26
skill 2-6
Assessing the cardiovascular system
(continued)
Comments
Excellent
Satisfactory
Needs practice
Copyright © 2014 by Wolters Kluwer Health | Lippincott Williams & Wilkins.
Checklists for Clinical Nursing Skills by Louise Sparkes, Jennifer Bassett and Elisabeth Jacob.
15. Auscultate systematically, beginning at the aortic area,
then moving to the pulmonic area, Erb’s point, the
tricuspid area and finally the mitral area. Ask the patient
to breathe normally. Use the stethoscope diaphragm to
listen for high-pitched sounds and then use the bell to
listen for low-pitched sounds. Focus on the overall rate
and rhythm of the heart and the normal heart sounds.
16. Inspect the extremities for colour, temperature,
continuity, lesions, venous patterns and oedema.
17. Palpate the peripheral pulses.
18. Assist the patient in replacing the gown and then assist
them into a position of comfort.
19. Remove used PPE/equipment and dispose of them in the
appropriate receptacle.
20. Perform hand hygiene.
21. Document your assessment findings on the patient’s chart
and make any necessary referrals. Report any abnormal
results to a senior nurse, medical officer or endorsed
nurse practitioner immediately.
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