This document provides information about assessing the peripheral vascular system for nursing students. It includes the structure and function of arteries, veins and capillaries. It describes how to inspect, palpate and auscultate the arms and legs to assess peripheral pulses, skin temperature, edema, hair growth, and lesions. It discusses normal versus abnormal findings and characteristics of arterial and venous insufficiency. The goal is for students to learn techniques to properly examine the peripheral vascular system and identify any abnormalities.
This document provides information on gastrointestinal disorders, specifically chronic inflammatory bowel disease. It discusses two main conditions: Crohn's disease and ulcerative colitis. Crohn's disease causes inflammation of the digestive tract that can affect any area from the mouth to the anus, and symptoms may include abdominal pain, diarrhea, and weight loss. Ulcerative colitis only affects the large intestine and rectum, causing ulcers and inflammation of the lining. It can cause diarrhea with blood or pus, abdominal pain, and weight loss. Both conditions involve periods of flare-ups and remission and are treated with medications, nutrition therapy, or surgery in some cases.
This document provides information on assessing the gastrointestinal system through nursing assessment. It begins by outlining the objectives and structures of the GI system. It then describes techniques for inspecting, auscultating, percussing and palpating the abdomen. Key areas of the abdomen are defined and normal and abnormal findings are differentiated. The document outlines the process of digestion and how aging impacts the GI tract. Assessment methods including inspection of the skin, contour, and visible features are covered.
The document discusses care of the dying individual. It begins with an introduction to death and dying, including definitions of death and dying. It then outlines the 5 stages of dying according to Kubler-Ross: denial, anger, bargaining, depression, and acceptance. The stages are described in detail. The document also discusses assessing the physiological signs of approaching death and providing physical, psychological, social, and spiritual care for the dying individual. It emphasizes meeting the patient's needs, maintaining communication, and allowing for dignity in death.
The document discusses the musculo-skeletal system including its main components and functions. It describes the three types of muscles, tendons, ligaments, bones, joints, and cartilages. It then discusses the assessment of the musculo-skeletal system including history taking, physical examination, common tests like bone marrow aspiration and arthroscopy, and common musculoskeletal problems and their nursing management.
The document discusses cholecystitis and cholelithiasis. It begins by reviewing the anatomy of the gallbladder and its connection to the liver and bile ducts. It then defines cholecystitis as inflammation of the gallbladder, which can be acute or chronic, and calculous or acalculous. The pathophysiology of calculous cholecystitis involves gallstones obstructing bile flow and damaging the gallbladder walls. Clinical features include pain in the upper right abdomen and fever. The document also defines cholelithiasis as gallstone formation, discusses the types of gallstones, risk factors like obesity and genetics, and the pathophysiology of cholesterol crystals forming in supersaturated bile and
The document provides a nursing care plan for a 62-year-old female patient, Mrs. Kulsum, who is being treated for Pott's Spine at L3 and L4 levels. It includes her medical history, physical examination findings, lab results, medications and nursing assessments. The nursing diagnoses identified are acute pain, impaired mobility, altered nutrition, impaired skin integrity, self-care deficit, ineffective coping and risks for infection and aspiration due to her condition and restricted activity.
Physical assessment of nose , mouth and throat 2018nahla khalil
This document outlines the process for conducting a physical examination of the ears, nose, mouth, and throat. It describes inspecting and palpating each area and provides normal findings. Key tests include the Weber test to assess hearing lateralization using bone conduction, the Rinne test comparing bone and air conduction, and examining the external ear canal, tympanic membrane, and sinuses. The mouth and oropharynx are also examined, including inspecting the lips, teeth, gums, tongue, palate, uvula, and tonsils.
This document defines and classifies different types of burns, including thermal, electrical, chemical, and radiation burns. It describes burns based on depth, with first degree involving the epidermis, second degree also involving the dermis and causing blisters, third degree being full thickness and causing charring, and fourth degree extending into underlying tissues. Burns are also classified based on percentage of total body surface area affected as minor, moderate, or major. The pathophysiology of burns is described, including increased vascular permeability, fluid shifts leading to hypovolemia, and increased risk of infection, renal failure, and multiorgan dysfunction. Infections from bacteria such as Streptococcus and Pseudomonas are common complications. Causes
This document provides information on gastrointestinal disorders, specifically chronic inflammatory bowel disease. It discusses two main conditions: Crohn's disease and ulcerative colitis. Crohn's disease causes inflammation of the digestive tract that can affect any area from the mouth to the anus, and symptoms may include abdominal pain, diarrhea, and weight loss. Ulcerative colitis only affects the large intestine and rectum, causing ulcers and inflammation of the lining. It can cause diarrhea with blood or pus, abdominal pain, and weight loss. Both conditions involve periods of flare-ups and remission and are treated with medications, nutrition therapy, or surgery in some cases.
This document provides information on assessing the gastrointestinal system through nursing assessment. It begins by outlining the objectives and structures of the GI system. It then describes techniques for inspecting, auscultating, percussing and palpating the abdomen. Key areas of the abdomen are defined and normal and abnormal findings are differentiated. The document outlines the process of digestion and how aging impacts the GI tract. Assessment methods including inspection of the skin, contour, and visible features are covered.
The document discusses care of the dying individual. It begins with an introduction to death and dying, including definitions of death and dying. It then outlines the 5 stages of dying according to Kubler-Ross: denial, anger, bargaining, depression, and acceptance. The stages are described in detail. The document also discusses assessing the physiological signs of approaching death and providing physical, psychological, social, and spiritual care for the dying individual. It emphasizes meeting the patient's needs, maintaining communication, and allowing for dignity in death.
