Exam (elaborations)
NR 304 Final Exam
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Exam of 37 pages for the course NR 304 at NR 304 (NR 304 Final Exam)
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NR 304 FINAL EXAM QUESTIONS ANDANSWERS GRADED A+
A arteries - active blood flow
veins - passive blood flow - do not have a pulse, returns to the heart via movement through the skeletal
muscles
femoral pulse site - groin
popliteal pulse site - back of knee
radial pulse site - Located at the wrist on the thumb side
dorsalis pedis pulse site - top of foot
posterior tibial pulse site - on medial surface of ankle near ankle bone
ischemia - Lack of blood supply, causes pain
necrosis - long term lack of blood supply, tissue death
axillary lymph nodes - located under the arms in the armpits
cervical lymph nodes - located along the sides of the neck
Epitrochlear lymph nodes - Epitrochlear lymph nodes- drains from the hand and forearm
inguinal lymph nodes - located in the inguinal (groin) area of the lower abdomen
Children and Lymph Nodes - nodes can be enlarged with no pain/infection
Pregnancy and PV - dependent edema, varicose veins
peripheral artery disease - A form of peripheral vascular disease in which there is partial or total
blockage of an artery, usually one leading to a leg or arm. 50% of cases are African Americans. RF:
smoking, HTN, diabetes
intermittent claudication - when walking, muscle needs more O2 blood, and you have any kind of
occlusion, when walking pain is increased
Pulse Scale - 0: absent
1+: weak
2+: normal
3+: increased, full, bounding
,Allen test - determining the patency of the radial and ulnar arteries by compressing one artery site and
observing return of skin color as evidence of patency of the other artery, determine if radial artery has
been damaged, press radial artery then see if ulnar artery perfuses to hand
venous ulcers - bleed, medial malleolus
arterial (ischemic) ulcers - does not bleed, has a necrotic black crust, lateral malleolus
neuropathic ulcer - destroys nerve endings, burning pain/numbness
Edema 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
Doppler ultrasound - determine location of pulse
Raynaud's disease - autoimmune, sporadic vasoconstriction then relaxation, happens in hands/toes
usually
Lymphadema - enlarged lymph nodes, hard edema
Varicose veins - abnormally swollen, twisted veins with defective valves; most often seen in the legs
DVT - inflammatory process, swelling, redness, heat, pain, happens from venastasis, pooling of blood in
calf
-tachycardia, low grade temp
-women on birth control who smoke are at a higher risk, and also those who are dehydrated since blood
is more viscous
-Do not perform homan's sign test (flexing foot back)
anneurysm - can be born with or develop, serious with abdominal aorta/coronary arteries/brain
Decreased Arterial Flow - doesn't work well around gravity, blue then pallor
Decreased Venous Flow - brown, using muscles improves
What happens when valves of the veins do not work right - edema/varicose veins
arterial insufficiency - not getting enough arterial blood flow = ischemic pain, usually happens on one
leg, leg appears shiny, hairless, red/blue then pallor, limb gets cool, pain gets better when resting since
the limb doesn't need as much O2 blood flow (intermittent claudication), gravity works for it when legs
are down, causes impotence in males, can affect nails/toes
venous insufficiency - constant, achy, fullness, pain. Pain gets better by moving. When you stand/sit pain
gets worse. Gravity works against when legs are down. Usually happens on both legs, skin turns
red/brown, starts below the knee to the ankle, skin is scaly, can get slits in skin (weeping edema), there
is no cure, no change in skin temp.
,pulse - rhythm, rate, symmetry, amplitude/strength
arterial occlusion - -extreme coolness
-pain
-loss of sensation
-hair loss and skin changes
-pallor
-pulselessness
arterial insufficiency - -intermittent claudation (pain brought on by exercise and relieved with rest)
-hair loss on toes and shiny skin
-impotence
-pain (gnawing, sharp or stabbing and increases with exercise, relieved with rest)
-decreased pulses
-rusty discoloration due to blood leaking out of vessel and difficulty being reabsorbed
-skin ulcers on pressure points, toes, and lateral malleoli
-necrosis
-bluish/red feet with dependence and pallor with elevation
-sensory and motor loss
-thickened, yellow toenails
-cool skin
venous insufficiency - -pitting edema due to fluid leaking into tissue due to incompetent valves
-pain (aching or feeling of fullness and increases with standing/sitting and improves with elevating legs
or walking)
-varicosities may be present
-possible leg ulcers on medial malleoli
-normal temperature
-skin thickened with brown discoloration of ankles and flaky
deep vein thrombosis - -edema (only on one leg)
-pain - no pain or sharp, intense pain/tenderness
-red skin area
, -warmth
-mass
-low grade fever
-tachycardia
Peripheral Neuropathy - -burning skin
-numbness
-loss/decreased sensation
GERD - (pyrosis) - failure of pyloric valve, dont eat before bed or in middle of night, dont lie down after
eating for at least 30 mins
What causes peptic ulcers? - H. pylori - loves acid
Small Bowel - -small in diameter, huge in length 20ft
-where most digestion/breakdown ocurrs
-where enzymes from pancreas go
-most of absorption of nutrients ocurrs
large bowel - -shorter but larger diameter
-condense stool into formed stool (pulls water out)
-where you metabolize fats to absorb vit. D
E.coli - -essential bacteria that breaks down food in bowel
-if it is any other placer than the gut, it can kill you
-in wound = infection
-bladder = UTI
-lungs = dangerous pneumonia
C. Diff - -if you take antibiotics you kill e.coli in gut, so you have an overgrowth of other microbes
(importance of probiotics)
-when you kill all this bacteria you get C.diff - terrible bacteria that can kill you
-explosive diarrhea, highly contagious, gown/glove precautions, horrible smell
-can prevent C. Diff by probiotics - can have yogurt with live cultures or need probiotic with 50 million
bacteria
Peristalsis - Involuntary waves of muscle contraction that keep food moving along in one direction
through the digestive system.
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