Neurovascular assessment???

  1. 0
    Could anyone please elaborate this for me....
    I am having this mental understanding of the last two.
    What is a compartment syndrome?????


    5P'S OF NEUROVASCULAR ASSESSMENT

    Pain
    Determine amount and severity of pain if present.Ask client for descriptions;avoid coaching client with words to describe pain
    Ratioanale-manipulation and reduction may produce dull,aching pain as a result of pressure on nerve endings.Clients vary in perception and tolerence of pain.


    Pallor
    Observe color of tissues distal of cast
    Rationale-pink indicates arterial pressure is normal,whitish color signifies decreased arterial supply, and bluish color signifies venous stasis.


    Pulselessness
    When possible palpate distal pulse of casted extremity;note presence and strength of pulse.assess capillary refill by pressing on toenail or fingernail if cast is on extremity,releasing and noting pinking of nail;nail should pink up in 3 seconds or less.
    Rationale-weak and absent pulse may indicate decreased circulation.Blanching on pressure with subsequent capillary refill is indicative of arterial perfusion.Capillary refill is too sluggish if refill takes more than 3 seconds.It takes 2 seconds to say capillary refill is slowly and 4 seconds to repeat it once


    Paresthesia
    Assess for numbness,tingling, or abnormal sensations.
    Rationale-may indicate nerve damage and/or development of compartment syndrome


    Paraplegia
    Assess for motion
    Rationale-may indicate nerve damage and/or development of compartment syndrome
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  4. 5 Comments so far...

  5. 1
    You're having a mental understanding?

    Firstly, you need to understand the anatomy and physiology. I am a student, so perhaps I am able to translate this in a way I would want it explained to me and lastly... I hope what I say is correct. I am sure other members will jump in - so please please correct me.. but let me give it a try.

    Anatomy- compartments are basically sectioned off groups that contain: the muscles, vessels, and nerves all sectioned off by fascia, if you forgot what is from anatomy- look it up. Just think back to the cat (if you dissected one). I will say however fascia does NOT expand and that is key behind the patho.

    Patho- Basically d/t the injury the pressure inside (inflammation increases), so if the pressure within the compartment increases this means that perfusion into the compartment will not occur. Understand? Pressure inside is greater than pressure outside. The increased pressure eventually leads to the occlusion of the vessels.

    I'll stop here and let you reason the rest.

    What happens? Apply the P's to this. How do pulses, pallor, pain, paresthesia, and paraplegia apply to this?

    Think about ischemia... think about how to prevent this from happening.

    I don't want to just tell you ..... with the info I have given you now....think(=
    Last edit by StudentOfHealing on Apr 11, '13 : Reason: typo
    Esme12 likes this.
  6. 1
    We try not to do your homework for you. Tell us what you know and understand already, aside from copying from your assignment or book.

    Did you even look up "compartment syndrome" in the index of your med-surg book? Or anywhere else? What did you learn about it? How does the list of things you copied relate to that?
    psu_213 likes this.
  7. 0
    I know this is your first year.....and it can be over whelming at times.What about this is confusing you?

    Pain:
    Determine amount and severity of pain if present.Ask client for descriptions;avoid coaching client with words to describe pain.
    Allow patient to describe their own pain. At times a severe break once set/reduced/fixed in the OR and placed in a cast the extremity can experience a sudden swelling that cause unbearable pressure and constriction of the extremity and cause excruciating pain that has nothing to do with the actual break

    Pallor: Observe color of tissues distal of cast
    Look to the end of the cast look at the toes or fingers. At times there can be so much swelling that the circulation is cut off to the distal digits causing them to look paler that the opposite extremity and at times white in appearance

    Pulselessness: When possible palpate distal pulse of casted extremity;note presence and strength of pulse.assess capillary refill by pressing on toenail or fingernail if cast is on extremity,releasing and noting pinking of nail;nail should pink up in 3 seconds or less.
    Just what it says check the pulse if you can...is there a pulse? you can sometimes fit your finger in enough to check the pulse this is usually the pedal pulse. Check the cap refill if it is less than 3 sec you are ok indication that there is ample blood supply. I have even attached a pulse ox to the digit to ensure adequate circulation

    Paresthesia: Assess for numbness,tingling, or abnormal sensations.
    Have you ever fell asleep on your arm or hit your funny bone? Well that is from a lack of blood flow causing numbness

    Paraplegia: Assess for motion
    Digits Don't move indicating the swelling has cut off circulation enough to paralyze the fingers/toes.

    Now what is compartment syndrome......compartment syndrome
  8. 0
    Are you saying your not sure of what you need to asses for under the last 2 P's?

    Parasthesia: What about Cap Refill? Blunt and Sharp sensation differentiation? Recognition of warm and cold on the problematic area? Warmth of area? Are nail beds intact and healthy looking? Etc...

    Paraplegia: Motor function of area? I.e is their still a reflex? Or is a negative reflex occurring? I.e. positive Babinski reflex happening in someone older than 6-9 months old is a negative finding that could indicate more complex neurological damage. Is the area cool to the touch? Cap Refill? Pedal pulses palpable?
  9. 1
    The 7 P's song: https://www.youtube.com/watch?v=voKclY9ni1E

    Maybe this video I've created can help I started making nursing-related songs to help me study for the NCLEX exam. If you have any requests on certain topics you'd like for me to cover, feel free to leave a comment on my video or email me at nerdysara1990@gmail.com. Good luck, present and future nurses!
    pmabraham likes this.


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