PVS Assessment Flashcards
What is 6 subjective data you could collect?
- leg pain or cramps
- changes in skin on arms or legs (color & temp)
- edema of arms or legs
- exercise
- smoking history
- family history
Varicose veins are common with…
diabetes, obesity, hereditary
What increases the risk of PVD?
prolonged sitting or standing
What do you inspect and palpate?
- arms/hands
- radial & brachial pulse
- legs
- lymph nodes
- femoral, popliteal, posterior tibial, dorsalis pedis pulses
- edema
Where is the epitrochlear lymph node present?
elbows, neck/head, axial
What does it mean if the epitrochlear lymph node is palpable?
should be less than <1cm, smooth, non-tender, and moveable
What does it mean if the epirochlear lymph node deviates from normal?
infection or cancer present
When palpating pulses, what are you noting?
HR, rhythm, symmetry
How are pulses graded?
0-4+
What is Homan’s sign?
patient sits down with leg out straight in front of them. nurse pushes against foot and the patient experiences pain
(positive result meaning blood clot)
What is the grading of pitting edemas?
1+ - 4+
What finding is common in infants and children?
enlarged lymph nodes because of frequent exposure to infections
What are two common findings in pregnant women?
hormonal changes that cause vasodilation
edema
What does it mean when pregnant women experience vasodilation?
change in BP
orthostatic hypotension
What are two common findings in an aging adult?
arteriosclerosis
weak pulses
What does CMS stand for?
circulation, movement, sensation
When assessing circulation what do you inspect and palpate?
inspect= color
palpate= warmth, pulse
What questions do you ask when inspecting movement?
Are they able to move with that injury?
Are they able to move their toes?
How do you chart when there are deviations to CMS?
CMS except…
What are 6 interventions with edema?
- TED hose
- SCDs, IPC (inflate/deflate device)
- elevation of swelling body part
- ROM exercises
- ambulation
- health promotion
What are 4 health promotion ideas?
- avoid crossing legs
- don’t sit for prolonged periods of time
- don’t wear clothes that constrict legs or waist
- no smoking
What two things increase the risk of blood clots?
smoking
birth control
