CADIOVASCULAR SYSTEM PHYSICAL ASSESSMENT

Good day, everyone. Good day clinical instructors. I am Allen Binondo, a 1st year student nurse from section C.
Today, I will be assessing my patient’s cardiovascular system. But before that, I need to close the windows and
curtains to provide privacy and dignity to my patient. I have gathered now all the materials that I will be
needing, we have here: Stethoscope, Sphygmomanometer, Tape measure and 2 rulers. Before anything else, I
need to perform hand hygiene first.

Hello Sir, Good day. I am Allen Binondo and I will be your nurse for today. Your name Sir? How old are you?
Okay, thank you Mr. Binondo. So today Mr. Binondo I will be assessing your cardiovascular system, its purpose
sir will help me identify significant factors that can influence cardiovascular health such as high blood
cholesterol, cigarette use, diabetes, or hypertension. It involves me sir to look at your face, your chest, lower
extremities. It requires me to feel your chest and listen to your heart. Are you willing to cooperate with me Sir?
Okay thank you. So how are you feeling right now Sir? Are you comfortable? Okay.

Before proceeding with the assessment Sir, I have a few questions Sir. Do you experience chest pain Sir? Have
you been diagnosed with a heart defect or murmur Sir? Okay. Is there a history of hypertension, coronary heart
disease, or diabetes mellitus in your family Sir? Okay thank you very much.

I. Let’s start with the neck area. May I ask you to turn your face in the left side and look at the
corner of the walls for me sir? Thank you.
1. We will now locate the carotid and jugular pulsations.

2. Jugular vein is superficial and lateral in the neck, it is better seen than felt. The carotid artery is
deeper and medial in the neck, it is better felt than seen.

We will now measure the Jugular venous pressure. We will position the patient with head of bed
at 45 degrees. I will now open your chest Sir, is that okay?

I’m gonna locate the angle of louis. This is where I will put the first ruler vertically

The measurement of JVP is . Normally, JVP should be less than 3 cm.

3. After taking the Jugular Venous Pressure, this is now the time we are going to palpate carotid
arteries. Sir can you bend your head upward? Thank you. Can you look at the left side, okay. I will
 palpate the carotid pulse for 1 minute and will note for its characteristics and pulse amplitude. To
the other side as well.

4. (rub hands) I will now palpate the jugular vein by

palpating first the lower part of the jaw. We will occlude next above the clavicle
(this area depressed because we are trying because we are allowing blood to pull
there.
to occlude the flow of blood in Jugular vein)

5. After that, we will proceed to abdominojugular reflux. We are going to place this pre-inflated cuff
on the right upper quadrant of the patient’s abdomen where the liver is located. Let’s make sure to
apply 30-40 mmhg pressure for 30 seconds while looking at the jugular vein pulsation for
distention and the rise of the pulsation. Upon releasing it, there is easy decompression of jugular
vein so that is a negative JVP.

6. We are now going to auscultate using the bell of the stethoscope. Kindly bend your head up Sir.
Hold your breath please (then breathe normally). Other side as well. Hold your breathe. Breathe
normally.
KINDLY LOOK AT THE LEFT AND LOOK AT THE WALLS FOR ME SIR. Hold your breath and breathe
normally.

II. After we auscultate the neck vessels, we will now be assessing the precordium. We are going to
expose the chest. Is that okay with you Sir? So we will try to look at and observe our patient’s
chest for visible pulsations. Bend your head up Sir (inspect).

This is now the time to locate the point of maximal impulse or PMI or the apical impulse in the mitral area
located at 5th intercostal space midclavicular line.

WE WILL NOW PALPATE FOR LIFTS AND THRILLS (RUB HANDS)

Let’s not percuss for cardiac dullness

AORTIC PULMONIC AND SO ON

We are now going to Auscultate. Starting from the Mitral Area. Tricuspid, Erb’s point, pulmonic area.

LET’S NOW USE THE BELL. COVER THE PATIENT, ARE U COMFORTABLE SIR?
 I. Let’s now perform an assessment in the peripheral-vascular system. Let’s start from the upper
extremities. Sir, can you show me your hands? We will check for temperature, skin color. Check
nails for tar color and capillary refill. Your palms sir, let’s press on it if there is evidence of palor,
okay negative. SKIN COLOR IS CONSISTENT, SAME COLOR AS THE USUAL COLOR OF
THE SKIN OF THE PATIENT. SCARS IS PRESENT. TEMPERATURE OF THE SKIN OF
PATIENT IS NORMAL.

Lower extremities.

COLOR IF THE SKINS IS CONSISTENT, SCARS ARE PRESENT. NO PRESENCE OF

Abdomen.
SO THERE IS NO VISIBLE PULSATIONS

(ALCOHOL)
Let’s now palpate peripheral pulses. Let’s start from the distal part (except carotid).

Include ulnar pulses

ALCOHOL AFTER.

Palpate Lymph nodes.