ASSESSMENT OF PERIPHERAL VESSELS

AREA ASSESSED TECHNIQUE NORMAL FINDINGS ACTUAL FINDINGS INTERPRETATION

Clinical Signs Inspection No missing There’s a scar seen at Abnormal
limbs/digits, scars his right shoulder
complex while
inspecting the client’s
upper limbs.
Inspection and No peripheral cyanosis, No abnormalities, Normal
Comparing pallor, tar straining, irregularities is seen.
xanthomata and
gangrene
Temperature Assessing and Skin is normally warm. The client’s Normal
Comparing temperature is
Upper Limbs symmetrically warm.
Capillary Refill Time Assessing Pink tones return The client’s CRT Normal
(CRT) immediately to doesn’t exceed more
blanched nail beds than 2 seconds when it
when pressure is returns to its normal
released. colour.
Radial Pulse Palpation Pulse is symmetrical,
regular and within the
normal rate and rhythm. The client’s pulsations
Radio-radial delay Assessing Both radial pulses in are felt equally and Normal
sync synchronously.
Brachial Pulse Palpation Pulse is symmetrical,
regular and within the
normal rate and rhythm.
Allen Test Performing Normal color comes Normal color to both Normal
back within 5-15 hands return during
seconds. occlusion.
Blood Pressure Measuring (or PP: 140 Normal
Assessing?) BP: 130/80
 Carotid Artery Auscultation Smooth and equal No presence of bruit is Normal
bilaterally, no bruits heard.
Neck Carotid Pulse Palpation Regular rhythm The client’s carotid Normal
pulse is smooth and
pulsations equal
bilaterally.
Visible Pulsations Inspection A visible pulsation is Normal
seen during the
inspection of the
client’s abdomen.
Abdomen Aorta Palpation Aorta is palpated in the Normal
client’s upper abdomen.
Aorta & Renal Arteries Auscultation No presence of bruit is Normal
heard during the
auscultation.
Clinical Signs Inspection and No missing limbs/digits Normal
comparing or scars seen at the
client’s upper limbs.
Temperature Assessing and Skin is normally warm The client’s Normal
Comparing temperature is
symmetrically warm.
Capillary Refill Time Assessing Pink tones return The client’s CRT Normal
Lower Limbs (CRT) immediately to doesn’t exceed more
blanched nail beds than 2 seconds when it
when pressure is returns to its normal
released. colour.
Femoral Pulse Auscultation Hindi inassess
Popliteal Pulse
Posterior Tibial Pulse Palpation Client’s popliteal, Abnormal
Dorsalis Pedis Pulse posterior tibial and
dorsalis pulse has weak
pulsations.
Gross Peripheral Assessing Normal
Sensation
Color Observation No discolorations or Skin tone is even , no Normal
redness discoloration or any
marked pallor is seen.
 AREA ASSESSED TECHNIQUE NORMAL FINDINGS ACTUAL FINDINGS INTERPRETATION

Heart Irregular Palpation and The normal pulse rate is RADIAL PULSE: 93 bpm Normal
rhythm and auscultation between 60-100 beats per (beats per minute)
pulse rate minute
deficit
APICAL PULSE:
93 bpm (beats per minute)

Neck Vessels Jugular Inspection The jugular venous pulse is The left jugular vein was Normal
venous pulse not normally visible with visible with a measurement
the client sitting upright of 0.5 cm

Carotid Auscultate No blowing, swishing, or No presence of blowing, Normal

Artery other sounds are heard swishing, or other sounds are
heard

Carotid Palpation Pulses are equally strong The pulse of the client is Normal
Arteries and normal normal and equally strong

Pulsation on Inspection The apical pulse may or The apical pulse of the client Normal
the anterior may not be visible was not visible
chest over
the heart

Apical Palpation The apical impulse is The apical impulse was Normal
impulse palpated at the mitral area palpated in the mitral area

Heart Rate Auscultate The rate should be 60-100 The rate was 93 beats per Normal
and Rhythm beats per minute with a min with a regular
regular rhythm Rhythm