Assessing for the Indicators of Circulatory Status

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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 consists of 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, blood pressuer, 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.


Blood Pressure

Measuring your blood pressure is a simple method of finding out how your circulatory system is working. One of the important jobs of the circulatory system is to get oxygenated blood to all of the tissues and organs throughout the body. This is accomplished by the beating of the heart. When the heart beats, it creates pressure that pushes blood through the blood vessels, which include arteries, veins and capillaries.

This pressure is measured by the blood pressure, the two numbers you see when you check your blood pressure. The first number or the top number is called the systolic pressure. The systolic number occurs as the blood pumps out of the heart and into the arteries that are a part of the circulatory system.

The second number is the diastolic number, which is created as the hearts rests between heart beats.

A healthy blood pressure is usually around 110/70, or systolic of 110 and a diastolic number of 70. The medical term for high blood pressure is hypertension. The higher the blood pressure, the harder your heart has to beat to get the blood pumping through the circulatory system.

The different hypertension categories are as follows:

Blood Pressure


Systolic mm hg

(upper number)

Diastolic mm hg

(lower number)





Less than 120

Less than 80


120 – 129

Less than 80

High blood pressure

Hypertension stage 1

130 – 139

80 - 89

High blood pressure

Hypertension stage 2

140 or higher

90 or higher

If someone has a systolic higher than 180 and or a diastolic higher than 120, call a doctor right away.

You can measure you blood pressure at home easily with a home blood measure meter. It is also a good idea to compare your readings at home with your doctor’s office readings also.

Symptoms of High Blood Pressure

Of course using your blood pressure readings along with the tests mentioned above are helpful in telling you how healthy your circulatory system is working. There are symptoms that can let you know that you should talk to your doctor about your circulatory system that include:

  • Tingling
  • Numbness
  • Stinging pain in the limbs
  • Erectile dysfunction

Treating High Blood Pressure

If you do have high blood pressure, your doctor will most likely put you on medication to lower the blood pressure.

Changing your diet by limiting all types of animal foods, dairy and oil or eating a healthy vegan diet can lower your blood pressure to a healthy level.