Vitals

Question 1

Whats considered a normal ABI?

Answer 1

1.0-1.4

Question 2

Whats does an ABI OF 0.9 - 1.0 mean?

Answer 2

Acceptable calcification/vessel hardening

Question 3

Whats does an ABI OF 8 - 0.9 mean?

Answer 3

Some arterial disease - treat risk factors

Question 4

Whats does an ABI OF 0.5 - 0.8 mean?

Answer 4

Moderate arterial disease - refer to vascular specialist

Question 5

Whats does an ABI OF less than 0.5 mean?

Answer 5

Severe arterial disease - refer to vascular specialist

Question 6

Apical pulse

Answer 6

*Most central pulse

Supine, index finger of your right hand on the Angle of Louis (The angle formed at the junction of the manubrium and the body of the sternum.)

Move the index finger of your right hand to the left to locate patient’s 2nd intercostal space.

Walk index finger down from 2nd ICS to 5th ICS.

Place the diaphragm of stethoscope firmly over apex of heart. (The apex is normally located in the fifth intercostals space left of the sternum in the midclavicular line)

Question 7

Pulse deficit

Answer 7

*Possible poor perfusion

Count the apical and radial pulse at the same time

Apical pulse is typically more accurate by about 10 bpm and gives an assessment of rhythm. Both measurements underestimate the true rate

Be aware – pts. w/ dysrhythmias

Question 8

Describe amplitude of a pulse score 0-3+ :

Answer 8

+ 3 = BOUNDING - readily palpable, forceful, not easily obliterated by finger-pressure

+ 2 = NORMAL

+ 1= WEAK

0 = ABSENT

Question 9

What could an amplitude of 0 indicate?

Answer 9

Absent =

Cardiac arrest
Arterial insufficiency
Peripheral arterial thrombus/embolus
Gross edema

Question 10

What could an amplitude of +1 indicate?

Answer 10

Diminished pulse = heart failure, arterial insufficiency, edema, altered vascular tone

Question 11

What could an amplitude of +3 indicate?

Answer 11

Bounding =

Heart failure
Renal failure
Altered vascular tone

Question 12

Regularly Irregular

Answer 12

Regular overall rhythm with evenly skipped beats

Question 13

Irregularly Irregular

Answer 13

Chaos! No real pattern, very difficult to measure rate accurately

Question 14

Carotid artery landmarks

Answer 14

b/w trachea and SCM

Caution!! Don’t want to record both at the same time because you do not want to occlude blood to the brain

Question 15

Femoral a. landmarks

Answer 15

b/w ASIS and pubic symphysis, below inguinal ligament

Question 16

Dorsalis pedis

Answer 16

Medial ankle, POST/inferior to medial malleoli b/w it and achilles tendon

Question 17

POST tibial a landmarks

Answer 17

Dorsum of foot, “ext big toe”

Question 18

What is a normal respiration rate?

Answer 18

12-20

Question 19

How should you take respiration rate?

Answer 19

Pretend taking radial pulse
Place over chest, every rise + fall = 1
Count for 60 seconds
Describe depth - shallow, moderate, deep
Note if they’re a “chest or belly - breather”

Question 20

What are contraindications to taking BP in L arm?

Answer 20

Emphydema
Fistula
Dialysis port
Lymph node involvement

Question 21

What does ABI tell you?

Answer 21

Detects PAD

Question 22

How do you take someones ABI?

Answer 22

Take at brachial artery first
Then foot
Cuff above malleoli
Gel on post tibial a and dorsalis pedis a. (use the higher pressure)

ABI = ANKLE / ARM

Blow up BP cuff while listening w/ doppler till don’t hear anymore, record when you hear it again