The Effects of Obesity on the Cardiopulmonary System: Implications for Critical Care Nursing

Kim Garrett, RN, MS, CNP; Kathy Lauer, RN, PhD; Beth-Anne Christopher, RN, MS

Disclosures

Prog Cardiovasc Nurs. 2004;19(4) 

In This Article

Altering the Cardiac Physical Assessment for the Obese Patient

Because of the increased tissue mass, auscultation of heart sounds may be difficult. Minimizing extraneous noise by turning down TV volume, closing the door, and putting equipment such as intra-aortic balloon pumps on standby (as tolerated by the patient) maximizes the ability to hear heart sounds. Placing the patient in the left lateral position or sitting them up at 45° will bring the heart closer to the chest wall when listening for extra heart sounds and murmurs. Having the patient hold their breath may also accentuate murmurs.

Excess adipose tissue may make the assessment of jugular venous distension and palpation of intra-abdominal organs such as the liver or bladder impossible. Peripheral pulses, particularly those in the lower extremities, may require the use of Doppler ultrasound.[17]

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