Vascular Assessment Flashcards
Proper patient protocol for taking blood pressure
avoid caffeine, tobacco, and alcohol 30 min prior, rest quietly 5 min, feet flat, back supported, no talking or moving, few deep breaths, arm at level of heart
Obtain orthostatic vital signs when concerned about…
dehydration, blood loss, syncope
Obtaining orthostatic vitals
lay pt down 5 minutes, obtain pulse and bp, assist to seated position, check bp and pulse after 1-2 min
Positive orthostatics
pulse increase 10bpm or greater, b/p decrease 20mmHg or greater
0/4 pulse
absent, not palpable
1/4 pulse
diminished, difficult to palpate
2/4 pulse
normal, easy to palpate
3/4 pulse
full, increased
4/4 pulse
bounding, strong
Prevalence of AAAs increases with what two factors
smoking and age
Grade 1+ pitting edema
2mm
Grade 2+ pitting edema
4mm
Grade 3+ pitting edema
6mm
Grade 4+ pitting edema
8mm
6 P’s of acute limb ischemia
paraesthesia, perishing cold, pulselessness, pain, paralysis, pallor
ABI equation
highest pressure in foot/highest pressure in arm
ABI suggesting PAD
<0.9
varicosities
small irregular dark blue lines that indicate venous congestion
Stasis dermatitis
reddish/purplish discoloration that develops due to hemosiderin deposits staining the skin
Cellulitis signs
marked erythema, increased warmth and swelling
lymphedema
impaired fluid return due to hereditary or secondary causes including crush injuries and tropical infections
1 infectious cause of lymphedema
filarial infection
Clubbing of digits is associated with
lung disease
Sxs emphysema
dyspnea, minimal cough, pink skin, tachypnea, cachexia, decreased sounds
Sxs chronic bronchitis
chronic, productive cough, hemoptysis, mild dyspnea initially, cyanosis, obese, prolonged expiration
Primary modifiable risk factors for CVD
smoking, obesity, diet, physical inactivity, dyslipidemia, hypertension, diabetes
Modifiable risk factors for stroke
hypertension, DM, smoking, dyslipidemia, physical inactivity
Non-modifiable risk factors for stroke
older age, race and ethnicity, sex, family history
Goals in initial phase of stroke exam
ensure medical stability (ABC), reverse contributing factors, determine if patient is a candidate for IV thrombolytic therapy or endovascular thrombectomy
PE for stroke patients
evaluate neck, palpate pulses, asses heart and lungs, assess skin, fundoscopic exam, head trauma
Three most predictive exam findings for diagnosis of acute stroke
facial paresis, arm drift/weakness, abnormal speech
Screening patients for carotid artery stenosis
not suggested to screen asymptomatic individuals
Vascular testing may be indicated for pts based on…
symptoms. PE findings or pts with high risk factors for atherosclerosis or other arterial pathology
Virchow’s triad
alterations in blood flow, vascular endothelial injury, alterations in constituents of blood
Genetic risk factors for DVT
factor V Leiden mutation, Protein S or C mutation, antithrombin deficiency
PE for DVT… look for…
dilated superficial veins, unilateral edema or swelling, unilateral warmth, pain and tenderness, local or general signs of malignancy
Most common presentation of peripheral venous insufficiency
limb discomfort, pain, limb swelling
Pain pattern of peripheral venous insufficiency
pain does not radiate as with radiculopathies and is not exacerbated by joint movement, relieved with leg elevation and walking
Pain pattern PAD
pain with walking or when elevated
