EMILIO AGUINALDO COLLEGE

School of Nursing and Midwifery

PERFORMANCE EVALUATION TOOL

PHYSICAL ASSESSMENT

Procedure 28-13: Assessing the Peripheral Vascular System

NAME OF STUDENT:
SECTION/GROUP: Date:

LEGEND:
4 Very Satisfactorily Performed
(Student performs consistently in an effective and efficient manner)
3 Satisfactorily Performed
(Performance is usually effective and efficient but not always)
2 Fairly performed
(Progress in performance is too slow to judge satisfactorily; task performance is not properly for majority of the
time)
1 Poorly performed
(No progress in performance has been demonstrated, and or performance is consistently inefficient)

Procedure 28-13: Assessing the Peripheral Vascular System

Procedure 4 3 2 1 REMARKS
1. Introduce yourself; explain to the
client what you are going to do,
why it is necessary, and how she/he
can cooperate.
2. Wash hands and observe other
appropriate infection control
procedures.
3. Provide for client privacy.
4. Determine client’s history of the
following:
● Past history of heart disorders,
varicosities, arterial disease, and
hypertension
● Lifestyle patterns, specifically
exercise patterns, activity
patterns, and tolerance
● Smoking habits and use of
alcohol
Assessment
Peripheral Pulses
5. Palpate the peripheral pulses
(except the carotid pulse) on both
sides of the client’s body
individually, simultaneously, and
systematically to determine the
symmetry of pulse volume. If you
have difficulty palpating some of
the peripheral pulses, use a
Doppler ultrasound probe.
Peripheral Veins
6. Inspect the peripheral veins in the
arms and legs for the presence and/
or appearance of superficial veins
when limbs are dependent and
when limbs are elevated.
 7. Assess the peripheral leg veins for
signs of phlebitis.
Peripheral Perfusion
8. Inspect the skin of the hands and
feet for color, temperature, edema,
and skin changes.
9. Assess the adequacy of arterial flow
if arterial insufficiency is suspected.
10. Document findings in the client
record.
TOTAL

GRADING SYSTEM

Performance Score _________ x 90% = ______

Punctuality and Grooming _________ x 10% = ______

Total = ______

Evaluated by: Conformed by:

____________________________ ______________________________
Signature over printed name Signature over printed name