Chapter 33: Concepts of Care for Patients With Vascular Problems Ignatavicius: Medical-Surgical Nursing, 10th Edition
A nurse is assessing the peripheral vascular system of an older adult. What action by the nurse would cause the supervising nurse to intervene? a. Assessing blood pressure in both upper extremities b. Auscultating the carotid arteries for any bruits c. Classifying capillary filling of 4 seconds as normal d. Palpating both carotid arteries at the same time d. Palpating both carotid arteries at the same time ANS: D The nurse would not compress both carotid arteries at the same time to avoid brain ischemia.Blood pressure would be taken and compared in both arms. Prolonged capillary filling is considered to be greater than 5 seconds in an older adult, so classifying refill of 4 seconds as normal would not require intervention. Bruits would be auscultated.
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