When assessing the lower extremities for arterial function, which intervention should the nurse perform?
A. Assessing the medial malleoli for pitting edema.
B. Performing Allen’s test.
C. Assessing the Homans’ sign.
D. Palpating the pedal pulses.
Correct Answer: D. Palpating the pedal pulses.
Palpating the client’s pedal pulses assists in determining if arterial blood supply to the lower extremities is sufficient. Finding a pedal pulse is part of the trauma patient assessment and performed before and after lower extremity splint application as well as long backboard immobilization. Assessing a pedal pulse is part of the ongoing assessment for a patient on a backboard or a lower extremity splint.
Option A: Assessing the medial malleoli for pitting edema is appropriate for assessing the venous function of the lower extremity. The lower extremity examination should focus on the medial malleolus, the bony portion of the tibia, and the dorsum of the foot. Pitting edema also occurs in the early stages of lymphedema because of an influx of protein-rich fluid into the interstitium, before fibrosis of the subcutaneous tissue; therefore, its presence should not exclude the diagnosis of lymphedema.
Option B: Allen’s test is used to evaluate arterial blood flow before inserting an arterial line in an upper extremity or obtaining arterial blood gases. The Allen test is a first-line standard test used to assess the arterial blood supply of the hand. This test is performed whenever intravascular access to the radial artery is planned or for selecting patients for radial artery harvesting, such as for coronary artery bypass grafting or for forearm flap elevation.
Option C: Homans’ sign is used to evaluate the possibility of deep vein thrombosis. Homan’s sign test also called dorsiflexion sign test is a physical examination procedure that is used to test for Deep Vein Thrombosis (DVT). A positive Homan’s A positive Homan’s sign in the presence of other clinical signs may be a quick indicator of DVT.