Health Assessment: Blood vessels

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Terms in this set (39)
Personal and Social History-employment -tobacco -nutritional status -usual diet -weight -exercise -use of alcohol -use of recreational drugsInfants and children-hemophilia -sickle cell disease -renal disease -coarctation of the aorta -leg pains during exercisePregnant women-bp -leg healthOlder adults-leg edema -interference with ADLs -claudication -medicationsPalpation-carotid, brachial, femoral, popliteal, dorsalis pedis, and posterior tibial arteries -assess heart rate, rhythm, contour, amplitude, symmetryAmplitude of pulse4 bounding, aneurysmal 3 full, increased 2 expected 1 diminished, barely palpable 0 absent, not palpableAuscultatelisten over an artery for a bruit -unexpected sound- usually low pitched -use bellAssessment for peripheral artery disease-arteries in any location can become narrowed, leading to decreased blood flow AKA reduced circulationClaudicationpain that results from muscle ischemia -characterized as a dull ache with muscle fatigue and cramps -the site of pain is distal to the narrowingJugular venous pressure-critical -place ruler with tip at midaxillary line at the level of the nipple and extended vertically -place second ruler level with meniscus of JVP extended horizontally -vertical distance above the level of the heart is noted as the mean JVP in cm of aq -less than 9 is expectedHepatojugular reflex-is exaggerated when right heart failure is present -use hand to apply firm and sustained pressure to abdomen in the midepigastric region and instruct pt to breathe regularly -observe neck for elevation in JVP followed by abrupt fall in JVP when hand is releasedHand veins-you can compress vein when hand is flat -raise hand until vein collapses -ruler to note vertical distance between the midaxillary line at the nipple level and the level of collapse of the hand veins -should equal JVPThrombosis-redness, thickening, tenderness along superficial vein -swelling, pain, tenderness of deep vein thrombosisHoman sign-flex pts knee slightly with one hand -dorsiflex foot with other -calf pain is positive sign and may indicate venous thrombosisEdema-depression that does not rapidly refill and resume original contour indicates orthostati (pitting) edema -right side heart failure leads to increased fluid volumeSeverity of edema1+ slight pitting, disappears rapidly 2+ somewhat deeper pit than in 1, disappears in 10-15 seconds 3+ noticeably deep pit that may last more that a minute 4+ very deep pit lasts as long as 2-5 minutesVaricose veins-dilated and swollen with diminished rate of blood flow -from incompetence of vessel wall or valves or obstructionTemporal arteritisan inflammatory disease of the branches of the aortic arch, including the temporal arteriesarterial aneurysmlocalized dilation, generally defined as 1.5 times the diameter of the normal after, caused by a weakness in the arterial wallArteriovenous fistulapathologic communication between an artery and a veinPeripheral artery diseasestenosis of the blood supply to the extremities by atherosclerotic plaquesRaynaud phenomenonexaggerated spasm of the digital arterioles usually in response to cold exposureArterial embolic diseaseatrial fibrillation can lead to clot formation within the atrium; if the clot is unstable, emboli may be dispersed throughout the arterial systemVenous thrombosiscan occur suddenly or gradually and with varying severity of symptoms; can be the result of trauma or prolonged immobilizationTricuspid regurgitationback flow of blood into the right atrium during systole; mild degree of tricuspid regurgitation can be seen in up to 75% of the normal adult populationCoarctation of the aortastenosis seen most commonly in the descending aortic arch near the origin of the left subclavian artery and ligamentum arteriosumKawasaki diseaseacute small vessel vasculitic illness of uncertain cause affecting young males more often than females; the critical concern is cardiac involvement in which coronary artery aneurysms may developPreeclampsia-eclampsiapregnancy; hypertension that occurs after the 20th week of pregnancy and the presence of proteinuria; eclampsia includes seizuresVenous ulcersfrom chronic insufficiency in which lack of venous flow leads to lower extremity venous hypertension