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Physical Assessment > Chapter 21 > Flashcards

Chapter 21 Flashcards

1
Q

How many blocks (stairs) does it take to produce this pain?

A

Claudication distance is the number of blocks walked or stairs climbed to produce pain.

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2
Q

Does the pain wake you up at night?

A

Night leg pain is common in aging adults.

It may indicate the ischemic rest pain of PAD, severe night muscle cramping (usually the calf), or restless legs syndrome.

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3
Q

Is it associated with any change in sexual function (males)?

A

Aortoiliac occlusion is associated with erectile dysfunction (Leriche syndrome).

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4
Q

Any history of vascular problems, heart problems, smoking, diabetes, obesity, pregnancy, hypertension, trauma, prolonged standing, or bed rest?

A

Diabetes and smoking are stronger risk factors for PVD than they are even for heart disease.

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5
Q

Do your leg veins look bulging and crooked?

A

Varicose veins

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6
Q

Any change in temperature—what does coolness indicate?

A

occurs with PAD

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7
Q

Swelling in arms and legs:

Is swelling associated with pain, heat, redness, ulceration, hardened skin?

A

Edema is bilateral when the cause is generalized (heart failure) or unilateral when it is the result of a local obstruction or inflammation.

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8
Q

What range is the point scale when grading the force?

A

0 to 3

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9
Q

What does “full, bounding pulse” indicate?

A

hyperkinetic states like exercise, anxiety, fever, anemia, and hyperthyroidism

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10
Q

What does “Weak, thready pulse (1+)” indicate?

A

shock and PAD.

decreased cardiac output, peripheral arterial disease, aortic valve stenosis

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11
Q

What is the Allen test used for?

A

evaluate the adequacy of collateral circulation before cannulating the radial artery.

used to evaluate upper extremity arterial circulation

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12
Q

If pitting edema is present, what is the grading scale?

A

1 to 4

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13
Q

this Use of the Doppler stethoscope is a highly specific, noninvasive, and readily available way to determine the extent of peripheral arterial disease (PAD).

A

Ankle- brachial index

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14
Q

Use this device to detect a weak peripheral pulse, to monitor blood pressure in infants or children, or to measure a low blood pressure or blood pressure in a lower extremity.

A

Doppler ultrasonic probe

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15
Q

accumulation of protein-rich fluid in the interstitial spaces of the arm following breast surgery or treatment.

A

Lymphedema

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16
Q

May have cold, numbness, or pain along with pallor or cyanosis stage; then burning, throbbing pain, swelling along with rubor.

A

Raynaud’s Phenomenon

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17
Q

Nurse is assessing a patient with chief complaints of cold, numbness, and pain in her fingers, which abnormal finding do you suspect?

A

Raynaud’s Phenomenon

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18
Q

Nurse assess a patient and objective data includes unilateral swelling, measurement of arm volume, non pitting brawny edema, overlying skin indurated. What does the patient have?

A

Lymphedema

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19
Q

What kind of ulcer:
Diabetes hastens changes described with arterial ischemic ulcer, with generalized dysfunction in all arterial areas: peripheral, coronary, cerebral, retinal, and renal

A

Neuropathic ulcer

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20
Q

What type of ulcer?
Objective data includes: Firm, brawny edema; coarse, thickened skin; pulses normal; brown pigment discoloration; petechiae; dermatitis

A

Venous stasis ulcer

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21
Q

Subjective data includes:

Aching, heaviness in calf, easy fatigability, restless legs, burning, throbbing, cramping.

A

Superficial varicose veins

22
Q

Patient complains of aching pain when sitting or standing too long. Skin assessment findings of lower extremities including weeping and edema. Which ulcers might also be present?

A

Venous stasis ulcer

23
Q

What type of ulcer?
Coolness in only one foot or leg, pallor, dependent rubor; diminished pulses; systolic bruits; signs of malnutrition, distal gangrene.

A

Arterial ischemic ulcer

24
Q

Buildup of fatty plaques on intima (atherosclerosis) plus hardening, calcification of arterial wall (arteriosclerosis).
What does the patient have?

