Ch.21- Peripheral Vascular Assessment

Question 1

Peripheral Arterial Disease= think what?

Answer 1

plaques and blockages

Question 2

Peripheral artery disease is due to what?

Answer 2

stiffening, hardening, calcifications, plaque formation

Question 3

What does peripheral artery disease present as?

Answer 3

• Diminished pulses or absent pulses
• Cool extremities
• Limb pain with walking (claudication)
• Ulcerations
• Absence of hair growth
• dystrophic nails
• cyanosis

Question 4

Venous Insufficiency= think what?

Answer 4

Incompetent veins, dilated and torturous

Question 5

Venous insufficiency is due to what?

Answer 5

History of deep vein thrombosis, varicose veins, phlebitis, genetics, obesity

Question 6

What does venous insufficiency present as?

Answer 6

Tired achy legs, edema, redness from hemosiderin deposits, ulcerations

Question 7

What subjective data is important in a Peripheral vascular assessment?

Answer 7

• leg pan or cramps
• skin changes on extremities
• temp changes
• swelling
• varicosities
• activity tolerance
• meds
• past medical history
• smoking history
• family history

Question 8

Inspection and palpation is done in what manner for upper extremities in a peripheral vascular assessment?

Answer 8

concurrently and compare your findings with opposite extremity

Question 9

How do you inspect/palpate the upper extremities in a peripheral vascular assessment?

Answer 9

• lift person’s both hands in your hands
• inspect, then turn person’s hands over, noting color or skin and nail beds; temp, texture, add turgor of skin; and the presence of any lesions, edema, or clubbing
• CRT of nail beds

Question 10

What objective data should be obtained when assessing radial pulses?

Answer 10

• Palpate both radial pulses nothing
• rhythm
• elasticity of vessel wall
• equal force/amplitude (3-point scale)

Question 11

Standing a person during a peripheral vascular assessment will give further what?

Answer 11

detail about veins

Question 12

When performing peripheral vascular assessment of the lower extremities what should be noted?

Answer 12

(easiest to do while supine)

• symmetry
• presence of skin discoloration, ulcerations, temp changes
• edema
• varicosities

Question 13

Palpation of the lower extremity arteries are done in what manner?

Answer 13

unilaterally and compared to opposite side

Question 14

Where is the femoral pulse?

Answer 14

groin

Question 15

Where in the popliteal pulse?

Answer 15

popliteal fossa, often just lateral to the medial tendon, sometimes very hard to palpate

Question 16

Where is the posterior tibialis pulse?

Answer 16

groove between the medial malleolus and Achilles

Question 17

Where is the dorsals pedis pulse?

Answer 17

along the first metatarsal, sometimes in-between the first and second metatarsal mid-foot

Question 18

How do you check for peripheral edema?

Answer 18

• Firmly depress skin over tibia or medial malleolus for 5 seconds and release
• normally finger should leave no indentation (may see a pit in a person who has been standing all day or pregnant)

Question 19

How do you grade pitting edema?

Answer 19

• 1+= mild pitting, slight indentation, no perceptible swelling
• 2+= moderate pitting, indentation subsides rapidly
• 3+deep pitting, indentation remains, leg looks swollen
• 4+ very deep pitting, indentation lasts long time, leg very swollen

Question 20

In the aging adult what pulses may be more difficult to find?

Answer 20

dorsalis pedis and posterior tibialis

Question 21

In the aging adult trophic changes associated with arterial insufficiency may be seen as what?

Answer 21

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