The document discusses the musculo-skeletal system including its main components and functions. It describes the three types of muscles, tendons, ligaments, bones, joints, and cartilages. It then discusses the assessment of the musculo-skeletal system including history taking, physical examination, common tests like bone marrow aspiration and arthroscopy, and common musculoskeletal problems and their nursing management.
The document discusses cholecystitis and cholelithiasis. It begins by reviewing the anatomy of the gallbladder and its connection to the liver and bile ducts. It then defines cholecystitis as inflammation of the gallbladder, which can be acute or chronic, and calculous or acalculous. The pathophysiology of calculous cholecystitis involves gallstones obstructing bile flow and damaging the gallbladder walls. Clinical features include pain in the upper right abdomen and fever. The document also defines cholelithiasis as gallstone formation, discusses the types of gallstones, risk factors like obesity and genetics, and the pathophysiology of cholesterol crystals forming in supersaturated bile and
The document provides a nursing care plan for a 62-year-old female patient, Mrs. Kulsum, who is being treated for Pott's Spine at L3 and L4 levels. It includes her medical history, physical examination findings, lab results, medications and nursing assessments. The nursing diagnoses identified are acute pain, impaired mobility, altered nutrition, impaired skin integrity, self-care deficit, ineffective coping and risks for infection and aspiration due to her condition and restricted activity.
Physical assessment of nose , mouth and throat 2018nahla khalil
This document outlines the process for conducting a physical examination of the ears, nose, mouth, and throat. It describes inspecting and palpating each area and provides normal findings. Key tests include the Weber test to assess hearing lateralization using bone conduction, the Rinne test comparing bone and air conduction, and examining the external ear canal, tympanic membrane, and sinuses. The mouth and oropharynx are also examined, including inspecting the lips, teeth, gums, tongue, palate, uvula, and tonsils.
This document defines and classifies different types of burns, including thermal, electrical, chemical, and radiation burns. It describes burns based on depth, with first degree involving the epidermis, second degree also involving the dermis and causing blisters, third degree being full thickness and causing charring, and fourth degree extending into underlying tissues. Burns are also classified based on percentage of total body surface area affected as minor, moderate, or major. The pathophysiology of burns is described, including increased vascular permeability, fluid shifts leading to hypovolemia, and increased risk of infection, renal failure, and multiorgan dysfunction. Infections from bacteria such as Streptococcus and Pseudomonas are common complications. Causes
elimination, bowel elimination, physiology of elimination, process of bowel eliminaton factor impaired bowel, factors improve bowel elimination, alteration in bowel elimination, maintenance of bowel motility, assessment of bowel elimination, characteristics of feces, type of feces, methods for maintain the bowel elimination:- enemas, rectal suppositories and colostomies, types of colostomies, colostomy care
The patient's mother understands the situation and treatment regimen including safety measures such as limiting range of motion and use of Taylor brace after nursing interventions of encouraging position changes every 2 hours, scheduling rest periods with activities, providing skin care and passive exercises, explaining use of devices, and encouraging nutritious intake.
The document provides guidance on examining a patient's breasts and axillae. It describes the anatomy and outlines the procedure which involves inspection and palpation. Inspection involves examining the breasts visually for signs of abnormalities while palpation involves thoroughly feeling the breasts using a systematic approach to identify any masses or irregularities. Any findings should be carefully documented including location, size, shape, consistency and characteristics. The exam also includes inspecting and palpating the axillae and nipple areas.
The document discusses the five stages of dying as proposed by Elisabeth Kubler-Ross: denial, anger, bargaining, depression, and acceptance. It also summarizes the typical nursing care approach for terminally ill patients, which involves comfort, safety, addressing needs, teaching coping strategies, explaining what is happening, and facilitating end-of-life decisions and a peaceful death.
The document provides guidance on assessing the anus and rectum, including objectives to specify anatomy and physiology, identify normal findings, and enumerate interview questions. It covers anatomy, subjective and objective assessment techniques, normal and abnormal findings, and health promotion topics like cancer screening. The assessment involves inspection, palpation, and examination of the anal area and rectum using various positions and techniques.
This document provides guidance for conducting a physical assessment of a patient. It outlines the key components of a physical exam that should be evaluated, including general appearance, vital signs, skin, nails, hair, head, eyes, ears, nose, mouth, and other areas. For each component, it lists the potential findings and observations that should be noted, such as consciousness, orientation, temperature, pulse, lesions, discoloration, nail shape, scalp condition, eye movements, nasal passages, teeth, and more. The purpose is to conduct a thorough physical exam and document all relevant findings.
The document provides an overview of assessing the musculo-skeletal system including describing the types of muscles, tendons, ligaments, bones, and joints; it outlines the steps of physical examination including inspection, palpation, range of motion testing; and it provides examples of assessing specific areas like the neck, upper extremities, lower extremities, and knees.
Note on assessment of renal or urinary systemBabitha Devu
A guide to help the students review themselves about the A & P of the urinary system. it also helps in collecting history and appraise the client suffering from various urinary tract disorders or diseases.
This document discusses fractures, including their definition, causes, types, clinical manifestations, diagnosis, management, and complications. It defines a fracture as a break in the continuity of bone structure. Fractures can be caused by trauma or pathology and are classified as open or closed, complete or incomplete. The clinical signs of a fracture include pain, swelling, deformity, and loss of function. Diagnosis involves history, physical exam, x-rays, and sometimes CT or MRI. Management focuses on realignment, immobilization, and rehabilitation through various methods like casting, traction, or surgery. Potential complications include delayed healing, nonunion, malunion, and infection.
