Bruit
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• Audible murmur ( a blowing sound) heard when auscultating over a
peripheral vessel or organ
Left Sided Heart Failure Symptoms
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Caused by
1. Increased resistance with aortic stenosis or hypertension
when ventricle can no longer contract effectively due to an
increase in workload
2. Weakening of left ventricular contraction that occurs after
a myocardial infarction when dead cells cause ineffective
contraction
Pitting edema
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• When the indentation of the thumb or finger remains in the
skin, after releasing an area of
• Indicates excess fluid in the interstitial space
• Pitting edema scale range from 1+ (2 mm) to 4+ (8 mm)
(Wilson & Giddens, 2017, p. 222)
Which action does a nurse anticipate when suctioning a patient with excessive
secretions?
a. Decrease the patient's oxygen flow rate before beginning the deep suctioning.
b. Avoid lubricating the catheter tip to prevent getting the substance in the lung
tissues.
c. Limit the time that the catheter is suctioning to prevent excessive loss of oxygen
during the process.
Flush the artificial airway with 3 mL of tap water to loosen secretions before
suctioning
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1. Answer: C
Oxygen is removed during the suctioning procedure, and the amount of
time needs to be limited. In some cases, the nurse provides extra oxygen
during suctioning procedures and decreasing the oxygen is
contraindicated. Lubrication of the catheter tip with normal saline solution
(NSS) is indicated and does not damage the lungs. Tap water is not sterile
and should not be introduced into the airway. Evidence-based practice
show that flushing with sterile NSS has no benefit, because saline does not
mix with secretions, and the procedure may have negative emotional
effects for the patient.
Lymphadenopathy
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• Enlargement of the lymph nodes greater than 1.5 cm
Pericardial Friction Rub
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scraping or grating noise heard (high pitch) on auscultation of the heart;
suggestive of pericarditis, pericardium is inflamed
, Femoral pulse
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• To locate: palpate below the inguinal ligament, midway
between the symphysis pubis and anterior superior iliac
crest
• Move your fingers inward toward the pubic hair
• Mnemonic NAVEL to help locate the anatomy: N, nerve; A,
artery; V, vein; E, empty space; L, lymph
(Wilson & Giddens, 2017, p. 225)
Crackles Presenting in
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Pneumonia, heart failure, restrictive pulmonary disease
Rhonchi presenting in
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Disorders caused by obstruction of trachea or bronchus - bronchitis +
COPD
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• Audible murmur ( a blowing sound) heard when auscultating over a
peripheral vessel or organ
Left Sided Heart Failure Symptoms
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Caused by
1. Increased resistance with aortic stenosis or hypertension
when ventricle can no longer contract effectively due to an
increase in workload
2. Weakening of left ventricular contraction that occurs after
a myocardial infarction when dead cells cause ineffective
contraction
Pitting edema
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• When the indentation of the thumb or finger remains in the
skin, after releasing an area of
• Indicates excess fluid in the interstitial space
• Pitting edema scale range from 1+ (2 mm) to 4+ (8 mm)
(Wilson & Giddens, 2017, p. 222)
Which action does a nurse anticipate when suctioning a patient with excessive
secretions?
a. Decrease the patient's oxygen flow rate before beginning the deep suctioning.
b. Avoid lubricating the catheter tip to prevent getting the substance in the lung
tissues.
c. Limit the time that the catheter is suctioning to prevent excessive loss of oxygen
during the process.
Flush the artificial airway with 3 mL of tap water to loosen secretions before
suctioning
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1. Answer: C
Oxygen is removed during the suctioning procedure, and the amount of
time needs to be limited. In some cases, the nurse provides extra oxygen
during suctioning procedures and decreasing the oxygen is
contraindicated. Lubrication of the catheter tip with normal saline solution
(NSS) is indicated and does not damage the lungs. Tap water is not sterile
and should not be introduced into the airway. Evidence-based practice
show that flushing with sterile NSS has no benefit, because saline does not
mix with secretions, and the procedure may have negative emotional
effects for the patient.
Lymphadenopathy
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• Enlargement of the lymph nodes greater than 1.5 cm
Pericardial Friction Rub
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scraping or grating noise heard (high pitch) on auscultation of the heart;
suggestive of pericarditis, pericardium is inflamed
, Femoral pulse
Give this one a try later!
• To locate: palpate below the inguinal ligament, midway
between the symphysis pubis and anterior superior iliac
crest
• Move your fingers inward toward the pubic hair
• Mnemonic NAVEL to help locate the anatomy: N, nerve; A,
artery; V, vein; E, empty space; L, lymph
(Wilson & Giddens, 2017, p. 225)
Crackles Presenting in
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Pneumonia, heart failure, restrictive pulmonary disease
Rhonchi presenting in
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Disorders caused by obstruction of trachea or bronchus - bronchitis +
COPD
