Cardiovascular system (Peripheral Vascular Assessment)

Question 1

Palpable arteries of the body

Answer 1

Temporal 
Carotid 
Brachial 
Radial 
Femoral 
Popliteal
Dorsalis pedis 
Posterior tibial

Question 2

Function of lymphatic system

Answer 2

Destroy old red blood cells
Produce antibodies
Store red blood cells
Filter microorganisms from blood

Question 3

Inspection and palpation of the arms

Answer 3

Inspect, noting color of skin and nail beds; temperature, texture and turgor of skin as well as the presence of edema or clubbing

• Nail bed angle should be 160 degrees
• Note any presence of any scars on hands and arms

Check capillary refill

• Blanch nails beds; release and node time for color to return
• Should be less than 1 or 2 seconds

Palpate radial pulses, noting rate, rhythm, elasticity of vessel wall and equal force

• 3+, increased, full, bounding
• 2 + normal
• 1 + weak
• 0 absent

Palpate brachial pulse bilaterally

Palpate notes
- Epitrochlear

Question 4

Inspection and palpation of the legs

Answer 4

Note presence of skin discoloration, skin ulcers, or gangrene, note size and exact location

Palpate for temperature along legs down to feet

Palpate inguinal nodes

Palpate the femoral artery

• halfway between pubis and anterior superior iliac spines
• If diminished or weak, auscultate site for bruit

Palpate the popliteal pulse
- Often normal popliteal pulse is impossible to palpate

Palpate posterior tibial pulse

Palpate dorsalis pedis pulse

Check for pretibial edema

• 1+ mild pitting
• 2+ moderate pitting
• 3 + deep pitting
• 4+ very deep pitting

Question 5

Developmental competence: Pregnant woman

Answer 5

Diffuse bilateral pitting edema in the lower extremities

Varicose veins

Question 6

Developmental competence: aging adult

Answer 6

Trophic changes associated with arterial insufficiency may be seen:

• Thin, shiny skin
• Thick, ridged nails
• Loss of hair on lower leg

Question 7

If wound is found you would:

Answer 7

Document:
- anatomical location
wound shape, color, size, depth
tissue type(s)
exudate
edges or margins
periwound
surrounding skin

Question 8

Arterial ulcer

Answer 8

Location: Toes or foot

Appearance: Irregular margin, cool cyanotic

Temperature: Cold

Pain: Usually severe

Sensation: Variable, often decreased

Arterial pulse: Absent

Veins: Collapsed

Question 9

Venous ulcer

Answer 9

Location: Malleolus or metatarsal

Appearance: Typically sloped edges; may have exudate, irregular shape

Temperature: Warm

Pain: Mild

Sensation: Present, variable

Arterial pulse: Present, variable

Veins: Dilated, varicosities, edema