Nur 6512 Final Exam Latest Updated 2024

NUR 6512 FINAL EXAM LATEST UPDATED 2024 Varicosity Findings In Pregnant Women - With increasing cardiac output beginning in the 1st trimester, the pulse may be more easily palpated, with an abrupt rise and rapid fall. With increasing blood volume in the second trimester, jugular a and v waves may be easier to see. JVP should remain normal. Peripheral edema is a common finding as the pregnancy progresses. Varicose veins can develop during pregnancy and in the postpartum period. Heart Sounds - S1 - Closure of the mitral and tricuspid (AV) Valves, indicates the beginning of systole. Best heard toward the apex. S2 - Closure of the aortic and pulmonic (semilunar) Valves, indicates the end of systole. Best heard in the aortic and pulmonic areas. Higher pitch and shorter duration. S3 - Best heard when the patient is in the left lateral decubitus (recumbent) position. Ventricular Gallup - Ken-Tuck-Y S4 - Most commonly heard in the older patients, but may be heard at any age when there is increased resistance to filling because the ventricular walls have lost compliance. Atrial Gallup - Ten-nes-see Examination Technique for the Apical Pulse - PMI Point of Maximal Impulse typically noted at the left 5th intercostal space, midclavicular line in adults, and 4th intercostal space medial to the nipple in children. If the apical impulse is more vigorous than expected, characterize it as a "heave" or "lift." Pg 337 Grading of Heart Murmurs - Grade I - Barely audible in quiet room Grade II - Quiet but clearly audible Grade III - Moderately loud Grade IV - Loud, associated with thrill Grade V - Very loud, thrill easily palpable Grade VI - Very loud, audible with stethoscope not in contact with chest, thrill palpable and visible Cardiac Examination Findings for Rheumatic Fever - Carditis Mitral or Aortic Valve becomes stenotic and regurgitant. Chest Pain Palpitations Murmurs of mitral regurgitation and aortic insufficiency Cardiomegaly Friction rub of pericarditis Signs of CHF Examination Findings of a child with Kawasaki disease - Fever, Conjunctival Injection, Strawberry Tongue, and Edema of the Hands and Feet. Lymphadenopathy and Polymorphous Nonvesicular Rashes. Peripheral Edema - Grading: 1+ Slight Pitting, no visible distortion, disappears rapidly. 2+ A Somewhat Deeper Pit than in 12+, but again no readily detectable distortion, disappears in 10-15 seconds. 3+ Noticeably Deep Pit that may last more than a minute; dependent extremity looks fuller and swollen. 4+ Very Deep Pit that lasts as long as 2-5 min; dependent extremity is grossly distorted. Ammonia in breath odor - Uremia (ammonia) Grading of Pulses - 4+ Bounding 3+ Full, Increased 2+ Expected 1+ Diminished, barely palpable 0 Absent, not palpable Acute Limb Ischemia (ALI) - Stage I - Viable - No sensory impairment - No motor impairment - Audible Arterial Doppler Signal - Audible Venous Dopler Signal Stage IIa - Marginally Threatened - Minimal Sensory Impairment - No Motor Impairment - Often inaudible Arterial Doppler Signal - Audible Venous Doppler Signal Stage IIb - Immediately Threatened - Rest Pain Sensory Impairment - Mild to moderate Motor Impairment - Inaudible Arterial Doppler Signal - Audible Venous Doppler Signal Stage III - Irreversible - Anesthetic Sensory Impairment - Paralytic/rigor Motor Impairment - Inaudible Arterial Doppler Signal - Inaudible Venous Doppler Signal Assessment for Peripheral Arterial Disease - Site of Pain is Distal to the Narrowing. Note: Pulses (strong, weak or possibly absent) Possible systolic bruits over the arteries that may extend through diastole. Loss of expected body warmth. Localized pallor and cyanosis. Collapsed superficial veins, with delay in venous filling. Thin, atrophied skin; muscle atrophy. Types of Shortness of Breath - Orthopnea - Difficulty Breathing While Lying Down Platypnea - Shortness of breath is relieved when lying down or worsens when standing up Tachypnea - Faster than 20 breaths per minute Bradypnea - Slower than 12 breaths per minute Cocaine Use Findings in Heart and Lungs - Severe, acute chest pain. Tachycardia, HTN, Coronary Aterial Spasm (with Infarction), and pneumothorax (lung collapse), with severe acute chest pain being the common result. ECG - Records 2 basic events: depolarization, which is the spread of a stimulus through the heart muscle, and the repolarization, which is the return of the stimulated heart muscle to a resting state. P Wave-spread of a stimulus through the atria (atrial depolarization) PR interval-time from initial stimulation of the atria to initial stimulation of the ventricles usually 0.12-0.20 second