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Exam (elaborations)

Health Assessment Final (NR 304) || 100% Verified Solutions.

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Health Assessment Final (NR 304) || 100% Verified Solutions.

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Health Assessment Final (NR 304) || 100% Verified Solutions.


hypovolemic shock correct answers emergency situation which severe blood or fluid loss makes
heart unable pump enough blood to body
-can cause organ failure


causes of hypovolemic shock correct answers bleeding
burns
diarrhea
excessive perspiration
vomiting


signs & symptoms of hypovolemic shock correct answers major blood loss
rapid heartbeat (tachycardia)
quick, shallow breathing
fatigue/weakness
confusion
little - no urine output
low BP
cool, clammy skin


deep vein thrombosis (DVT) correct answers blood clot (thrombus) forms in a large vein, usually
in a lower limb
-if swells = thrombophlebitis


risk factors for DVT correct answers prolonged bed-rest
immobility
heart failure

,obesity
varicose veins


used to determine severity of DVT correct answers wells score
-1 to 2: moderate
-3+: high


signs & symptoms of DVT correct answers aching calf pain/lower leg pain
-worse at end of day/prolonged siting or standing
itching w/ stasis dermatits
lower leg edema unresolved w/ diuretic therapy
-firm & brawny
coarse, thickened skin
normal pulse
brown pigment discoloration
petichea
venous stasis = increased venous pressure/RBC leakage


expected vital signs of 2 month old infant correct answers -reverse order: respirations, pulse then
temperature
-temperature = rectal
*probe no further 1 in.
*normally higher than older ages (~100 degrees)
-pulse = apical rate
*fluctuates more in response to illness & emotions
*awake ~100-190
*asleep ~90-160

,-respirations = count 1 full minute
*more diaphragmatic than thoracic
*sleeping rate more accurate
*tachypnea = >60/min (indication of infection/fever)
*~30-53 breaths/min
-BP = electronic device or doppler ultrasound
*smaller arm vessels = harder hear korotkoff sounds
*~72-104/37-53


peripheral artery disease (PAD) correct answers Common circulatory problem in which narrowed
arteries reduce blood flow to limbs
-affects non-coronary arteries
-blood flow can't match muscle demand during exercise


signs & symptoms of PAD correct answers painful cramping after certain activities
leg numbness/weakness
coldness lower leg & foot
shiny skin/no hair on legs
no pulse/weak pulse in legs & foot
non-healing sores on toes, feet, leg
change color legs
hair loss/distribution changes


causes of PAD correct answers atherosclerosis


risk factors for PAD correct answers smoking
diabetes mellitus

, kidney disease
high BP
high cholesterol
>50 yrs old
obesity
sedentary lifestyle
African American


first sign of PAD correct answers intermittent claudation


signs of advanced PAD correct answers burning/aching pain in feet & toes while resting
cool skin
redness/other skin color changes
foot ulcers


chronic obstructive pulmonary disease (COPD) correct answers group lung diseases block
airflow making it difficult to breathe
-most common = emphysema & chronic bronchitis
-damage to lungs irreversible


signs & symptoms of COPD correct answers wheezing
shortness of breath (SOB)
barrel chest
decreased breath sounds
clubbing
paradoxical pulse
hemoptysis

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