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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 Peripheral Vascular Disease • • • • Disorders which alter the normal flow of blood through the arteries and veins Effects the lower extremities more frequently the the upper A client with a diagnosis of PVD implies arterial disease rather than venous Some client have both arterial and venous disease
Focus of Assessment
Assessment of skin hair nails pulses temperature pain and sensation
etc Protect area from trauma . cold air temp. coldness.Raynaud’s Disease • • • • • • • Caused by vasospasms of the arterioles and arteries of the upper and lower extremities Affects hands but can be on toes and tip of nose S/S – chronic. numbness. pain and pallor Women 16-40 years of age Cause is unknown After spasm the skin becomes reddened and hyperemic Nursing care • • • • • Pain control Teach client to avoid stimuli which may trigger episode (stress. intermittent. smoking) Keep extremity warm Use hair dryer. warm H2O.
Review of Assessment of Arterial Pulses Palpate the central and peripheral pulses Carotid brachial radial femoral popliteal dorsalis pedis posterior tibial Subjective data: .
brownish discoloration Temp: any changes in temperature Vein bulging or crooked Sores • Swelling in arms or legs • When did it start. relief • • Lymph node enlargement Medications What medications is the patient taking? Focus of Assessment Upper extremities: Arms and hands Inspection: skin nails hair Palpation: pulses (describe). blue. type of pain Aggravating factors • Skin changes on arms or legs • • • • Color: redness. when is it worse.• Leg pain or cramps • • Where. .
Radial Pulses capillary refill time palpate arms for temperature. moisture and edema Focus of Assessment • Palpate pulses noting: • • • • • Rate Rhythm Elasticity Force Pulses • Grade force (four-point scale) • • • • • 4+ bounding 3+ increased 2+ normal 1+ weak 0 absent • Lower extremities • Inspection: • skin .
• • • • nails hair presence of varicosities on legs Palpation: • pulses.Inspect & palpate. continuation • Legs. capillary refill time Objective Data The Physical Exam. continuation • • • • Femoral pulse Popliteal pulse Posterior tibial pulse Dorsalis pedal pulse .Inspect & palpate • • • • • Skin & hair Symmetry Temperature Calf muscle Inguinal lymph nodes • Legs.
.the allen test evaluates patency of the radial or ulnar arteries. using the bell of the stethoscope (the bell detects low pitch sound) Auscultate for bruit Perform the allen test (optional) Allen test. It is implemented when patency is questionable or before such procedures as a radial artery puncture.Femoral Pulse Popliteal Pulse Review of Assessment of Arterial Pulses Auscultate the carotid and femoral arteries Auscultate for bruits.
Homan’s Sign To determine whether a deep vein thrombosis is present Varicose Veins .
which results in venous congestion and vein enlargement Usually affects the saphenous vein and its branches Causes – – – – Unknown but may be R/T congenital weakness of valve Thrombophlebitis Venous stasis – pregnancy. tortuous leg veins with back flow of blood caused by incompetent valve closure.• Dilated. prolonged standing Familial tendency • • • Diagnosis – – – History and physical Venogram Trendelburg’s test –demonstrates the backward flow of the blood in the venous system .
Catandaunes State Colleges COLLEGE OF HEALTH SCIENCES Virac. Molina . Catnduanes Submitted by: Patricia Dawn G.
BSN I-A Submitted to: Mary Elaine Tapel RN MAN Clinical Instructor .