NUR 118 EXAM 3 | | |
Study |online |at |https://quizlet.com/_c40ul8
1. What are considerations when assessing pulses in the peripheral vascular
| | | | | | | | |
system?: -what is the strength? 0: absent, 1+: diminished, 2+: brisk (expected), 3+:
| | | | | | | | | | | | |
increased, 4+: full volume, bounding
| | | | |
-what is the rate? is the pulse irregular, regular?
| | | | | | | |
-are they equal bilaterally (on both sides)?
| | | | | |
-is it beating at the same rate as the heart?
| | | | | | | | |
2. What are specific modifiable risk factors related to heart disease?: -dietary
| | | | | | | | | |
choices (nutrition)
| |
-lifestyle choices (exercise or sedentary lifestyle)
| | | | |
-weight
-smoking
3. Modifiable risk factors: things we can help patients alter through different be- | | | | | | | | | | |
havior changes
| |
4. What are specific non-modifiable risk factors related to heart disease?: -age
| | | | | | | | | |
-gender
-family history |
5. Non-modifiable risk factors: things that neither the patient or us nurses can | | | | | | | | | | |
modify
|
6. What are the parts of the ABCDE skin assessment?: A: asymmetry of shape B:
| | | | | | | | | | | | |
border irregularity (not round, circle, etc.)
| | | | | |
C: color variation within one lesion
| | | | |
D: diameter is greater than 6 mm (pencil eraser) E:
| | | | | | | | |
evolving/changing features
| |
7. What are the signs/symptoms of venous insufficiency?: -aching pain, in-
| | | | | | | | |
creases in evening and with dependent position
| | | | | | |
-no paresthesia
|
-temperature normal to touch | | |
-normal or cyanotic color | | |
-capillary refill not applicable | | |
-pulses are present | |
-skin change of brown pigmentation around ankles
| | | | | |
-shallow ulcers around ankles (chronic venous stasis); edema apparent
| | | | | | | |
8. What are the signs/symptoms of arterial insufficiency?: -burning, throbbing,
| | | | | | | |
cramping; increases with exercise
| | | |
-numbness, tingling, decreased sensation (most common in foot and toes) | | | | | | | | |
-cool to touch | |
-palecolor;worsened by elevation of extremity;dusky red when extremity is lowered
| | | | | | | | | | | |
-capillary refill greater than 2 seconds | | | | |
-decreased of absent pulses | | |
1 |/ |6
, NUR 118 EXAM 3 | | |
Study |online |at |https://quizlet.com/_c40ul8
-thin, shiny skin; decreased hair growth; thickened nails
| | | | | | |
-deep ulcerations; well defined at site of trauma or tips of toes
| | | | | | | | | | |
9. What are normal age changes with cardiac/peripheral vascular?: -systolic
| | | | | | | |
hypertension
|
-PMI harder to palpate with larger AP chest diameter
| | | | | | | |
-cardiac output decreases and blood vessels thicken
| | | | | |
-heart valves stiffen | |
-left ventricle thickens (not as elastic as usual)
| | | | | | |
-higher systolic BP (primary hypertension)
| | | |
-peripheral circulation lessens | |
-thicker, mire rigid peripheral blood vessel walls and narrowed lumen
| | | | | | | | |
-slower wound healing | |
10. What are normal age changes with abdominal?: -weaker abdominal muscles
| | | | | | | | |
(higher risk of hernias)
| | | |
-abdomen appears more protruding | | |
-saliva, gastric secretions, and pancreatic enzymes decrease
| | | | | |
-decreased GI motility | |
-diminished s/s of peritoneal inflammation so may not present with typical fever, | | | | | | | | | | |
guarding or rebound tenderness.
| | | |
-reduced blood flow to kidneys | | | |
11. What are normal age changes with integumentary?: -skin appears thin and
| | | | | | | | | |
translucent
|
-skin is drier, and tears more easily
| | | | | |
-wrinkles
-loss of skin elasticity
| | |
-cherry angiomas and liver spots (age spots)
| | | | | |
12. What are normal age changes with musculoskeletal?: -reduced muscle
| | | | | | | |
mass
|
-decline in speed and strength of muscle response
| | | | | | |
-decreased coordination |
-osteoporosis (loss of bone mass, risk for fractures) | | | | | | |
-degenerative joint alterations | |
-limited ROM |
-thinning intervertebral disks; kyphosis | | |
-wider stance alters their posture
| | | |
13. How should the nurse assess the abdomen?: -inspect: shape (flat, round,
| | | | | | | | | |
distended, obese)
| |
-auscultate: each quadrant for 1 full minute | | | | | |
2 |/ |6
Study |online |at |https://quizlet.com/_c40ul8
1. What are considerations when assessing pulses in the peripheral vascular
| | | | | | | | |
system?: -what is the strength? 0: absent, 1+: diminished, 2+: brisk (expected), 3+:
| | | | | | | | | | | | |
increased, 4+: full volume, bounding
| | | | |
-what is the rate? is the pulse irregular, regular?