A

Arterial ischemic ulcer

25
Q

Patient states: aching pain in calf or lower leg, worse at end of day, worse when standing or sitting for a long time. What do you indicate the patient has?

A

Venous stasis ulcer

26
Q

You inspect the patient, and she states deep muscle pain in the calf and worsens when she elevates her leg. Objective findings include: Coolness in only one foot or leg, diminished pulses, bruits, and thick ridged nails. What do you determine the patient has?

A

Arterial ischemic ulcer

27
Q

Intermittent claudication, feels like “cramp,” “numbness and tingling,” “feeling of cold”

A

chronic arterial disease

28
Q

IT feels like throbbing; & associated symptoms: Six Ps: pain, pallor, pulselessness, paresthesia, poikilothermia (coldness), paralysis (indicates severe

A

acute arterial disease

29
Q

The relieving factors include “rest” and “dangling”?

A

chronic arterial disease

30
Q

patient complains of leg pain while walking on the treadmill. The nurse asks what relieves the pain and patient states “rest,” this is most likely due to arterial or venous disease?

A

arterial

31
Q

Patient complains of pain in lower extremities, you note pallor on inspection, and you are unable to palpate posterior tibialis or dorsalis pedis pulses. What is the significance of these findings?

A

acute arterial disease

32
Q

Patient comes in for assessment on the lower leg calf. He describes it feels like aching, tiredness, feeling of fullness. & associated symptoms of edema, weeping ulcers at the ankle

A

chronic venous

33
Q

moderate to intense; sharp deep muscle tender to touch; symptoms include: red, warm, swollen leg

A

acute venous

34
Q

What is the strongest risk factor for PAD?

A

Smoking

35
Q

Rhythm coupled, every other beat comes early, or normal beat followed by premature beat; conduction disturbance

A

pulsus bigeminus

36
Q

Rhythm regular, but force varies, with alternating beats of large and small amplitude

A

pulsus alternans

37
Q

Beats have weaker amplitude with inspiration, stronger with expiration

A

pulsus paradoxus

38
Q

Each pulse has two strong systolic peaks with a dip in between; best assessed at the carotid artery

A

pulsus biferiens

39
Q

deep vein is occluded by a thrombus, causing inflammation, blocked venous return, cyanosis, and edema.

A

DVT

40
Q

chronic gradual buildup of fatty streaks, fibroid plaque, calcification of the vessel wall, and thrombus formation.

A

occlusions, caused by athersclerosis

41
Q

What are the subjective and objective data for DVT?

A

S–> Sudden onset of intense, sharp, deep muscle pain.

O–> Increased warmth; swelling; redness; dependent cyanosis is mild or may be absent; tender to palpation

42
Q

a sac formed by dilation in the artery wall.

A

aneurysm

43
Q

What are the risk factors of arterial occulsions?

A

obesity, cigarette smoking, hypertension, diabetes mellitus, elevated serum cholesterol, sedentary lifestyle, and family history of hyperlipidemia

44
Q

What is the purpose of the profile sign?

A

to detect early clubbing

45
Q

Aneurysm increases rapidly in what factor?

A

men older than 55 years and women older than 70 years

46
Q

You are assessing cap refill of the feet and note 4 second filling time. These findings can indicate the presence of which of the following abnormalities?

A

vasoconstriction & decreased cardiac output

47
Q

A patient is complaining of numbness and tingling in her left foot, which pulse should you assess for circulation?

A

left dorsalis pedis

48
Q

The nurse is assessing circulation of the peripheral arms, which pulses should he assess?

A

radial

49
Q

a patient complains of sudden onset of intense, sharp, deep muscle pain. What finding would you indicate?

A

DVT

50
Q

These type of veins are dilated and torturous

A

Superficial varicose veins

51
Q

Describe the Water- hammer. “Corrigan” 3+

A

Greater than normal force, then collapses suddenly

Physical Assessment (6 decks)

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