NSG 460 Exam 1 Study Set
What are the risk factors for developing a blood clot? - CORRECT ANSWER-Immobility,
clotting factors, elderly people (aging), pregnancy, weight, long periods of sitting and
standing
What would you expect to be the cause of unilateral swollen epitrochlear lymph nodes
and what symptoms would they likely to have? - CORRECT ANSWER-Surgery and
Cancer.
Epitrochlear greater than 5 mm (more than 6 mm is worrisome), hard, nonmobile
Concerning: Epitrochlear, Supraclavicular, Unilateral inguinal
Not Concerning: Neck
Describe the normal findings on examination of the lymphatic system in a pediatric
patient. - CORRECT ANSWER-Soft and mobile. Sometimes kids can have enlarged
neck nodes and that will be considered normal.
What happens to the peripheral vasculature as we age and how does this affect blood
pressure? - CORRECT ANSWER-Stiffening & Calcification
(Arteriosclerosis/Atherosclerosis)
Can cause Peripheral Arterial Disease >> HTN
PAD is increasingly prevalent over age of 85
Can cause poor perfusion
What is claudication and how would you assess for it? What disease is this finding often
associated with? - CORRECT ANSWER-A condition in which cramping pain in the leg is
induced by exercise, typically caused by obstruction of the arteries. You assess it by
having them walk, if it hurts when they walk and when they stop it goes away. This is
often associated with PAD
What is venous insufficiency and how would you assess for it? - CORRECT ANSWER-
Chronic venous insufficiency occurs when your leg veins don't allow blood to flow back
up to your heart. There will be skin and changes in the lower leg. It can be assessed
with a duplex ultrasound.
The most common cause of venous insufficiency previous blood clots and varicose
veins
Explain what the "profile sign" is and what it is used to assess for. - CORRECT
ANSWER-It's called clubbing.
Associated with reduced O2 perfusion (COPD)
Primary= Inherited; Secondary= Acquired
, In assessing your patient you find that the patient's bilateral carotid pulses are unequal
in strength. What would be the next step in your assessment of this abnormal finding? -
CORRECT ANSWER-Auscultate the heart
Listen for a Bruit
or use a doppler
Check radial pulses
The carotid can recover, but degree and timing matters
Cardiothoracic surgeons would then do a Bypass surgery address the problem
If you are unable to palpate a distal pulse in a patient's extremities, which can be a
normal variant, what other ways can you assess for adequate perfusion of the
extremity? - CORRECT ANSWER-Try: Cap refill, use a doppler, assess skin color, skin
sensation
Explain the pathophysiology and findings you would expect on assessment of a patient
with varicose veins. - CORRECT ANSWER-Varicose veins are normal veins that have
dilated under the influence of increased venous pressure.
Veins will appear visibly crooked under skin surface
Often palpable(spongy) veins.
Explain the pathophysiology and findings you would expect on assessment of a patient
with lymphedema. - CORRECT ANSWER-Lymphedema is most commonly caused by
the removal of or damage to your lymph nodes as a part of cancer treatment. Protein
rich content of fluid builds up in the interstitial spaces and causes increased colloid
osmotic pressure.
Sx's= Swelling (unilateral), Heaviness, Aching, Infections, Thickened fibrotic skin,
restricted ROM, recurrent infections and non healing wounds.
During your assessment you ask your patient to raise her legs and hold them up for 30
seconds. Upon returning her legs to a dangling position you note it takes greater than
15 seconds for her skin to return to her baseline color. You recognize this finding as a
dysfunction in which system? - CORRECT ANSWER-Arterial Deficit
Describe the procedure and expected findings when auscultating of the pediatric heart. -
CORRECT ANSWER-Infants have a faster heart rate and physiological murmur (S3 can
occur), not uncommon for systolic murmur with no s/sx of cardiac disease, usually
grades I-I.
