Physical Assessment Peripheral Vascular System & Lymphatic
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| Subjective Data | 1.Leg Pain or Cramps 2.Skin changes on Arms or Legs 3.Swelling 4.Lymph node enlargement 5.Medications
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| 1.Leg Pain or Cramps | Any leg pain? Where? Describe the type of pain; is it burning, aching, cramping, stabbing? Did it come on gradually or suddenly? How many blocks of stairs does it take to produce the pain? Note CLAUDICATION DISTANCE
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| 1.Leg Pain or Cramps CLAUDICATION DISTANCE | Claudication distance is the number of blocks walked or stairs climbed to produce pain.
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| 1. Leg Pain or Cramps Has this amount changed recently? Is the pain worse with elevation? Worse with cool Temperatures? Does this pain wake you up at night? | Note sudden decrease in claudicatoin distance or pain not relieved by rest.
Night leg pain is common in aging adults it may indicate ischemic rest pain of PVD, severe night muscle cramping (usually the calf) or the restless leg syndrome.
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| 1.Leg pain or Cramps | Any Recent Change in exercise, a new exercise, increasing exercise?
Pain of musculoskeletal origin rather than vascular.
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| 1.Leg Pain or Cramp | What relieves this pain: dangling, walking, rubbing? is the leg pain associated with any skin changes? Associated with any change in sexual function?
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| 1.Leg Pain or Cramp Leriche Syndrome | Aortoiliac occlusion is associated with impotence.
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| 1.Leg Pain or Cramp | Any history of Vascular problems, heart problems, diabetes, obesity, pregnancy, smoking, trauma, prolong standing or bedrest?
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| 2.Skin Changes on Arm and Legs | Any skin changes on arms or legs? what color:Redness, Pallor, blueness, brown discolorations
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| 2.Skin Changes on Arm and Legs | ANy change in temperature- excess warmth or coolness?
Coolness is associated with arterial disease
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| 2.Skin Changes on Arm and Legs | Do your leg veins look bulging and crooked? How have you treated these? Do you use support hose?
Varicose Veins
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| 2.Skin Changes on Arm and Legs | Any leg sores or ulcers? Where on the leg? Any pain with the leg ulcer?
Leg ulcers occur with chronic arterial and chronic venous disease.
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| 3.Swelling in the arms or legs EDEMA | bilateral when the cause is generalized (heart failure) or unilateral when it is the result of a local obstruction or inflammation
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| 3.Swelling in the arms or legs | Swelling in one or both legs? when did this start? What time of day is the swelling at its worst: moring or after up most of the day? Does the swelling come and go or is it constant? What seems to bring it on: trauma, standing all day or sitting?
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| 3.Swelling in the arms or legs | What relieves swelling: elevation, support hose? Is swelling associated with pain, heat, redness, ulceration, hardened skin?
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| 4.Lymph node enlargement | Any swollen glands (lumps, kernels? Where in body? How long have you had them?
Any recent change? How do they feel to you: hard, soft? Are the swollen glands associated with pain, local infection?
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| 4.Lymph node enlargement | Enlarge lymph nodes occur with infection, malignancies and immunologic disease.
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| 5.Medications | What Medications are you taking? Oral contraceptives, hormone replacement
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