Health
Assessment RLE
Peripheral
Peripheral Vascular System and Lymphatic System
Peripheral Vascular :
Vein – carry blood to heart
Arteries – carry blood away from the heart
Lymphatic system
lymph nodes – filter microorganisms and foreign substances from lymph
tonsils – lymphatic tissue in oropharynx destroys microorganism and foreign
sybstance
thymus – secretes thymosin, helps with T cells differentiation
- in the chest, between the lungs and behind the breastbone or sternum
spleen – filters blood and produces lymphocytes and monocytes
Peyer’s patches – clusters of lymphoid tissue found in the small intestine
Common Concerning Symptoms
Common or Concerning Symptoms:
Pain in the arms or legs
Intermittent claudication - is usually a symptom of peripheral artery disease, in which the arteries
that supply blood to the arms or legs, usually the legs, are narrowed. The narrowing is usually due
to a buildup of fatty deposits (plaques) on the artery walls.
Cold, numbness, or pallor in the legs; hair loss
Swelling in the calves, legs, or feet
Swelling with redness and tenderness
HEALTH HISTORY: OLDCART
o Claudication
Do you have pain or cramping in your legs during walking or exertion?
Onset: When did you first feel it?
Location: In which side? Left, right or both legs?/
Duration: Does the cramping remain at all times or does it come and go? If it comes and
goes, when is it present and when does it disappear?
Characteristic Symptoms: What does crampy feel like?
Associated Manifestations: What else happens when the cramping is present
Relieving Factors: Does anything make it go away?
Treatment: Have you done anything about the cramp to make it less?
Past history, family history and lifestyle and personal habits
A nurse should learn how to gather the aforementioned information as these will create a detailed picture
of the patient’s status
PAST HISTORY: Medications, especially oral contraceptives or hormone replacement Therapy, Estrogen
use and pregnancy increase one’s risk for blood clots. ● Pregnancy or recent childbirth ● Inflammatory
diseases such as lupus, rheumatoid arthritis, or irritable bowel disease Inflammation contributes to clot
formation. ● Active cancer ● Coronary artery disease (CAD) Coronary artery disease and cerebral
artery disease are also caused by atherosclerosis; an individual with either is at risk for PAD. ● Heart
attack ● Congestive heart failure ● Stroke (cerebral arterial disease) ● Clotting disorders ●
Hypertension ● Diabetes ● Problems in circulation, such as blood clots, leg ulcers, swelling, or poor
healing of wounds ● Major surgery or fracture of a long bone in the last 4 weeks
FAMMILY HISTORY: CV disease, varicose vein, DM, high cholesterol
RISK FACTORS: Peripheral vascular disease ● Varicose veins ● Abdominal aortic aneurysm ● CAD ●
Sudden death younger than 60 years of age ● Diabetes
LIFESTYLE : Job requiring prolonged standing or sitting ● Sedentary lifestyle ● Decreased mobility such
as paralysis or cast
PHYSICAL HISTORY
PHYSICAL HISTORY
PHYSICAL HISTORY
PHYSICAL HISTORY
PHYSICAL HISTORY
PHYSICAL HISTORY
PHYSICAL HISTORY
PHYSICAL HISTORY
Palpate for pitting edema. Press firmly but gently with
your thumb for at least 5 seconds (1) over the dorsum
of each foot, (2) behind each medial malleolus, and (3)
over the shins. Look for pitting—a depression caused by
pressure from your thumb. Normally there is none. The
severity of edema is graded on a four-point scale
PHYSICAL HISTORY
PHYSICAL HISTORY
PHYSICAL HISTORY
Special Test for Arterial or Venous
Insufficiency