NR 509 Week 3: Cardiovascular and Peripheral Vascular Systems

Introduction to Cardiovascular and Peripheral Vascular Systems Assessment

The assessment of the cardiovascular and peripheral vascular systems is essential for identifying and managing heart and vascular diseases. This assessment involves evaluating the heart’s function, blood flow through the vessels, and detecting any abnormalities that may indicate cardiovascular pathology.

Components of Cardiovascular and Peripheral Vascular Assessment

A comprehensive assessment includes several key components:

1. Inspection: Observing the chest for visible pulsations, heaves, or scars.
2. Palpation: Feeling for thrills, heaves, and the point of maximal impulse (PMI).
3. Auscultation: Listening to heart sounds, including the rate, rhythm, and presence of murmurs, clicks, or rubs.
4. Peripheral Vascular Examination: Assessing the peripheral pulses, capillary refill, and signs of peripheral vascular disease.

Conducting the Cardiovascular Examination

The cardiovascular examination is performed systematically, starting with inspection and progressing through palpation and auscultation:

1. Inspection: Observe the precordium for any visible pulsations, heaves, or abnormalities. Note any scars from previous surgeries. Assess the jugular venous pressure (JVP) to evaluate right heart function.
2. Palpation: Palpate the chest to locate the PMI, typically found at the fifth intercostal space at the midclavicular line. Feel for any thrills, which are vibrations indicating turbulent blood flow, and heaves, which are forceful heart movements.
3. Auscultation: Use a stethoscope to listen to the heart at various locations (aortic, pulmonic, tricuspid, and mitral areas). Identify the S1 and S2 heart sounds, which correspond to the closing of the mitral/tricuspid and aortic/pulmonic valves, respectively. Listen for additional sounds like S3, S4, murmurs, or pericardial rubs.

Conducting the Peripheral Vascular Examination

The peripheral vascular examination assesses blood flow in the extremities and identifies signs of vascular disease:

1. Peripheral Pulses: Palpate the major peripheral pulses (carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibial) for presence, amplitude, and symmetry. Weak or absent pulses may indicate arterial occlusion.
2. Capillary Refill: Press on the nail bed until it blanches, then release and observe the time it takes for color to return. A capillary refill time of more than 2 seconds suggests poor perfusion.
3. Peripheral Edema: Inspect and palpate for swelling in the extremities, which may indicate heart