The document provides an overview of gastrointestinal assessment techniques. It discusses taking a patient history, including appetite, weight changes, dysphagia, food intolerances, nausea, vomiting, past medical history, medications, and lifestyle factors. It also describes techniques for physical examination of the abdomen, including inspection, auscultation, percussion, and palpation to evaluate for things like masses, hernias, or organ enlargement. Specific tests for assessing abdominal pain are also outlined. The document emphasizes the importance of a thorough gastrointestinal evaluation to identify any disruptions in digestion.
The document discusses assessing vital signs including body temperature, pulse rate, respiratory rate, and blood pressure. It provides details on:
- The purposes and importance of vital sign assessment
- Factors that can affect each vital sign reading
- Proper technique for measuring each vital sign, including sites of measurement and positioning
- Normal ranges and clinical significance of abnormal readings
This document outlines the expected learning objectives and assessment procedures for examining the peripheral vascular system. Students are expected to understand vascular anatomy, risk factors for peripheral vascular disease, and how to perform and interpret a physical exam of the peripheral pulses, skin, edema, and signs of arterial and venous insufficiency. The assessment involves inspection, palpation, and auscultation of pulses in the arms and legs as well as examining skin color, temperature, hair distribution, edema, lesions, and varicosities.
Assessing the Thorax and Lungs presentationsrslytrd
The document provides guidance on assessing the thorax, lungs, and peripheral vascular system. It describes preparing the client, inspecting various areas, palpating for sensations, and expected normal findings. Specific assessments include inspecting the chest wall, observing breathing patterns, palpating the lungs, assessing peripheral pulses, inspecting skin and veins in the extremities, and assessing arterial flow. When assessing the breasts, the client is positioned upright and instructed to expose one breast at a time for inspection and palpation while maintaining privacy. Teaching breast self-examination is also described.
I examined this patient's peripheral vascular system. On inspection from the end of the bed, the patient appeared comfortable at rest with no signs of vascular disease. Both limbs were pink and well perfused with normal capillary refill times. All pulses were present and equal bilaterally. Buerger's test was negative. To complete my examination, I would assess the cardiovascular system and test the relevant muscles and nerves of the affected limb, and perform duplex scans and ankle-brachial pressure indexes.
General physical examination involves assessing the patient's general appearance, vital signs, and examining the hands, scalp/face/neck, lymph nodes, and edema. Examining the hands focuses on signs like clubbing, cyanosis, and nail changes. Examination of the face evaluates features such as jaundice, pallor, and oral lesions. Neck examination includes assessing carotid pulses, jugular venous pressure, thyroid, and lymph nodes. Vital signs include pulse, blood pressure, respiratory rate, temperature, oxygen saturation, and blood glucose.
This document provides instructions for performing various clinical skills assessments including: resuscitation, assessing peripheral pulses, taking blood pressure, performing a cardiovascular examination, assessing the respiratory system, performing peak flow and vitalograph tests. The key steps are outlined for each skill with the goal of assessing vital signs, breathing, circulation and identifying any abnormalities.
CM3 - CU12 ASSESSMENT OF HEART & NECK VESSELS.pdfZyraPascual1
This document provides information about assessing the heart and neck vessels as part of a nursing course. It outlines the objectives of the unit, which include describing heart and vessel structures and functions, performing a physical assessment using various techniques, and differentiating normal from abnormal findings. The document then details the anatomy and physiology of the cardiovascular system and steps for performing an assessment, including inspection, palpation, percussion, and auscultation of the neck, precordium, and heart sounds in various positions. It describes normal findings and potential abnormalities.
This document provides guidance on performing a cardiovascular examination, including:
1. Examining the general appearance, vital signs, jugular venous pressure, peripheral edema, and hands of the patient.
2. Performing a local heart examination using the IPPA sequence of inspection, palpation, percussion, and auscultation of the four heart valve areas.
3. During auscultation, commenting on heart sounds, extra sounds like murmurs, and lung bases.
This document provides guidance on performing a peripheral vascular examination, including examining the arms and legs to check for signs of vascular disease. It describes how to inspect and palpate pulses in the upper and lower limbs, listen for bruits, and perform additional tests like Buerger's angle test. The document also covers examining the venous system, including inspection for varicose veins, palpating for fascial defects, and tests like Trendelenburg's test to check for venous incompetence.
Basics of nursing of patient with heart disease 1.pptxsneha334357
1) Cardiovascular diseases are a major health problem worldwide due to their high prevalence, complications, and mortality. They are the leading cause of death in Russia.
2) Common cardiovascular conditions include hypertension, coronary artery disease, myocardial infarction, arrhythmias, heart failure, heart valve disease, and congenital heart defects.
3) Typical symptoms patients may experience include chest pain, shortness of breath, palpitations, dizziness, edema, and syncope.
This document outlines the general principles and procedures for performing a physical examination. The physical exam aims to understand a patient's physical and mental well-being by systematically collecting objective information through examination techniques. Key components include assessing vital signs like pulse, blood pressure, temperature and respiratory rate. Other assessments include examining general appearance, oral cavity, hair, nails, lymph nodes, edema, clubbing, pallor, icterus and cyanosis. The exam is conducted in a private, relaxed environment with the patient's consent and reassurance.
elimination, bowel elimination, physiology of elimination, process of bowel eliminaton factor impaired bowel, factors improve bowel elimination, alteration in bowel elimination, maintenance of bowel motility, assessment of bowel elimination, characteristics of feces, type of feces, methods for maintain the bowel elimination:- enemas, rectal suppositories and colostomies, types of colostomies, colostomy care
The patient's mother understands the situation and treatment regimen including safety measures such as limiting range of motion and use of Taylor brace after nursing interventions of encouraging position changes every 2 hours, scheduling rest periods with activities, providing skin care and passive exercises, explaining use of devices, and encouraging nutritious intake.
