NUR1 239 Chapter Notes -Hypovolemia, Radial Artery, Palpation
12 Sep 2014
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Cyanosis or pallor occurs with myocardical infarction or low cardiac output states as a result of decreased tissue perfusion. If you suspect arterial deficit, raise the legs approx. 30 cm off the table and ask pt to wag feet for 30 sec to drain off veinous blood. The skin color now reflects only the contribution of arterial blood. A light skinned persons feet should look a little pale but still pink. Flattening of nail bed angle and clubbing ( diffuse enlargement of terminal phalanges) occur with congenital cyanotic heart disease and cor pulmonale. This is an index of peripheral perfusion and cardiac output. Normal capillary refill= color returns in less than 1-2sec. Refill times more than 1-2 sec signifies vasoconstriction or decreased cardiac output ( hypovolemia, heart failure, shock). Edema is bilateral when caused by a systemic problem such as heart failure or unilateral when it is the result of local obstruction or inflammation.
