NUR 242 - Med Surg exam 4 Study Guide.

NUR 242 - Med Surg exam 4 Study Guide/NUR 242 - Med Surg exam 4 Study Guide. Med Surg Exam 4 Unit 9: Caring for the patient common perfusion problems CARDIOVASCULAR ASSESSMENT:  Perform a complete cardiovascular assessment. As HTN is a risk factor for CAD, assess BP in both arms. Check for all major pulses as well as capillary refill and temperature of lower extremities. Prolonged capillary filling (3 seconds in young to middle-aged adults; 5 seconds in older adults) indicates poor circulation.  Listen with a stethoscope or use a Doppler to assess for the presence of a bruit, which is heard as a swishing sound as blood attempts to push through a narrowed artery. Bruits often occur in the carotid, aortic, femoral, and popliteal arteries.