Physical Exam (2)- Cardio Flashcards
what does the capillary bed join
arterial and venous systems
what is there b/w the arterial and venous ends of the system
normal balance
purpose of capillary refill time
determine the time is takes the capillary bed to fill
after it is occluded by pressure
what does the capillary refill time indicate
status of the system
technique of capillary refill time
blanch the nail bed w/ sustained pressure of several seconds on a toenail or fingernail
release the pressure
observed the time elapsed before the anil regains its full color
interpretation of capillary refill time if the system is intact
refill occurs in < 2 seconds
interpretation of capillary refill time if the system is compromised
refill will take longer than 2 seconds
is capillary refill time a specific test
no
may suggest a problem that doesn’t exist
what may alter the results of a capillary refill test
environmental influences
even a small change in room temp will prolong refill time
how should capillary refill times be used
cautiously in making clinical judgements
what is apart of any CV eval
inspecting the extremities for edema
purpose of checking for edema
screen for changes in the orthostatic pressure system
screen for venous insufficiency
venous insufficiency
deep vein obstruction
venous valvular incompetence
technique for checking edema
observe for any unusual contours of the legs
press index finger over the bony prominence of the tibia or medial malleolus for several seconds
measure severity
how do we measure severity of edema
how deep the index finger goes into the area
how long it takes for distortion to disappear
how may edema be characterized and documented
pitting edema
pitting edema scale
1+
2+
3+
4+
1+
slight pitting
no visible distortion
disappears rapidly
2+
somewhat deeper pit than 1+
not readily detectable distortion
disappears in 10-15 s
3+
the pit is noticeably deep and may last more than 1 min
the extremity looks fuller or swollen
extremity looks different
4+
pit is very deep
lasts as long as 2-5 min
extremity is grossly distorted
purpose of BP
peripheral measurement of CV fxn
what is BP taken with
stethoscope and sphygmomanometer
where is BP taken
arm
should be measured in both arms at least once
how should the pt’s arm be
slightly flexed
comfortably supported on a table, pillow or you hand
free of clothing
size of cuff
appropriate for the arm
what indicated the systolic pressure and phase 1 of Korotkoff sounds
2 consecutive beats
what should we note –> BP
the point when the sounds become muffled
the first is the diastolic sound & considered to be the closest approximation of direct diastolic arterial pressure
what else should we note –> BP
point at which the sounds disappear
second diastolic sound
what could we do after we hear the point where the sound disappears
deflate the cuff
interpretation of BP
screen for elevated or depressed values
monitor the pt’s response to changes in position
responses to exercise
limitations
limited by various variables
various variables –> limitations of BP
height
weight
race
meds
type of sphygmomanometer
self care eval
first assessment of the pt’s response to exercise
