An appropriate technique that the nurse should implement for the assessment of the carotid vessels is:
A. Massaging the arteries briskly
B. Using the diaphragm of the stethoscope
C. Palpating each carotid artery separately
D. Placing the client in a supine position
C
C. Palpate each carotid artery separately with index and middle fingers around medial edge of sternocleidomastoid muscle. Ask client to raise chin slightly, keeping the head straight. Note rate and rhythm, strength, and elasticity of artery. Also note if pulse changes as client inspires and expires.
A. Critical Decision Point: Do not vigorously palpate or massage the artery. Stimulation of carotid sinus may cause a reflex drop in heart rate and blood pressure.
B. Place bell of stethoscope over each carotid artery, auscultating for blowing sound (bruit).
D. To assess venous pressure have client recline at a 45-degree angle and slowly recline into the supine position, avoiding neck hyperextension or flexion. Measure the distance between the angle of Louis and the highest point of vein pulsation.
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