Exam (elaborations)
Assessment of Cardiac & Peripheral Vascular Systems.
- Institution
- MedSurg Notes Nurse’s Clinical Pocket Guide
Assessment of Cardiac & Peripheral Vascular Systems.
[Show more]
Seller
Follow
Content preview
Assessment of Cardiac & PeripheralVascular Systems
A normal apical should be... - ANS-Should be 1 x 2 cm in size
Amplitude: small, gentle tap
Abdominal aorta is larger in..... - ANS-Men
Abnormal carotid palpations: - ANS-Normal: Pulse should be 2+, bilaterally.
Abnormal: If you have a difference in pulse strengths,
weak or bounding pulse; variations in strength with respiration or from beat to beat.
Can be a sign of a-fib
Allen Test: - ANS-Done to determine the patency of the radial and ulnar arteries.
Typically done prior to an "A" line which goes in the ulnar artery.
To perform:
Tell pt to open and close hands fast, then squeeze a fist tightly. Then compress radial
and ulnar arteries. Keep occluded for a few seconds. Tell pt to open hand. Then release
radial artery and watch for the hand to turn from white back to red/pink. This means the
flow of the radial artery is patent. Repeat process but release the ulnar artery.
Ankle-brachial pressure index (ABPI or ABI): - ANS-Used to test arterial peripheral
disease.
Need a BP cuff and a doppler/US gel.
Everyone who is 60 or over 50 years with DM or smoker should all be screened!!!
Pt should be in supine position, and relaxed for a stable BP.
Measure pressure at the arm, and place US gel at antecubital space.
You will listen to the signal with the doppler at the pace. Then you will inflate the cuff
until you cannot hear the signal from the doppler. Then gradually release pressure when
you heart. Note the pressure when the sound comes back for the bottom fraction (arm
blood pressure)
Then you will want to check the Dorsalis Pedis and Posterior tibial.
, You put the BP cuff around the ankle, above the medial malleolus. You will then listen at
the PT with doppler. Then inflate the cuff until you cannot hear the pulse, then release to
note when you hear it. You will note the pressure for the top of the fraction. You can do
the same for the DP.
To calculate:
Right ABI= Highest pressure you read in the RIGHT foot/ Highest pressure in BOTH
arms
Left ABI= highest pressure in Left foot/ highest pressure in BOTH arms
EX: 110/100: right ABI of 1.1
Results:
Normal = 1 or greater
Mild disease = 0.8 - 1.0
Moderate disease = 0.5 - 0.8
Severe disease = < 0.5
Limb threatening = < 0.3
Another location to feel a thrill, and what would it mean? - ANS-•If a thrill is palpated
over the 2nd and 3rd R ICS space, it can indicate *severe aortic stenosis and or
systemic HTN*
•If you feel it on the L at the 2nd and 3rd ICS that would mean the *pulmonic stenosis*
Aortic aneurysms: - ANS-Occurs in the aorta. The vessel "balloons out." Recall that this
blood vessel is a strong, thick muscle layer. With this disorder, the muscle looses its
strength and structure, and is not able to control the blood flow pressures.
The biggest problem you are facing is that the blood vessel can/will rupture, causing
death. It is essential to catch aneurysms before they rupture.
Apical pulse (how to palpate) - ANS-To palpate: palmar surface of hand in the mitral
area.
Located on the left side of the chest, under the breastbone; (L MCL, 4th-5th ICS)
After locating pulse, use one finger pad to palpate.
1 x 2 cm in size
Amplitude: small, gentle tap
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller modockochieng06. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £6.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
62555 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy revision notes and other study material for 14 years now