The document provides guidance on examining a patient's breasts and axillae. It describes the anatomy and outlines the procedure which involves inspection and palpation. Inspection involves examining the breasts visually for signs of abnormalities while palpation involves thoroughly feeling the breasts using a systematic approach to identify any masses or irregularities. Any findings should be carefully documented including location, size, shape, consistency and characteristics. The exam also includes inspecting and palpating the axillae and nipple areas.
The document discusses the five stages of dying as proposed by Elisabeth Kubler-Ross: denial, anger, bargaining, depression, and acceptance. It also summarizes the typical nursing care approach for terminally ill patients, which involves comfort, safety, addressing needs, teaching coping strategies, explaining what is happening, and facilitating end-of-life decisions and a peaceful death.
The document provides guidance on assessing the anus and rectum, including objectives to specify anatomy and physiology, identify normal findings, and enumerate interview questions. It covers anatomy, subjective and objective assessment techniques, normal and abnormal findings, and health promotion topics like cancer screening. The assessment involves inspection, palpation, and examination of the anal area and rectum using various positions and techniques.
This document provides guidance for conducting a physical assessment of a patient. It outlines the key components of a physical exam that should be evaluated, including general appearance, vital signs, skin, nails, hair, head, eyes, ears, nose, mouth, and other areas. For each component, it lists the potential findings and observations that should be noted, such as consciousness, orientation, temperature, pulse, lesions, discoloration, nail shape, scalp condition, eye movements, nasal passages, teeth, and more. The purpose is to conduct a thorough physical exam and document all relevant findings.
The document provides an overview of assessing the musculo-skeletal system including describing the types of muscles, tendons, ligaments, bones, and joints; it outlines the steps of physical examination including inspection, palpation, range of motion testing; and it provides examples of assessing specific areas like the neck, upper extremities, lower extremities, and knees.
Note on assessment of renal or urinary systemBabitha Devu
A guide to help the students review themselves about the A & P of the urinary system. it also helps in collecting history and appraise the client suffering from various urinary tract disorders or diseases.
This document discusses fractures, including their definition, causes, types, clinical manifestations, diagnosis, management, and complications. It defines a fracture as a break in the continuity of bone structure. Fractures can be caused by trauma or pathology and are classified as open or closed, complete or incomplete. The clinical signs of a fracture include pain, swelling, deformity, and loss of function. Diagnosis involves history, physical exam, x-rays, and sometimes CT or MRI. Management focuses on realignment, immobilization, and rehabilitation through various methods like casting, traction, or surgery. Potential complications include delayed healing, nonunion, malunion, and infection.
The document provides an overview of gastrointestinal assessment techniques. It discusses taking a patient history, including appetite, weight changes, dysphagia, food intolerances, nausea, vomiting, past medical history, medications, and lifestyle factors. It also describes techniques for physical examination of the abdomen, including inspection, auscultation, percussion, and palpation to evaluate for things like masses, hernias, or organ enlargement. Specific tests for assessing abdominal pain are also outlined. The document emphasizes the importance of a thorough gastrointestinal evaluation to identify any disruptions in digestion.
The document discusses assessing vital signs including body temperature, pulse rate, respiratory rate, and blood pressure. It provides details on:
- The purposes and importance of vital sign assessment
- Factors that can affect each vital sign reading
- Proper technique for measuring each vital sign, including sites of measurement and positioning
- Normal ranges and clinical significance of abnormal readings
This document outlines the expected learning objectives and assessment procedures for examining the peripheral vascular system. Students are expected to understand vascular anatomy, risk factors for peripheral vascular disease, and how to perform and interpret a physical exam of the peripheral pulses, skin, edema, and signs of arterial and venous insufficiency. The assessment involves inspection, palpation, and auscultation of pulses in the arms and legs as well as examining skin color, temperature, hair distribution, edema, lesions, and varicosities.
Assessing the Thorax and Lungs presentationsrslytrd
The document provides guidance on assessing the thorax, lungs, and peripheral vascular system. It describes preparing the client, inspecting various areas, palpating for sensations, and expected normal findings. Specific assessments include inspecting the chest wall, observing breathing patterns, palpating the lungs, assessing peripheral pulses, inspecting skin and veins in the extremities, and assessing arterial flow. When assessing the breasts, the client is positioned upright and instructed to expose one breast at a time for inspection and palpation while maintaining privacy. Teaching breast self-examination is also described.
I examined this patient's peripheral vascular system. On inspection from the end of the bed, the patient appeared comfortable at rest with no signs of vascular disease. Both limbs were pink and well perfused with normal capillary refill times. All pulses were present and equal bilaterally. Buerger's test was negative. To complete my examination, I would assess the cardiovascular system and test the relevant muscles and nerves of the affected limb, and perform duplex scans and ankle-brachial pressure indexes.
General physical examination involves assessing the patient's general appearance, vital signs, and examining the hands, scalp/face/neck, lymph nodes, and edema. Examining the hands focuses on signs like clubbing, cyanosis, and nail changes. Examination of the face evaluates features such as jaundice, pallor, and oral lesions. Neck examination includes assessing carotid pulses, jugular venous pressure, thyroid, and lymph nodes. Vital signs include pulse, blood pressure, respiratory rate, temperature, oxygen saturation, and blood glucose.
This document provides instructions for performing various clinical skills assessments including: resuscitation, assessing peripheral pulses, taking blood pressure, performing a cardiovascular examination, assessing the respiratory system, performing peak flow and vitalograph tests. The key steps are outlined for each skill with the goal of assessing vital signs, breathing, circulation and identifying any abnormalities.