| | | | | | | |
-are they equal bilaterally (on both sides)?
| | | | | |
-is it beating at the same rate as the heart?
| | | | | | | | |
2. What are specific modifiable risk factors related to heart disease?: -dietary
| | | | | | | | | |
choices (nutrition)
| |
-lifestyle choices (exercise or sedentary lifestyle)
| | | | |
-weight
-smoking
3. Modifiable risk factors: things we can help patients alter through different be- | | | | | | | | | | |
havior changes
| |
4. What are specific non-modifiable risk factors related to heart disease?: -age
| | | | | | | | | |
-gender
-family history |
5. Non-modifiable risk factors: things that neither the patient or us nurses can | | | | | | | | | | |
modify
|
6. What are the parts of the ABCDE skin assessment?: A: asymmetry of shape B:
| | | | | | | | | | | | |
border irregularity (not round, circle, etc.)
| | | | | |
C: color variation within one lesion
| | | | |
D: diameter is greater than 6 mm (pencil eraser) E:
| | | | | | | | |
evolving/changing features
| |
7. What are the signs/symptoms of venous insufficiency?: -aching pain, in-
| | | | | | | | |
creases in evening and with dependent position
| | | | | | |
-no paresthesia
|
-temperature normal to touch | | |
-normal or cyanotic color | | |
-capillary refill not applicable | | |
-pulses are present | |
-skin change of brown pigmentation around ankles
| | | | | |
-shallow ulcers around ankles (chronic venous stasis); edema apparent
| | | | | | | |
8. What are the signs/symptoms of arterial insufficiency?: -burning, throbbing,
| | | | | | | |
cramping; increases with exercise
| | | |
-numbness, tingling, decreased sensation (most common in foot and toes) | | | | | | | | |
-cool to touch | |
-palecolor;worsened by elevation of extremity;dusky red when extremity is lowered
| | | | | | | | | | | |
-capillary refill greater than 2 seconds | | | | |
-decreased of absent pulses | | |
1 |/ |6
, NUR 118 EXAM 3 | | |
Study |online |at |https://quizlet.com/_c40ul8
-thin, shiny skin; decreased hair growth; thickened nails
| | | | | | |
-deep ulcerations; well defined at site of trauma or tips of toes
| | | | | | | | | | |
9. What are normal age changes with cardiac/peripheral vascular?: -systolic
| | | | | | | |
hypertension
|
-PMI harder to palpate with larger AP chest diameter
| | | | | | | |
-cardiac output decreases and blood vessels thicken
| | | | | |
-heart valves stiffen | |
-left ventricle thickens (not as elastic as usual)
| | | | | | |
-higher systolic BP (primary hypertension)
| | | |
-peripheral circulation lessens | |
-thicker, mire rigid peripheral blood vessel walls and narrowed lumen
| | | | | | | | |
-slower wound healing | |
10. What are normal age changes with abdominal?: -weaker abdominal muscles
| | | | | | | | |
(higher risk of hernias)
| | | |
-abdomen appears more protruding | | |
-saliva, gastric secretions, and pancreatic enzymes decrease
| | | | | |
-decreased GI motility | |
-diminished s/s of peritoneal inflammation so may not present with typical fever, | | | | | | | | | | |
guarding or rebound tenderness.
| | | |
-reduced blood flow to kidneys | | | |
11. What are normal age changes with integumentary?: -skin appears thin and
| | | | | | | | | |
translucent
|
-skin is drier, and tears more easily
| | | | | |
-wrinkles
-loss of skin elasticity
| | |
-cherry angiomas and liver spots (age spots)
| | | | | |
12. What are normal age changes with musculoskeletal?: -reduced muscle
| | | | | | | |
mass
|
-decline in speed and strength of muscle response
| | | | | | |
-decreased coordination |
-osteoporosis (loss of bone mass, risk for fractures) | | | | | | |
-degenerative joint alterations | |
-limited ROM |
-thinning intervertebral disks; kyphosis | | |
-wider stance alters their posture
| | | |
13. How should the nurse assess the abdomen?: -inspect: shape (flat, round,
| | | | | | | | | |
distended, obese)
| |
-auscultate: each quadrant for 1 full minute | | | | | |
2 |/ |6
