairing contraction and valvular function.
Have you ever had heart surgery or cardiac Previous heart surgery may change the heart
balloon interventions? sounds heard during auscultation. Surgery
and cardiac balloon interventions indicate
prior cardiac compromise.
Family History
Is there a history of hypertension, MI, coronary A genetic predisposition to these risk factors
heart disease or CHD, elevated cholesterol increases a client’s chance for developing
levels, or diabetes mellitus in your family? heart disease.
Lifestyle and Health Practices
Do you smoke? are you trying to or interested Cigarette smoking greatly increases the risk
in trying to quit smoking? of heart disease.
What type of stress do you have in your life? Stress has been identified as a possible factor
how do you cope with it? for disease?
What is your usual diet and exercise patterns? An elevated cholesterol level increases the
chance of fatty plaque formation in the
coronary vessels.
A sedentary lifestyle is a known modifiable
risk factor contributing to heart disease.
Aerobic exercise three times per week for 30
mins is more beneficial than anaerobic
exercise or sporadic exercise in preventing
heart disease.
Use of alcohol? Excessive intake of alcohol has been linked to
hypertension. More than two drinks per day
for men, or one drink per day for women, is
associated with high blood pressure
How many pillows do you use to sleep at night? If heart function is compromised, CO to the
Do you get up to urinate during the night? Do kidneys is reduced during episodes of activity.
you feel rested in t6he morning? At rets, CO increase as does glomerular
filtration and urinary output. Orthopnea, the
inability to breathe while supine and nocturia
may indicate heart failure. In addition, these
two conditions may also impede the ability to
get adequate rest.
Use of medications or treatments for heart
disease?
