Cardiac and Peripheral Vascular Assessment

Complete hand hygiene

verbal

Provide patient privacy

verbal

Verify patients name and DOB and wristband. Verify allergies.

verbal

Inspect Carotid artery

Turn head slightly away

Normal Finding: Pulse wave is normal

Inspect precordium

Normal Finding: No visible pulsations, bulges and symmetrical

Inspect extremities

Warm bilaterally + equal, no rashes or lesions

Inspect symmetry

Symmetrical thoracic shape, even contour, expansion, no visible pulsations

Inspect skin color

Normal color no cyanosis, dusky or pallor

Inspect nail beds

Pink nail beds

Ask a question for inspection

Have you noticed any change in your nail texture? Have you noticed any change in your skin color?

Palpate carotid pulse left and right

Both are equal bilaterally rate, rhythm and strength

Palpate precordium

No thrills,no heaves/lifts, no exaggerated pulsations

Palpate radial pulse, dorsalis pedis pulse, and post tibial pulse left and right

Equal bilaterally

Palpate bilateral lower extremity edema

No swelling bilaterally

Palpate PMI- Point of maximal impulse

Listen for 1 minute

No visible abnormal pulsations

Check radial pulse against apical pulse

Bilaterally equal

Palpate extremities

Warm and no swelling bilaterally

Palpate capillary refill upper and lower bilaterally

Normal less than 2 seconds

Ask question for palpation

Do you have any chest pain?

Auscultate carotid arteries left and right

no sounds heard, no bruit

Listen with diaphragm at APETM

Regular rhythm, s1 + s2 sound heard, no murmurs or bruits

Listen with bell at APETM

No extra heart sounds heard

Ask a question for auscultation

Do you have murmurs? Do you have any preexisting heart conditions?