Physical Assessment checklist: Cardiovascular and Peripheral Vascular System

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INTRODUCTION

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Introduces self to patient

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States purpose of examination

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Ensures adequate exposure of the chest and extremities

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Washes hands prior to examination

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Demonstrates professionalism throughout the examination

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CARDIOVASCULAR: INSPECTION

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Inspects for apical impulse (patient sitting)

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Inspects for pulsations (patient sitting)

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Inspects for lifts or heaves (patient sitting)

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Inspects for jugular venous pulsations and distention (patient at 30)

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Differentiates between jugular and carotid pulse waves (patient at 30)

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CARDIOVASCULAR: PALPATION

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Palpates for lifts heaves, or thrills (finger pads) (patient at 30)

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Palpates for thrills (ball of hand) (patient at 30)

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Palpates 2nd intercostal space right sternal border (patient at 30)

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Palpates 2nd intercostal space left sternal border (patient at 30)

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Palpates 3rd intercostal space left sternal border (Erb's point, tricuspid area) (patient at 30)

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Palpates 4th intercostal space left sternal border (tricuspid area) (patient at 30)

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Palpates 5th intercostal space left sternal border (tricuspid area) (patient at 30)

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Palpates 5th intercostal space at the apex (mitral area) (patient at 30)

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Palpates for location of PMI (patient at 30)

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CARDIOVASCULAR: AUSCULTATION

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Auscultates precordium at 6 areas (in bold above) with DIAPHRAGM of stethoscope

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Auscultates precordium at 6 areas (in bold above) with BELL of stethoscope

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While auscultating notes "listening for S1, S2, S2 split, general rate and rhythm"

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Auscultates for murmurs gallops, rubs, and clicks

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Places patient in left lateral decubitus position and auscultates tricuspid and mitral areas with the BELL

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Auscultates aortic and pulmonic areas with DIAPHRAGM (patient sitting leaning forward, exhales and holds breath out)

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Follows order of examination by first inspecting then palpating, then auscultating

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PERIPHERAL VASCULAR: BRUITS

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Auscultates bilaterally for bruits in the carotid arteries

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Auscultates for bruits in the abdominal aortic artery

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Auscultates bilaterally for bruits in the renal arteries

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Auscultates bilaterally for bruits in the iliac arteries

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Auscultates bilaterally for bruits in the femoral arteries

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PERIPHERAL VASCULAR: PALPATION

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Palpates carotid arteries bilaterally for rate, rhythm and quality.

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Palpates brachial arteries bilaterally for rate, rhythm and quality

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Palpates radial arteries bilaterally for rate, rhythm and quality

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Palpates femoral arteries bilaterally for rate, rhythm and quality

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Palpates popliteal arteries bilaterally for rate, rhythm and quality

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Palpates posterior tibialis arteries bilaterally for rate, rhythm and quality

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Palpates dorsalis pedis arteries bilaterally for rate, rhythm and quality

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Palpates the radial and femoral pulse simultaneously for quality AND notes for pulse lag (unilaterally)

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Palpates for abdominal aortic aneurysm

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Notes for peripheral edema

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Notes for peripheral hair growth

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Palpates nail beds in upper extremities for capillary refill

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PERIPHERAL VASCULAR: LYMPH NODES (Palpates each bilaterally noting firmness, mobility, pain, and suppuration)

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Axillary (bilateral)

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Epitrochlear (bilateral)

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Inguinal horizontal and vertical (bilateral)

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