differences/culture
what are the differences between veins and arteries
vein: blue, surface, one-way valve, slow-moving, low-pressure, and not oxygenated
artery: red, deep, fast-moving, high-pressure, and oxygenated
how do you test for PAD extent, and what is a low score mean
what is a normal score
ankle-brachial index
low score= PAD
normal: 1-1.2
leg pain/cramps
discoloration
swelling
lymph node enlargement
meds and smoking history
how to do the radial pulse and what do you document
count for 30 seconds and multiple
-pulse force
-regular/irregular
in the arms, what is raynaud
vasospasm due to cold
what happens to the aging adult's vascular system
vessels become more rigid
enlargement of the intramuscular calf veins
what is the purpose of the modified allen test and how do you do it
collateral circulation
compressing the radial and ulnar arteries, asking the patient to clench and unclench their fist to blanch the palm, and then releasing pressure on the ulnar artery
why do you inspect the arms/hands
1. profile sign (clubbing)
2. cap refill
3. radial pulse
4. modified allen test
where is the femoral artery, and why do we get its pulse
groin (biggest artery)
-low bp
-no radial pulse
what is lymphedema
swollen lymph nodes
what puts people at risk for PAD and who are most at risk
-smoking
-diabetes/obesity
-total cholesterol
-HNT
Black Americans
if you cannot feel the dorsal pedis pulse, what do you do
the doppler technique
types of DVT
MI: heart
DVT: legs/arms
CVA: brain
where is the popliteal pulse, and how should they lie
prone and behind the knee
what are the three types of leg ulcers
1. arterial
2. venous
3. neuropathic
what are three changes associated with arterial insufficiency in the aging adult
1. thin and shiny skin
2. thick, ridge nails
3. loss of hair on lower legs
what is the pitting edema scale (say the numbers too)
press on the tibia and skin (hold for 5 seconds, then release)
1: mild, no swelling, slight indent
2: moderate, subsides rapidly
3: deep, pitting remains, leg looks swollen
4: very deep pitting, indent last, leg is very swollen
what else do you inspect in the arms
temp, color, size, and lesions
where is the posterior tibial pulse
towards the midline and near the heel
what is an aneurysm
bulge in the vascular system that separates and bursts
what are some focuses for foot care
diabetics
1. maintain exercise
2. comfortable shoes
3. lubricate the skin on the feet
well score for the DVT
probability of DVT (blood clots)
0: low
1-2: moderate
3: high
what is capillary refill
press on the tips of the fingers to see if there is color return in under 3 seconds
top of foot
what pulses are harder to find in the aging adult
DP and PT