Chest is more horizontal and heart is at 4th ICS (until 7yrs of age)
Describe the pathophysiology and presentation of Reynaud's disease. - CORRECT
ANSWER-Vasospasm of small arteries that supply blood to skin constrict
What are the risk factors for developing a blood clot? - CORRECT ANSWER-Immobility,
clotting factors, elderly people (aging), pregnancy, weight, long periods of sitting and
standing
What would you expect to be the cause of unilateral swollen epitrochlear lymph nodes
and what symptoms would they likely to have? - CORRECT ANSWER-Surgery and
Cancer.
Epitrochlear greater than 5 mm (more than 6 mm is worrisome), hard, nonmobile
Concerning: Epitrochlear, Supraclavicular, Unilateral inguinal
Not Concerning: Neck
Describe the normal findings on examination of the lymphatic system in a pediatric
patient. - CORRECT ANSWER-Soft and mobile. Sometimes kids can have enlarged
neck nodes and that will be considered normal.
What happens to the peripheral vasculature as we age and how does this affect blood
pressure? - CORRECT ANSWER-Stiffening & Calcification
(Arteriosclerosis/Atherosclerosis)
Can cause Peripheral Arterial Disease >> HTN
PAD is increasingly prevalent over age of 85
Can cause poor perfusion
What is claudication and how would you assess for it? What disease is this finding often
associated with? - CORRECT ANSWER-A condition in which cramping pain in the leg is
induced by exercise, typically caused by obstruction of the arteries. You assess it by
having them walk, if it hurts when they walk and when they stop it goes away. This is
often associated with PAD
What is venous insufficiency and how would you assess for it? - CORRECT ANSWER-
Chronic venous insufficiency occurs when your leg veins don't allow blood to flow back
up to your heart. There will be skin and changes in the lower leg. It can be assessed
with a duplex ultrasound.
The most common cause of venous insufficiency previous blood clots and varicose
veins
Explain what the "profile sign" is and what it is used to assess for. - CORRECT
ANSWER-It's called clubbing.
Associated with reduced O2 perfusion (COPD)
Primary= Inherited; Secondary= Acquired
, In assessing your patient you find that the patient's bilateral carotid pulses are unequal
in strength. What would be the next step in your assessment of this abnormal finding? -
CORRECT ANSWER-Auscultate the heart
Listen for a Bruit
or use a doppler
Check radial pulses
The carotid can recover, but degree and timing matters
Cardiothoracic surgeons would then do a Bypass surgery address the problem
If you are unable to palpate a distal pulse in a patient's extremities, which can be a
normal variant, what other ways can you assess for adequate perfusion of the
extremity? - CORRECT ANSWER-Try: Cap refill, use a doppler, assess skin color, skin
sensation
Explain the pathophysiology and findings you would expect on assessment of a patient
with varicose veins. - CORRECT ANSWER-Varicose veins are normal veins that have
dilated under the influence of increased venous pressure.
Veins will appear visibly crooked under skin surface
Often palpable(spongy) veins.
Explain the pathophysiology and findings you would expect on assessment of a patient
with lymphedema. - CORRECT ANSWER-Lymphedema is most commonly caused by
the removal of or damage to your lymph nodes as a part of cancer treatment. Protein
rich content of fluid builds up in the interstitial spaces and causes increased colloid
osmotic pressure.
Sx's= Swelling (unilateral), Heaviness, Aching, Infections, Thickened fibrotic skin,
restricted ROM, recurrent infections and non healing wounds.
During your assessment you ask your patient to raise her legs and hold them up for 30
seconds. Upon returning her legs to a dangling position you note it takes greater than
15 seconds for her skin to return to her baseline color. You recognize this finding as a
dysfunction in which system? - CORRECT ANSWER-Arterial Deficit
Describe the procedure and expected findings when auscultating of the pediatric heart. -
CORRECT ANSWER-Infants have a faster heart rate and physiological murmur (S3 can
occur), not uncommon for systolic murmur with no s/sx of cardiac disease, usually
grades I-I.
Chest is more horizontal and heart is at 4th ICS (until 7yrs of age)
Describe the pathophysiology and presentation of Reynaud's disease. - CORRECT
ANSWER-Vasospasm of small arteries that supply blood to skin constrict