CM3 - CU12 ASSESSMENT OF HEART & NECK VESSELS.pdfZyraPascual1
This document provides information about assessing the heart and neck vessels as part of a nursing course. It outlines the objectives of the unit, which include describing heart and vessel structures and functions, performing a physical assessment using various techniques, and differentiating normal from abnormal findings. The document then details the anatomy and physiology of the cardiovascular system and steps for performing an assessment, including inspection, palpation, percussion, and auscultation of the neck, precordium, and heart sounds in various positions. It describes normal findings and potential abnormalities.
This document provides guidance on performing a cardiovascular examination, including:
1. Examining the general appearance, vital signs, jugular venous pressure, peripheral edema, and hands of the patient.
2. Performing a local heart examination using the IPPA sequence of inspection, palpation, percussion, and auscultation of the four heart valve areas.
3. During auscultation, commenting on heart sounds, extra sounds like murmurs, and lung bases.
This document provides guidance on performing a peripheral vascular examination, including examining the arms and legs to check for signs of vascular disease. It describes how to inspect and palpate pulses in the upper and lower limbs, listen for bruits, and perform additional tests like Buerger's angle test. The document also covers examining the venous system, including inspection for varicose veins, palpating for fascial defects, and tests like Trendelenburg's test to check for venous incompetence.
Basics of nursing of patient with heart disease 1.pptxsneha334357
1) Cardiovascular diseases are a major health problem worldwide due to their high prevalence, complications, and mortality. They are the leading cause of death in Russia.
2) Common cardiovascular conditions include hypertension, coronary artery disease, myocardial infarction, arrhythmias, heart failure, heart valve disease, and congenital heart defects.
3) Typical symptoms patients may experience include chest pain, shortness of breath, palpitations, dizziness, edema, and syncope.
This document outlines the general principles and procedures for performing a physical examination. The physical exam aims to understand a patient's physical and mental well-being by systematically collecting objective information through examination techniques. Key components include assessing vital signs like pulse, blood pressure, temperature and respiratory rate. Other assessments include examining general appearance, oral cavity, hair, nails, lymph nodes, edema, clubbing, pallor, icterus and cyanosis. The exam is conducted in a private, relaxed environment with the patient's consent and reassurance.
This document provides an overview of cardiovascular assessment. It begins by outlining the objectives of reviewing cardiovascular anatomy and physiology, physical assessment techniques, and diagnostic procedures. It then describes the anatomy of the heart, including its four chambers and valves. Physical assessment techniques are explained, including inspection, palpation, percussion, and auscultation to evaluate the heart sounds and pulses. Common diagnostic tests like electrocardiograms, stress tests, and cardiac catheterization are also briefly mentioned.
This document provides information on assessing cardiovascular health. It begins with an introduction noting cardiovascular disease is a leading cause of death. It then outlines the objectives which are to review cardiovascular anatomy and physiology, describe physical assessment, and review diagnostic procedures. The document proceeds to describe cardiovascular anatomy including the heart, circulation, and valves. It provides details on performing a cardiovascular assessment including taking a history, inspection, palpation, auscultation, and measuring blood pressure.
This document provides an outline and overview of techniques for performing a history and physical examination of the heart. It discusses the anatomy and physiology of the heart, techniques for examining pulses, heart sounds, murmurs, blood pressure, jugular veins, and special tests. The examination involves inspection, palpation, percussion, and auscultation of the heart and surrounding vessels to evaluate for abnormalities.
1) The document reviews the anatomy and physiology of the cardiovascular system and describes methods for assessing cardiovascular status including health history, physical exam techniques like inspection, palpation, percussion and auscultation, and diagnostic tests.
2) The physical exam involves assessing things like vital signs, jugular vein pulsations, heart sounds and murmurs auscultated over the precordium.
3) Diagnostic tests discussed include electrocardiograms, echocardiograms, stress tests and cardiac catheterization.
Peripheral pulsations and blood pressure measurementabeerabdulkareem
This document describes how to assess peripheral pulses and measure blood pressure. It outlines the locations of major arteries where pulses can be felt, including the carotid, brachial, radial, femoral, popliteal, posterior tibial, and dorsalis pedis arteries. It provides steps for properly measuring blood pressure using a sphygmomanometer and stethoscope. This includes positioning the patient, wrapping the cuff, palpating pulses to estimate systolic pressure, auscultating Korotkoff sounds to determine systolic and diastolic pressures, and defining normal blood pressure ranges.
This document discusses vasospastic disorders and gangrene. It provides details on physiology of arteries, blood components, blood pressure measurement, classifications of occlusive diseases, causes of chronic limb ischemia, and clinical signs of ischemic limbs. Arterial diseases can be investigated through tests like ankle brachial index which helps identify ischemia. Chronic ischemia can lead to complications like gangrene if not addressed.
Pressure, blood flow, compliance and resistance are interrelated factors that govern circulation. Arteries have thick, muscular walls and are very elastic to withstand pressure changes. Arterioles regulate blood flow through diameter changes. Capillaries allow for gas, nutrient and waste exchange. Venules and veins have thin walls and valves to aid blood return to the heart. Blood pressure and flow are controlled by neural and hormonal mechanisms. Resistance depends on vessel properties and affects flow. Compliance refers to a vessel's distensibility and ability to store blood with pressure changes, aiding venous return.
The document provides an overview of how to assess the heart. It describes the heart's anatomy and location. Heart sounds are produced by valve closure, with S1 resulting from AV valve closure and S2 from semilunar valve closure. The assessment involves inspection, percussion, and auscultation of the heart sounds at different locations on the chest. Variations in assessment for geriatric patients and possible collaborative problems are also outlined.
