Peripheral Vascular Assessment.pdf

Peripheral Vascular System Assessment Shana Bouley – Spring 2024 Illustration by Smart-Servier Medical Art  Peripheral Vascular System ▪...

Peripheral Vascular System Assessment Shana Bouley – Spring 2024 Illustration by Smart-Servier Medical Art  Peripheral Vascular System ▪ Consists of a system of intertwining veins and arteries which carry blood to and from the heart and lungs. ▪ Also involves the capillaries and lymph system  Disorders which alter the normal flow of blood through the arteries and veins Affects the lower extremities more frequently than the upper extremities A client with a diagnosis of PVD implies arterial disease rather than venous Some clients have both arterial and venous disease Subjective Data Collection ▪ Aching calves ▪ Claudication distance ▪ Change in skin color on arms / legs ▪ Numbness in legs ▪ Leg cramps ▪ Loss of sensation in legs Subjective Data Collection Swelling / edema in arms or legs Pain in legs during exercise Hx: Diabetes / Thrombophlebitis / HTN / Alcoholism Medications Lymph node enlargement Objective Data Collection Inspect & Palpate the Arms Symmetrical in size Skin Clubbing Capillary Refill Pulses Epitrochlear lymph nodes Objective Data Collection Inspect & Palpate the Legs Skin color, hair distribution, venous pattern, size (swelling or atrophy), skin lesions or ulcers, symmetrical, calf Temperature Inguinal lymph nodes Pulses Edema Color Change Test Clubbing Color Change Test Peripheral Pulses Temporal Carotid Radial Ulnar Brachial Femoral Popliteal Posterior Tibial Dorsalis Pedis What do you do if you are unable to palpate a peripheral pulse? Rate, rhythm, equality, amplitude, and elasticity. Pulse amplitude should be described on a scale of 0 to 3: 0 = absent, not palpable 1+=diminished, weak, barely palpable 2+= normal, easy to palpate 3+=full, increased, easy to palpate 4+=strong, bounding against fingertips Chronic arterial insufficiency Chronic venous insufficiency Arterial (ischemic) ulcer Venous (stasis) ulcer Diabetic changes Chronic venous disease Acute venous disease Superficial varicose veins Deep venous thrombophlebitis Arterial disease signs and symptoms of O2 deficit Venous disease signs and symptoms of metabolic waste buildup Symptom analysis of pain for: Location, character, onset and duration, aggravating factors, relieving factors, associated symptoms, risk factors  Venous or Arterial Insufficiency Venous Arterial Aching pain Deep pain Pain worse at end of day Claudication with walking Pain worse with prolonged Pain at rest standing Coolness Edema Pallor Coarse, thickened skin and nails Elevational Pallor Normal pulses Dependant rubor Brown pigment discoloration Diminished pulses Weepy, pruritic stasis dermatitis Thin, shiny skin Absence of hair  Causes of Arterial Insufficiency Abnormal cholesterol Diabetes Heart Disease (CAD) High Blood Pressure Kidney disease Smoking Arterial Insufficiency Symptoms Intermittent Claudication Legs or feet may feel numb when at rest The legs also may feel cool to touch Skin may appear pale Pain and cramps at night Pain or tingling in the feet or toes Pain that is worse when leg is elevated Ulcers that do not heal  Venous Insufficiency Abnormal cholesterol Diabetes Heart Disease (CAD) High Blood Pressure Kidney disease Smoking Venous Insufficiency Decreased blood flow from the leg veins up to the heart with pooling of blood in the veins Symptoms: aching leg pain, leg fatigue, leg heaviness Severe cases: venous insufficiency can cause skin discoloration and ulceration Assess for Pitting Edema Press firmly with one finger for 5 seconds and release. Depth of indentation determines severity (p.178) Measuring Calf Circumference Use a tape measure to measure circumference of extremity. This also establishes a baseline for future measurements. Capillary Refill Grasping patient's fingernail or toenail while noting color of nailbed. Apply gentle, firm pressure to nailbed. Release quickly, watching for color change. Circulation is restored and should return to normal pink color in less than 2 seconds.  How would you document a peripheral vascular assessment? CREDITS: This presentation template was created by Slidesgo, including icons by Flaticon and infographics & images by Freepik Illustration by Smart-Servier Medical Art