Peripheral Vascular & Lymph Reference Sheet II. Physical Examination A. Arms Inspect Color of skin and nail beds: “Bilateral upper extremity color is (light-pink to dark brown with pink undertones) consistent with ethnicity. No erythema, pallor, or...
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Peripheral Vascular & Lymph Reference Sheet II. Physical Examination A. Arms Inspect Color of skin and nail beds: “Bilateral upper extremity color is (light-pink to dark brown with pink undertones) consistent with ethnicity. No erythema, pallor, or cyanosis.” (See table 20-2). Symmetry: “Arms are symmetric in size. No edema or atrophy.” Lesions: “No lesions.” Edema: “No edema.” Clubbing: “No fingernail clubbing.” Vs. Edema of upper extremity may occur when lymph drainage is obstructed after breast surgery or radiation (see Table 20-2). Palpate Temperature: “Warm bilaterally.” Texture: “Smooth bilaterally.” Capillary refill: “<3 seconds to bilateral fingers.” Locate and grade pulses: “Bilateral brachial & radial pulses 2+, regular, equal.” **usually only assess brachial pulses if suspect arterial insufficiency or when performing BP. Vs. 3+ or higher as with exercise, anxiety, fever, anemia, hyperthyroidism. Weak, thready, 1+ pulses as in shock or PAD (see Table 20-1). **Use Doppler if u
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