NSG 261 Study Guide Questions with 100% Correct Answers

NSG 261 Study Guide Questions with 100%
Correct Answers
Purpose of auscultating bowel sounds

to assess a pattern of bowel sounds

which area of the abdomen should you assess last?

where patient is having most pain

assessment sequence

inspection

auscultation

percussion

palpation

normal bowel sounds

5-34 clicks/gurgles per minute

abnormal bowel sounds

- Hypoactive bowel sounds

- Hyperactive bowel sounds

if no bowel sounds are heard, what is next step

continue listening for five minutes

purpose of palpating for costovertebral tenderness (CVA)

to assess tenderness or inflammation of the kidney

step to palpate for CVA

, - place patient in a sitting position

- stand facing the patient's back.

- use indirect blunt or fist percussion, thump over the 12th rib.

normal findings for CVA

no pain

pulse point locations

Brachial—mid-arm

Radial—thumb side of wrist

Popliteal—behind the knee

Dorsalis pedis—top of the foot

Posterior tibial—back of the ankle.

PAD

peripheral artery disease

PAD tips

Smoking Cessation, wound care, numbness and tingling in legs, Cyanosis

PVD

peripheral vascular disease

PVD tips

Erythema, edema, drainage, varicose veins, smoking cessation

DVT

deep vein thrombosis