NR 509 Latest Update with Verified Solutions

NR 509 Latest Update with Verified Solutions Crepitus A grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling. can be with or without pain. Retractions Occurs in severe asthma, COPD, or any upper airway obstruction. What is fremitus? Fremitus refers to the palpable vibrations that are transmitted through the bronchopulmonary tree to the chest wall as the patient is speaking and is normally symmetric. Where should one palpate when assessing for fremitus? Fremitus is typically more prominent in the inter-scapular area than in the lower lung fields over the right lung fields, and it is easy to detect other the right lung vs the left lung. It disappears below the diaphragm. What would cause tactile fremitus to be decreased? Asymmetric decreased fremitus raises the likelihood of unilateral pleural effusion, pneumothorax, or neoplasm. What is the purpose of percussion? Percussion sets the chest wall and underlying tissues in motion, producing audible sound and palpable vibrations. Percussion helps you establish whether the underlying tissues are air-filled, fluid-filled, or consolidated. 62 yr old male, everyday smoker, chronic cough, some SOB. He says he's had some nasal drainage but nothing else. Vital signs are normal, but he has decreased breath sounds in all lung fields. No dullness, fremitus, positive for rhonchi. What can be the cause of his symptoms? COPD: affects smokers and those of older age. Exam: barrel chest Ausc: Rhonchi, decreased breath sounds. Percussion: Hyperresonance What valve is responsible for the inspiratory splitting of S2 heart sound? Closure of the aortic & pulmonic valves Where would the provider more than likely hear a heart murmur ONLY over the cardiac apex? Mitral valve: MV murmurs are best heard over this area. Orthopnea presents itself in people as: May show up in CHF patients and is relieved when the patient sits up after lying down. What is the 1 determining factor when hypothesizing rather or not a patient will develop heart disease in 10 years? Gender: men have a higher risk than women. What are the ABCDEs of melanoma? A: asymmetric B: irregular borders C: color changes (especially blue color) D: diameter/size > 0.5 cm E: evolution/change that occurs to longstanding pigmented areas. 32 year old comes in with a large, patchy rash. on her belly she has open lesions that she claims are very itchy. On assessment the rash resembles a Christmas tree and there's also papules & macules on her back as well. What could be a possible diagnosis? Pityriasis Rosea. this rash has a distinct "herald" patch figure that one see's before the vesicles actually erupt. Multiple dark-tan rash on arms, chest, and neck that has a reddish cast. Rash has sharp borders and fine scales that are more prominent on back, chest, neck, and upper arms. Possible diagnosis? Tinea vesicolor: is a fungus that thrives in areas that produces alot of moisture. Actinic keratosis Flat papule that's dry, hard & at times are scattered all over one's body. Benign, however, if left untreated it can turn into squamous cell cancer. Signs of subarachnoid hemorrhage HAPPENS SUDDENLY THUNDERCLAP H/A WORST H/A OF MY LIFE H/A worse with exertion N/V, Neck stiffness Provider should r/o meningitis. General Survey of the Physical Assessment The physical appearance, height, and weight. You'll also assess the patient's speech, LOC, and gait. Brachial Artery & Blood Pressure Readings If the brachial artery is below heart level, the blood pressure reading will be higher; if the brachial artery is above heart level, the reading will be low. An itchy rash that's raised and disappears in various