Similar to CM3 - CU13 ASSESSMENT OF PERIPHERAL VASCULAR SYSTEM.pdf (20)
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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CM3 - CU13 ASSESSMENT OF PERIPHERAL VASCULAR SYSTEM.pdf
1. BACHELOR OF SCIENCE IN NURSING:
HEALTH ASSESSMENT
COURSE MODULE COURSE UNIT WEEK
3 13 13
Adult Physical Assessment: Peripheral Vascular System
✓ Read course and unit objectives
✓ Read and comprehend study guide prior to
class attendance
✓ Read and comprehend required learning
resources
✓ Engage in classroom discussions
✓ Participate in weekly discussion board
(Canvas)
✓ Answer and submit course unit tasks
At the end of this unit, the students are expected to:
Cognitive:
1. Describe the structure and the function of the blood vessels, including capillaries and
lymphatic circulation.
2. Discuss risk factors associated with peripheral vascular disease across the cultures and ways
to reduce one’s risks.
3. Perform a physical assessment of the peripheral vascular system using the correct
techniques.
2. 4. Differentiate between normal and abnormal findings of the peripheral vascular system.
5. Analyze the data from the interview and physical assessment of the peripheral vascular
system to formulate valid nursing diagnosis, collaborative problems, and/or referrals.
Affective:
1. Listen attentively during class discussions
2. Demonstrate tact and respect when challenging other people’s opinions and ideas
3. Accept comments and reactions of classmates on one’s opinions openly and graciously.
Psychomotor:
1. Participate actively during class discussions
2. Confidently express personal opinion and thoughts in front of the class
Weber, J.R., and Kelley, J. H., (2018) Health Assessment in Nursing 6th Edition, Philadelphia:
Wolters Kluwer
ASSESSMENT OF THE PERIPHERAL VASCULAR SYSTEM
Structure and Function
Arteries
• These are blood vessels that carry oxygenated, nutrient rich blood from the heart to the
capillaries
• A high-pressure system
• Arterial pulse
o The surge of blood as a result from a heartbeat which forces blood through the arterial
vessels under high pressure
• Major Arteries of the Arm
o Brachial artery
▪ Major artery that supplies the arm
▪ Palpated medial to the biceps tendon in and above the bend of the elbow
▪ Divides near the elbow to become the radial artery (extending down the thumb
side of the arm) and the ulnar artery (extending down the little-finger side of the
arm)
• Both arteries provide blood to the hand
o Radial artery
3. ▪ Palpated on the lateral aspect of the wrist
o Ulnar artery
▪ Located on the medial aspect of the wrist
▪ A deeper pulse, not easily palpated
• Major Arteries of the Leg
o Femoral artery
▪ Major supplier of blood to the legs
▪ Pulse palpated under the inguinal ligament
o Popliteal artery
▪ Pulse palpated behind the knee
o Dorsalis pedis artery
▪ Pulse palpated on the great-toe side of the top of the foot
o Posterior tibial artery
▪ Palpated behind the medial malleolus of the ankle
Veins
• Carry deoxygenated, nutrient depleted, waste-laden blood from the tissues back to the heart
• The veins of the arms, upper trunk, head, and neck carry blood to the superior vena cava,
where it passes into the right atrium
• Blood from the lower trunk and legs drains upward into the inferior vena cava
• Contain nearly 70% of the body’s blood volume
• Walls are much thinner, low-pressure system
• 3 types
o Deep veins
▪ Femoral veins
▪ Popliteal veins
o Superficial veins
▪ Great and small saphenous veins
o Perforator (or communicator) veins
▪ Connect the superficial veins with the deep veins
• 3 mechanisms of venous function
o 1st mechanism
▪ Structure of the veins
o 2nd mechanism
▪ Muscular contraction
o 3rd mechanism
▪ Creation of a pressure gradient through the act of breathing
4. Capillaries
• Small blood vessels that form the connection between the arterioles and venules
• Allow the circulatory system to maintain the vital equilibrium between the vascular and
interstitial spaces
Collecting Objective Data
Physical Examination
• The purpose is to identify any signs or symptoms of PVD including arterial insufficiency,
venous insufficiency, or lymphatic involvement
• Useful in acute care, extended care, and home health care settings
• A complete peripheral vascular examination involves inspection, palpation, and
auscultation
• When performing PE, the nurse should:
o Discuss risk factors for PVD with the client.
o Accurately inspect arms and legs for edema and venous patterning
o Observe carefully for signs of arterial and venous insufficiency (skin color, venous
pattern, hair distribution, lesions or ulcers) and inadequate lymphatic drainage
o Recognize characteristic clubbing
o Palpate pulse points correctly
o Use the Doppler ultrasound instrument correctly
Assessment Procedure
Arms
Inspection
• Observe coloration of the hands and arms
5. o Normal findings
▪ Color varies depending on the client’s skin tone, although color should be the
same bilaterally
o Abnormal findings
▪ Raynaud disorder
• A vascular disorder caused by vasoconstriction or vasospasm of the
fingers or toes, characterized by rapid changes of color (pallor,
cyanosis, and redness), swelling, pain, numbness, tingling, burning,
throbbing, and coldness
Palpation
• Palpate the client’s fingers, hands, and arms, and note the temperature
o Normal findings
▪ Skin is warm to the touch bilaterally from fingertips to upper arms
o Abnormal findings
▪ A cool extremity may be a sign of arterial insufficiency.
▪ Cold fingers and hands, for example, are common findings with Raynaud’s
• Palpate to assess capillary refill time.
✓ Compress the nailbed until it blanches. Release the pressure and calculate the time it takes
for color to return. This test indicates peripheral perfusion and reflects cardiac output.
o Normal findings
▪ Capillary beds refill (and, therefore, color returns) in 2 seconds or less
o Abnormal findings
▪ Capillary refill time exceeding 2 seconds may indicate vasoconstriction,
decreased cardiac output, shock, arterial occlusion, or hypothermia
• Palpate the radial pulse.
