Nursing 251 Exam 2 Questions With Complete Solutions
Define edema.
swelling in legs and feet
-what time of day does it occur?
-both legs or unilateral?
-dependent edema (gravity)
What personal habits create cardiac risk?
-BMI >25, obesity, blood sugar levels >100, smoking (pack
years), exercise
Angina (stable) Chest Pain
pressure, tightness, squeezing
-brought on by activity and relieved by rest
-nausea, diaphoresis, dyspnea
Acute Coronary Syndrome
unstable angina, MI
-heaviness, crushing, constricting
-20-30 minutes to hours
-does not resolve with rest
Describe Pulmonary Chest Pain
sharp, stabbing
-PE, pneumonia, pnuemothorax
Describe PE Chest Pain.
,worsens with deep breathing
-hemoptysis
-cough
Describe Pneumonia Chest Pain.
cough, fever, chills, body aches, malaise
Describe Pneumothorax Chest Pain.
localized to region of chest with referred pain to shoulder
-acute dyspnea, cough
-may be related to trauma or occur spontaneously
Peripheral Vascular System Evaluation
any leg pain? how long can you walk until you have the leg
pain? does the pain get worse with elevation or dangling?, any
change in erectile dysfunction? open areas in skin or any slow to
heal areas?
Define Hemosiderin.
reddish-brown color
-sign of venous insufficency, poor return of blood to heart,
breakdown of red blood cells, or brown pigmentation of Hgb
Peripheral Vascular Objective Data
capillary refill, variations
How do you assess capillary refill?
blanch the nailbed, release, observe time to turn pink
-should be brisk and less than 3 seconds
State some peripheral vascular variations.
, cold environment, decreased body temp, cigarette smoking,
edema, anemia
-caused by vasoconstriction, hypovolemia and shock, and heart
failure
Pulse Grading Scale
0 absent
+1 weak
+2 normal
+3 increased, bounding
Edema Grading Scale
• 1+ Mild pitting, slight indentation, no perceptible swelling of
the leg
• 2+ Moderate pitting, indentation, subsides rapidly
• 3+ Deep pitting, indentation remains for a short time, leg looks
swollen
• 4+ Very deep pitting, indentation lasts a long time, leg is very
swollen
Ankle Brachial Index
test used to evaluate for peripheral artery disease that establishes
a ratio of the blood pressure in the lower legs to the blood
pressure in the arms
-cannot smoke within 20 minutes, measure brachial and pedal
pulse, use best pedal and then best brachial
-best pedal/best brachial
Define the raynaud's phenomenon
Define edema.
swelling in legs and feet
-what time of day does it occur?
-both legs or unilateral?
-dependent edema (gravity)
What personal habits create cardiac risk?
-BMI >25, obesity, blood sugar levels >100, smoking (pack
years), exercise
Angina (stable) Chest Pain
pressure, tightness, squeezing
-brought on by activity and relieved by rest
-nausea, diaphoresis, dyspnea
Acute Coronary Syndrome
unstable angina, MI
-heaviness, crushing, constricting
-20-30 minutes to hours
-does not resolve with rest
Describe Pulmonary Chest Pain
sharp, stabbing
-PE, pneumonia, pnuemothorax
Describe PE Chest Pain.
,worsens with deep breathing
-hemoptysis
-cough
Describe Pneumonia Chest Pain.
cough, fever, chills, body aches, malaise
Describe Pneumothorax Chest Pain.
localized to region of chest with referred pain to shoulder
-acute dyspnea, cough
-may be related to trauma or occur spontaneously
Peripheral Vascular System Evaluation
any leg pain? how long can you walk until you have the leg
pain? does the pain get worse with elevation or dangling?, any
change in erectile dysfunction? open areas in skin or any slow to
heal areas?
Define Hemosiderin.
reddish-brown color
-sign of venous insufficency, poor return of blood to heart,
breakdown of red blood cells, or brown pigmentation of Hgb
Peripheral Vascular Objective Data
capillary refill, variations
How do you assess capillary refill?
blanch the nailbed, release, observe time to turn pink
-should be brisk and less than 3 seconds
State some peripheral vascular variations.
, cold environment, decreased body temp, cigarette smoking,
edema, anemia
-caused by vasoconstriction, hypovolemia and shock, and heart
failure
Pulse Grading Scale
0 absent
+1 weak
+2 normal
+3 increased, bounding
Edema Grading Scale
• 1+ Mild pitting, slight indentation, no perceptible swelling of
the leg
• 2+ Moderate pitting, indentation, subsides rapidly
• 3+ Deep pitting, indentation remains for a short time, leg looks
swollen
• 4+ Very deep pitting, indentation lasts a long time, leg is very
swollen
Ankle Brachial Index
test used to evaluate for peripheral artery disease that establishes
a ratio of the blood pressure in the lower legs to the blood
pressure in the arms
-cannot smoke within 20 minutes, measure brachial and pedal
pulse, use best pedal and then best brachial
-best pedal/best brachial
Define the raynaud's phenomenon
