Peripheral Vascular System & Lymphatic System Assessment

Peripheral Vascular System & Lymphatic System Assessment
Objectives:
At the end of this lab, the students will be able to:
1 .Demonstrate the ability to safely & accurately complete Peripheral Vascular System & Lymphatic System assessment.
2.Demonstrate the ability to accurately document Peripheral Vascular System & Lymphatic System assessment data in organized manner.
Equipment Needed:
I .Occasionally need: paper tape measure
2.Tourniquet or blood pressure cuff.
3.Stethoscope.
4.Doppler ultrasonic stethoscope.
Preparation
I .Room temperature should be proper.
2.Use inspection & palpation.
Compare the findings with the opposite extremity.
Subjective data:
1. Leg pain or cramps
2. Lymph node enlargement
3. Skin changes
4. Medications
5. Swelling arms or legs
Inspect & palpate both arms from the
the shoulders for the following:
Size & shape.
Normal : Two arms should be symmetric in
Shape.
Edema, discoloration, skin,hair distribution .
Palpate both radial pulses.
Palpate both ulnar pulses.
Normal : Bilateral pulses strong & equal.
Bilateral pulses strong & equal.
Perform Allen Test to determine Patency of
& ulnar arteries:
- Place thumbs lightly over radial & ulnar
arteries & ask the client to clench tightly.
- Firmly compress arteries & ask open
- - Release pressure on the ulnar artery while pressure on the radial
- Normal : palm of hand becomes pink when release of ulnar or radial artery. artery.
? Allen’s test & complication of arterial puncher
Palpate the brachial pulses.
Palpate for presence of epitroclear
Lymph node : Shake hands with the client
- Reaching your other hand under client s
elbow to the groove between biceps &
triceps muscles
Bilateral pulses strong & equal.
Normally the lymph node not palpable. Free of pain
Inspect & palpate the legs
- Uncover the leg while keeping the genitalia draped
- Inspect both legs together for shape & size.
Edema, discoloration, skin hair distribution .
Inspect size of both legs:
- Measure the calf circumference with a non - stretchable tape measure.
- Measure at the widest point.
- Measure the other leg in exactly
same place, the same number of centimeters down from patella or land mark.
- Record the findings in centimeters.
Normally: Both legs should be symmetric in
size.
Palpate superficial inguinal lymph nodes. Small in size I cm or less, movable & non- tender.
Palpate femoral pulse by pressing below inguinal ligament.
Popliteal pulse: have the client knees or, if on table roll on to flex leg 90 degree, press deeply to
Posterior tibial pulse: located on malleolus.
Dorsalis pedis pulse: on the foot,
Normal finding : Bilateral pulses strong & equal.
Bilateral pulses strong & equal.
Bilateral pulses strong & equal
(congenitally absent in 5%- 10%
of population).
Special maneuvers:
Check deep vein thrombosis & deep phlebitis.
Check Homan s sign by dorsoflexing foot
Client verbalizes no calf soreness or pain.
Check for varicose veins:
Mannual Compression Test:
- Put your client in standing
- Place one hand on the lower part of the varicose vein.
- Compress the vein with your about 15 to 20 cm higher.
- The finding: Competent valves will prevent a transmission
The trendelenberg test:
- Put the client in supine position.
- Elevate the involved leg 90 until the veins empty.
- Place a tourniquet high on the thigh.
- Help the client to stand up.
- take the tourniquet off
The finding : saphenous veins should fill
slowly from below .


Arterial insufficiency :
Changing Color :
- Raise both legs about 30cm(12 inches)
off the table.
- Ask the client to sit up with dangling legs over the side of the table.
. Normally pink color returns.
Normally 10 seconds or less.
Normally 15 seconds.