✓ Gently press the radial artery against the radius.
Note elasticity and strength.
6. o Normal findings
▪ Radial pulses are bilaterally strong (2+). Artery walls have a resilient quality
(bounce).
o Abnormal findings
▪ Increased radial pulse volume indicates a hyperkinetic state (3+ or bounding
pulse). Diminished (1+) or absent (0) pulse suggests partial or complete arterial
occlusion (which is more common in the legs than the arms). The pulse could
also be decreased from Buerger’s disease or scleroderma.
• Palpate the ulnar pulses.
✓ Apply pressure with your first three fingertips to the medial
aspects of the inner wrists. The ulnar pulses are not
routinely assessed because they are located deeper than
the radial pulses and are difficult to detect. Palpate the
ulnar arteries if you suspect arterial insufficiency.
o Normal findings
▪ The ulnar pulses may not be detectable
o Abnormal findings
▪ Obliteration of the pulse may result from compression by external sources, as
in compartment syndrome. Lack of resilience or inelasticity of the artery wall
may indicate arteriosclerosis.
• Palpate the brachial pulses.
✓ Do this by placing the first three fingertips of each hand at
the client’s right and left medial antecubital creases.
Alternatively, palpate the brachial pulse in the groove
between the biceps and triceps.
o Normal findings
▪ Brachial pulses have equal strength
bilaterally
o Abnormal findings
▪ Brachial pulses are increased, diminished, or absent
• Perform the Allen test.
✓ Evaluates patency of the radial or ulnar arteries. It is done when patency is questionable or
before such procedures as a radial artery puncture.
✓ The test begins by assessing ulnar patency. Have the
client rest the hand palm side up on the examination table
and make a fist. Then use your thumbs to occlude the
radial and ulnar arteries.
7. ✓ Continue pressure to keep both arteries occluded and have
the client release the fist.
✓ Note that the palm remains pale. Release the pressure on
the ulnar artery and watch for color to return to the hand.
To assess radial patency, repeat the procedure as before,
but at the last step, release pressure on the radial artery.
o Normal findings
▪ Pink coloration returns to the palms within 3–
5 seconds if the ulnar artery is patent.
▪ Pink coloration returns within 3–5 seconds if the radial artery is patent.
o Abnormal findings
▪ With arterial insufficiency or occlusion of the ulnar artery, pallor persists. With
arterial insufficiency or occlusion of the radial artery, pallor persists.
Legs
Inspection, Palpation, and Auscultation
✓ Ask the client to lie supine. Then drape the groin area and place a pillow under the client’s
head for comfort. Observe skin color while inspecting both legs from the toes to the groin.
• Observe skin color while inspecting both legs from the toes to the groin
o Normal findings
▪ Pink color for lighter-skinned clients and pink or red tones visible under darker-
pigmented skin. There should be no changes in pigmentation.
o Abnormal findings
▪ Pallor, especially when elevated, and rubor, when dependent, suggests arterial
insufficiency.
▪ Cyanosis when dependent suggests venous insufficiency.
▪ A rusty or brownish pigmentation around the ankles indicates venous
insufficiency
• Inspect distribution of hair on legs
o Normal findings
▪ Hair covers the skin on the legs and appears on the dorsal surface of the toes.
o Abnormal findings
▪ Loss of hair on the legs suggests arterial insufficiency. Often thin, shiny skin is
noted as well.
• Inspect for lesions or ulcers.
o Normal findings
▪ Legs are free of lesions or ulcerations.
8. o Abnormal findings
▪ Ulcers with smooth, even margins that occur at pressure areas, such as the
toes and lateral ankle, result from arterial insufficiency.
▪ Ulcers with irregular edges, bleeding, and possible bacterial infection that occur
on the medial ankle result from venous insufficiency.
• Inspect for edema.
✓ Inspect the legs for unilateral or bilateral edema. Note
veins, tendons, and bony prominences. If the legs appear
asymmetric, use a centimeter tape to measure in four
different areas: circumference at mid-thigh, largest
circumference at the calf, smallest circumference above the
ankle, and across the forefoot. Compare both extremities at
the same locations.
o Normal findings
▪ Identical size and shape bilaterally; no swelling or atrophy.
o Abnormal findings
▪ May be detected by the absence of visible veins, tendons, or bony
prominences.
▪ Bilateral edema usually indicates a systemic problem
▪ Unilateral edema is characterized by a 1-cm difference in measurement at the
ankles or a 2-cm difference at the calf, and a swollen extremity.
▪ A difference in measurement between legs may also be due to muscular
atrophy.
• Palpate edema.
✓ Determine if it is pitting or nonpitting. Press the edematous area with the tips of your fingers,
hold for a few seconds, then release. If the depression does not rapidly refill and the skin
remains indented on release, pitting edema is present.
o Normal findings
▪ No edema (pitting or nonpitting) present in the legs.
o Abnormal findings
▪ Pitting edema is associated with systemic problems
▪ A 1+ to 4+ scale is used to grade the severity of pitting edema, with 4+ being
most severe.
9. • Palpate bilaterally for temperature of the feet and legs.
✓ Use the backs of your fingers. Compare your findings in the same areas bilaterally. Note
location of any changes in temperature.
o Normal findings
▪ Toes, feet, and legs are equally warm bilaterally.
o Abnormal findings
▪ Generalized coolness in one leg or change in temperature from warm to cool
as you move down the leg suggests arterial insufficiency.
▪ Increased warmth in the leg may be caused by superficial thrombophlebitis
resulting from a secondary inflammation in the tissue around the vein.
• Palpate the femoral pulses.
✓ Ask the client to bend the knee and move it out to the side.
