Heart sounds at five areas, jugular venous pressure and pulses to the feet with an ankle-brachial index, written up for NU333 Unit 6 on a composite former smoker. Searches like "nu 333 unit 6 assignment example", "nu333 unit 6 sample" and "nu333 unit 6 example" land here.
Cardiovascular Assessment Write-Up: Calf Pain After Two Blocks and an Ankle-Brachial Index of 0.68
[Student Name]
Purdue University Global
NU333: Health Assessment for the Nursing Professional
Unit 6 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Pressures and findings are composite.
The Complaint
For six months she has had cramping in her left calf after about two blocks of walking, which eases within three to five minutes of standing still and returns at the same distance. She smoked for 35 years and quit two years ago. She has hypertension and high cholesterol, both treated.
Central Findings
Apical pulse 80, regular, palpated at the fifth intercostal space in the left midclavicular line; point of maximal impulse about 1 cm across.
Heart sounds by listening area: aortic, S2 louder than S1; pulmonic, S2 louder than S1, physiologic splitting on inspiration; Erb's point, S1 and S2 equal; tricuspid and mitral, S1 louder than S2. No S3 or S4.
Murmur: grade II of VI, midsystolic, heard best at the second right intercostal space, without radiation to the neck, medium pitch, harsh quality.
Jugular venous pressure measured at 2 cm above the sternal angle, trunk raised to 45 degrees. No carotid bruits.
Peripheral Findings
Pulses on a 0 to 4+ scale, where 0 is absent, 1+ diminished, 2+ normal, 3+ increased and 4+ bounding:
Radial: right 2+, left 2+.
Brachial: right 2+, left 2+.
Femoral: right 2+, left 1+.
Popliteal: right 1+, left 1+.
Dorsalis pedis: right 1+, left absent to palpation, present by Doppler.
Posterior tibial: right 1+, left 1+.
Doppler signals are recorded as audible, not graded as palpable pulses.
Below the knee: skin on the left lower leg shiny and thin, with sparse hair; left foot cooler than the right; capillary refill 2 seconds on the right great toe and 4 seconds on the left. No edema. No ulcers.
Ankle-Brachial Index
Brachial pressures, taken by Doppler after ten minutes lying flat: right 140, left 136; the higher, 140, is used for both legs. Ankle pressures (higher of dorsalis pedis and posterior tibial): right 123, left 95. Right index: 123 / 140 = 0.88. Left index: 95 / 140 = 0.68. An index of 0.90 or lower is the usual threshold for abnormal (Aboyans et al., 2012). Both legs fall below it, and the left, the leg that hurts, falls further.
Connecting Central and Peripheral
Her complaint lives in her legs, but the risk it signals is systemic: reduced arterial flow to the legs often travels with arterial disease elsewhere. The murmur and her smoking history are reported alongside the index (Bickley et al., 2021).
Reported
Findings consistent with reduced arterial flow to both legs, worse on the left, with a grade II midsystolic murmur, went to the provider the same afternoon, flagged for vascular follow-up.
References
Aboyans, V., Criqui, M. H., Abraham, P., Allison, M. A., Creager, M. A., Diehm, C., Fowkes, F. G. R., Hiatt, W. R., Jönsson, B., Lacroix, P., Marin, B., McDermott, M. M., Norgren, L., Pande, R. L., Preux, P.-M., Stoffers, H. E. J., & Treat-Jacobson, D. (2012). Measurement and interpretation of the ankle-brachial index: A scientific statement from the American Heart Association. Circulation, 126(24), 2890-2909. https://doi.org/10.1161/CIR.0b013e318276fbcb
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' guide to physical examination and history taking (13th ed.). Wolters Kluwer.
How this NU333 Unit 6 example is structured
Central and peripheral findings are kept in separate sections, then connected in a closing paragraph, because the complaint lives in the legs while the risk it signals is systemic. Heart sounds are documented by listening area rather than as a single line, and the murmur is described by timing, location, grade, radiation and quality. The pulse table names its scale in the header, since two scales are in common use and a 2+ means different things on each. Doppler findings are recorded as audible signals, not graded as palpable pulses. Skin changes below the knee, shiny skin, sparse hair and a cooler left foot, are described plainly. The index is calculated in the note, ankle pressure over the higher brachial pressure, so a reader can check the arithmetic. Interpretation stays modest: findings consistent with reduced arterial flow, reported to the provider.
Get an NU333 Unit 6 example written to your instructions
Some sections ask for cardiac findings alone, others for the full peripheral vascular survey. Share the Unit 6 instructions with their rubric and template; the composite write-up names its scales, locates every sound and shows each calculation. A volunteer's actual pulses and pressures remain for the student to record. The first sample is free, turned around in 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU333 Unit 6 questions, answered
What is an ankle-brachial index?
A ratio comparing blood pressure at the ankle with pressure in the arm, usually measured with a handheld Doppler. For each leg, the higher ankle pressure is divided by the higher of the two brachial pressures. Values of 0.90 or below commonly indicate reduced arterial flow, and very high values can mean stiff, noncompressible arteries. It is a screening measure, not a diagnosis.
How is a heart murmur described in a nursing assessment?
By timing in the cardiac cycle, systolic or diastolic, the location where it is loudest, its grade on the six-point scale, whether it radiates and where, and its quality, such as harsh or blowing. Pitch and the effect of position may be added. A new or changed murmur is reported, since interpretation belongs to the provider.
Which pulse grading scale should I use?
Use the one your course or facility specifies. The most common runs from 0, absent, through 1+ diminished and 2+ normal to 3+ increased and 4+ bounding; another uses 0 to 3+. Name the scale in your note so the numbers cannot be misread, and document Doppler findings separately from palpated pulses.