[natrgrrl]

What do I include in a client assessment for circulation?
So far I have color, temperature, edema, pedal pulse.
When assessing pedal pulse do I use a number like +3 or do I use words like weak or strong?

Thanks.

[cardiacRN2006]

Capillary refill as well.

I chart the pulses as +2 or +1, but you can also chart as weak, thready, bounding. It's up to you and what your teacher wants.

[TakeTwoAspirin]

I would probably start with the heart. It's the primary organ of circulation and no evaluation of the entire circulatory system should take place without it (or at least that's what I think).

[Daytonite]

Assessment of the circulation includes observation and documentation of/for the following:

• general
  • fatigue
  • syncope
  • symmetry of extremities
• chest
  • chest pain
  • palpitations
  • dyspnea
• skin and appendages (also note the nail beds and conjunctiva)
  • temperature
  • capillary refill
  • color changes (pallor, cyanosis, redness, brownishness)
  • shiny skin
  • presence of any ulcers
  • condition of the nails
  • presence or loss of hair
  • (dependent) edema (nonpitting or pitting)
• numbness
• tingling
• blood pressure (lying, sitting and standing)
  • by palpation
  • by auscultation
• pulses
  • rate and rhythm
  • pulsus alternans - alternating pattern of a weak and a strong pulse that occurs at regular intervals
  • pulsus bigeminus - same as pulsus alternans but occurs at irregular intervals
  • pulsus paradoxus - increased and decreased amplitude in pulse associated with respirations
  • thrills - vibrations you can feel over turbulence
  • bruits
• heart sounds
  • normal
  • S3 ventricular gallop
  • S4 atrial gallop
  • friction rub
  • murmur
  • clicks
  • snaps

Pules are graded on a four-point scale as follows:

4+ = bounding
3+ = increased
2+ = normal
1+ = weak, diminished
0 = absent

You should also check the links on this sticky thread:

• http://allnurses.com/forums/f205/hea...ms-145091.html and http://connection.lww.com/Products/b.../PDFs/ch08.pdf - assessment of the cardiovascular system which is on post #14 of that thread.