Press deeply and slowly below and medial to the inguinal
ligament. Use two hands if necessary. Release pressure
until you feel the pulse. Repeat palpation on the opposite
leg. Compare amplitude bilaterally
o Normal findings
▪ Femoral pulses strong and equal bilaterally.
o Abnormal findings
▪ Weak or absent femoral pulses indicate partial or complete arterial occlusion.
• Auscultate the femoral pulses.
✓ If arterial occlusion is suspected in the femoral pulse,
position the stethoscope over the femoral artery and listen
for bruits. Repeat for other artery.
o Normal findings
▪ No sounds auscultated over the femoral
arteries.
o Abnormal findings
▪ Bruits over one or both femoral arteries
suggest partial obstruction of the vessel and diminished blood flow to the lower
extremities.
• Palpate the popliteal pulses.
✓ Ask the client to raise (flex) the knee partially. Place your thumbs on the knee while positioning
your fingers deep in the bend of the knee. Apply pressure to locate the pulse. It is usually
detected lateral to the medial tendon.
o Normal findings
▪ It is not unusual for the popliteal pulse to be difficult or impossible to detect,
and yet for circulation to be normal.
o Abnormal findings
▪ Although normal popliteal arteries may be nonpalpable, an absent pulse may
also be the result of an occluded artery.
10. • Palpate the dorsalis pedis pulses.
✓ Dorsiflex the client’s foot and apply light pressure lateral to
and along the side of the extensor tendon of the big toe.
The pulses of both feet may be assessed at the same time
to aid in making comparisons. Assess amplitude bilaterally.
o Normal findings
▪ Dorsalis pedis pulses are bilaterally strong.
o Abnormal findings
▪ A weak or absent pulse may indicate impaired arterial circulation.
• Palpate the posterior tibial pulses.
✓ Palpate behind and just below the medial malleolus (in the
groove between the ankle and the Achilles tendon).
Palpating both posterior tibial pulses at the same time aids
in making comparisons. Assess amplitude bilaterally.
o Normal findings
▪ The posterior tibial pulses should be strong
bilaterally.
o Abnormal findings
▪ A weak or absent pulse indicates partial or complete arterial occlusion.
• Inspect for varicosities and thrombophlebitis.
✓ Ask the client to stand because varicose veins may not be visible when the client is supine
and not as pronounced when the client is sitting. As the client is standing, inspect for
superficial vein thrombophlebitis. To fully assess for a suspected phlebitis, lightly palpate for
tenderness. If superficial vein thrombophlebitis is present, note redness or discoloration on
the skin surface over the vein.
o Normal findings
▪ Veins are flat and barely seen under the surface of the skin.
o Abnormal findings
▪ Varicose veins may appear as distended, nodular, bulging, and tortuous,
depending on severity.
▪ Varicosities are common in the anterior lateral thigh and lower leg, the posterior
lateral calf, or anus (known as hemorrhoids).
▪ Superficial vein thrombophlebitis is marked by redness, thickening, and
tenderness along the vein.
▪ Aching or cramping may occur with walking.
Characteristics of Arterial and Venous Insufficiency
Arterial Insufficiency
• Pain: Intermittent claudication to sharp, unrelenting, constant
• Pulses: Diminished or absent
• Skin Characteristics: Dependent rubor
11. o Elevation pallor of foot
o Dry, shiny skin
o Cool-to-cold temperature
o Loss of hair over toes and dorsum of foot
o Nails thickened and ridged
• Ulcer Characteristics:
o Location: Tips of toes, toe webs, heel or other
pressure areas if confined to bed
o Pain: Very painful
o Depth of ulcer: Deep, often involving joint space
o Shape: Circular
o Ulcer base: Pale black to dry and gangrene
o Leg edema: Minimal unless extremity kept in
dependent position constantly to relieve pain
Venous Insufficiency
• Pain: Aching, cramping
• Pulses: Present but may be difficult to palpate through
edema
• Skin Characteristics:
o Pigmentation in gaiter area (area of medial and
lateral malleolus)
o Skin thickened and tough
o May be reddish-blue in color
o Frequently associated with dermatitis
• Ulcer Characteristics:
o Location: Medial malleolus or anterior tibial area
o Pain: If superficial, minimal pain; but may be very
painful
o Depth of ulcer: Superficial
o Shape: Irregular border
o Ulcer base: Granulation tissue—beefy red to yellow fibrinous in chronic long-term ulcer
o Leg edema: Moderate to severe
Types of Peripheral Edema
Edema Associated with Lymphedema
• Caused by abnormal or blocked lymph vessels
• Nonpitting
• Usually bilateral; may be unilateral
• No skin ulceration or pigmentation
12. Edema Associated with Chronic Venous Insufficiency
• Caused by obstruction or insufficiency of deep veins
• Pitting, documented as:
o 1+ = slight pitting
o 2+ = deeper than 1+
o 3+ = noticeably deep pit; extremity looks larger
o 4+ = very deep pit; gross edema in extremity
• Usually unilateral; may be bilateral
• Skin ulceration and pigmentation may be present
Abnormal Arterial Findings
• Necrotic great toes with blisters on toes and foot
• Raynaud Disease
o Blanching of fingers on both hands
Abnormal Venous Findings
• Superficial thrombophlebitis
o Often seen with unilateral localized pain, achiness, edema, redness, and warmth to
touch
• Lymphedema
• Varicose veins
D’Amico, D., and Barbarito, C., (2019) Health & Physical Assessment in Nursing 3rd Edition,
Singapore: Pearson Education, Inc.
Weber, J.R., and Kelley, J. H., (2018) Health Assessment in Nursing
6th Edition, Philadelphia: Wolters Kluwer