A nurse is using a Doppler ultrasound stethoscope to assess the pedal pulses of a client who has peripheral vascular disease. Which of the following actions should the nurse plan to take?
A.
Exert firm pressure when placing the probe.
B.
Apply the probe to the exterior aspect of the ankle.
C.
Move the probe until a whooshing sound is present.
D.
Hold the probe at a 30° angle to the blood vessel.
The Correct Answer and Explanation is:
The correct answer is C. Move the probe until a whooshing sound is present.
Explanation:
Peripheral vascular disease (PVD) is a condition that affects the circulation, particularly in the lower extremities, due to narrowed blood vessels. Assessing pedal pulses is essential in clients with PVD to determine the adequacy of blood flow to the extremities. In cases where pedal pulses are difficult to palpate, a Doppler ultrasound stethoscope can be used to detect blood flow by amplifying the sound of blood moving through the vessels.
Why Option C is Correct:
- Finding the Pulse: When using a Doppler ultrasound stethoscope, the nurse should move the probe slowly over the area where the pulse is expected. The goal is to locate the pulse by detecting the characteristic “whooshing” sound, which indicates blood flow. This sound is caused by the movement of blood through the artery and is a key indicator that the pulse has been located.
- Technique: The probe should be moved gradually and gently across the skin until this sound is heard. Once the sound is detected, it confirms that the blood flow through the artery is present, and the pulse can be assessed.
Why the Other Options are Incorrect:
- Option A (Exert firm pressure when placing the probe): Exerting firm pressure can actually occlude the artery and impede blood flow, making it more difficult to detect the pulse. The correct technique involves using light to moderate pressure to avoid compressing the vessel.
- Option B (Apply the probe to the exterior aspect of the ankle): The exterior aspect of the ankle is not a typical site for assessing pedal pulses. The common sites for palpating pedal pulses are the dorsalis pedis artery, located on the top of the foot, and the posterior tibial artery, located behind the medial malleolus (the bony prominence on the inner aspect of the ankle). Applying the probe to the exterior aspect of the ankle is unlikely to yield an accurate assessment.
- Option D (Hold the probe at a 30° angle to the blood vessel): While angling the probe may sometimes be necessary depending on the anatomy of the area, there is no specific requirement to hold the probe at a 30° angle. The probe should be held at an angle that allows the clearest detection of the blood flow sound, which may vary depending on the client’s anatomy.
Conclusion:
In summary, the correct approach to using a Doppler ultrasound stethoscope involves moving the probe until the characteristic whooshing sound is detected, confirming the presence of blood flow. This technique is crucial for accurately assessing the pulse in clients with PVD, ensuring that any issues with circulation are identified and managed appropriately.