Health Assessment

Performance Checklist

Cardio and Peripheral Vascular

– Focused Assessment

Professional Behaviours Completed/Not Completed

Hand Hygiene
Ensure safety
Introduce Self (full name and role)
Patient identity confirm (two identifiers)
Discuss Confidentiality
Ensure Privacy
Obtain Consent
“Close” interview appropriately following physical
assessment

Focused Health History Questions Findings/ Documentation

Determine reason for seeking care
P: (Palliative, Provocative)
Q: (Quality, Quantity)
R: (Region, Radiation)
S: Severity Scale
T: (Timing: Onset, Frequency, and Duration)
U: (Patient’s Understanding)
Chest Pain
Dyspnea
Cough
Orthopnea
Fatigue or Decreased Activity Tolerance
Cyanosis or pallor
Leg Cramps
Edema
Nocturia
Cardiac and PVD history
Family cardiac history
Personal habits (cardiac risk factors)

Vital Signs Findings/Documentation

Temperature (route)
Pulse (rate, rhythm, force, equality)

Adapted from:
Jarvis, C., Browne, A. J., MacDonald-Jenkins, J., & Luctkar-Flude, M. (2024). Physical
Examination and Health Assessment - Canadian (4th ed.). Elsevier Health Sciences (US).
https://pageburstls.elsevier.com/books/9780323875219
W24
 Health Assessment
Performance Checklist

Cardio and Peripheral Vascular

– Focused Assessment

Respirations (rate, rhythm, depth, effort, use of accessory

muscles)
Blood Pressure (1 or 2 Step)
Oxygen saturation
Pain (using numerical scale)
Dyspnea if diagnosed with COPD

Inspect and Palpate Arms Findings/Documentation

Inspect and Palpate the Arms
-Note colour of skin and nail beds;
-Assess skin turgor
-Assess for clubbing
-Measure capillary refill
-Symmetry of size of arms
-Radial and Brachial pulses bilaterally
-rate
-rhythm
-force
Neck Vessels Findings/Documentation
Auscultate the Carotid Artery
Lightly apply the bell of the stethoscope over the carotid
artery at three levels:
(1) the angle of the jaw,
(2) the midcervical area, and
(3) the base of the neck

Palpate the Carotid Arteries

Feel the contour and amplitude of the pulse.

Inspect the Jugular Venous Pulse

Assess for pulsations of the internal jugular veins in the
area of the suprasternal notch or around the origin of the
sternomastoid muscle around the clavicle.

Precordium Findings/Documentation
Inspect the Anterior Chest
Assess for pulsations of Apical Impulse
-level of the 4 of 5 ICS, MCL

Adapted from:
Jarvis, C., Browne, A. J., MacDonald-Jenkins, J., & Luctkar-Flude, M. (2024). Physical
Examination and Health Assessment - Canadian (4th ed.). Elsevier Health Sciences (US).
https://pageburstls.elsevier.com/books/9780323875219
W24
 Health Assessment
Performance Checklist

Cardio and Peripheral Vascular

– Focused Assessment

Palpate the Apical Impulse

Assess Supine and Left Lateral. Can verbalize assessment of AI
Note the following characteristics: in two positions.
-Location
-Size
-Amplitude
-Duration
Palpate Across the Precordium
-gently palpate over the apex, the left sternal border, and
the base, searching for any other pulsations
-Thrill?
-If any are felt, note the timing.
Auscultate
Identify the auscultatory areas where you will listen.
-Second right interspace: aortic valve area
-Second left interspace: pulmonic valve area
-Fifth intercostal space at left lower sternal border:
tricuspid valve area
-Fifth interspace at around left midclavicular line: mitral
valve area
-Inch your stethoscope in a rough Z pattern, from the base
of the heart across and down, then over to the apex.
Or start at the apex and work your way up.
-Communicate your approach to the client
Begin with the diaphragm endpiece and use the following
routine:
(a) Note the rate and rhythm,
If irregular, assess pulse deficit
(b) identify S1 and S2,
S1 at the apex
S2 at the base.
(c) assess S1 and S2 separately,
-Note whether each heart sound is normal, accentuated,
diminished, or split If extra heart sounds are heard
(d) listen for extra heart sounds during auscultation in supine
(e) listen for murmurs. position, turn patient to left side
After auscultation in supine, be sure to auscultate again and slightly leaning forward to
with client turned to left auscultate again. If no extra

Adapted from:
Jarvis, C., Browne, A. J., MacDonald-Jenkins, J., & Luctkar-Flude, M. (2024). Physical
Examination and Health Assessment - Canadian (4th ed.). Elsevier Health Sciences (US).
https://pageburstls.elsevier.com/books/9780323875219
W24
 Health Assessment
Performance Checklist

Cardio and Peripheral Vascular

– Focused Assessment

Then, listen asking client to sit up, lean forward slightly, heart sounds are heard, the
and exhale additional position changes can
-Timing - early, middle, or late systole or diastole be verbalized.
-Loudness
-Pitch – high, medium, low
-Any pattern?
-Quality – musical, blowing, harsh, rubbling
-Location
-Radiation

Inspect and Palpate Legs Findings/Documentation

-Inspect both legs together
-noting skin colour, hair distribution, venous pattern, size
(swelling or atrophy), and any skin lesions or ulcers.
-Symmetry of size of legs?
-measure calf circumference if indicated (edema,
asymmetrical)
- Palpate for temperature along the patient’s legs down to
the feet, comparing symmetrical spots
-Gently compress the gastrocnemius (calf) muscle
anteriorly against the tibia
-Palpate the dorsalis pedis, and posterior tibial pulses
-Assess for pretibial edema

Adapted from:
Jarvis, C., Browne, A. J., MacDonald-Jenkins, J., & Luctkar-Flude, M. (2024). Physical
Examination and Health Assessment - Canadian (4th ed.). Elsevier Health Sciences (US).
https://pageburstls.elsevier.com/books/9780323875219
W24