Assessing for the Indicators of Circulatory Status
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Assessing for the Indicators of Circulatory Status

Learn how to Assess for the Circulatory Status. This is useful for nurses and healthcare providers.

Our circulatory system refers to the circulation of blood as it is pumped by the heart to move around the body via the blood vessels in order to distribute the oxygen and nutrients to every cells in the body. It also function by removing the waste present in the body system. The circulatory system is believed to involve the cardiovascular and respiratory system.

Disorders in these systems can be determined by knowing your circulatory status through the following indicators: capillary refill time, edema, neck vein distention, and hand vein emptying time.

You will be using inspection and palpation to identify for these indicators.

Capillary Refill Time

You can estimate the rate of peripheral blood flow by observing capillary refill time. When the tip of a fingernail is depressed, the nail bed blanches. As soon as the pressure is released, the blood should rush back and the nail bed should immediately become pink again. A more sluggish rate of capillary refill indicates a slower rate of peripheral flow. Capillary refill time should be assessed on each extremity.


Edema is the abnormal accumulation of fluid in the intercellular tissues of the body. Edema is often dependent; that is, it occurs in dependent areas of the body. Periorbital edema which is located in the rim of the eyes is also relatively common. It may have diagnostic significance, or, in women, it may simply be related to cyclical hormonal changes. This type of edema is usually soft and resilient, not pitting.

To feel for edema, use the fingertips of the index and middle fingers, pressing firmly over a bony area. When you remove your fingers, observe the area for pitting and watch to see how long it takes for the depressed area to disappear.

Edema is generally rated on a scale of 1+ to 4+. 1+ is a slight depression that disappears quickly; 4+ is a deep depression that disappears slowly. Because the scale is subjective, daily weights and circumferential measurements of extremities are often used to provide more objective data about fluid accumulation.

A more objective measure of edema of the lower extremities can be obtained by measuring the number of centimeters the edema extends up the tibia beyond the malleoli.

Neck Veins

Neck veins can be checked by the distention of the jugular veins for an estimation of venous pressure. When the person is standing, or sitting at an angle greater than 45° to the horizontal, the jugular veins of the neck are normally collapsed. Distention of these veins in a position above 45° indicates an abnormally high venous pressure.

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