exam 2

Question 1

Peripheral pulses

Answer 1

-Popiletal: Behind knee, difficult to palpate
-Posterior Tibial: Above ankle, difficult
-Dorsalis Pedis: top of foot, easy

Question 2

Pulse Grading & descriptions

Answer 2

0: absent
1: weak, thready (low BP)
2: slightly diminshed
3: Normal
4: Bounding (HTN, preg)

Question 3

Why palpate skin

Answer 3

-Temp: should be warm (can indicate low BF is cold and fever/DVT if hot)
-Moisture: should be dry
-Diaphretic: sweating (xeroxes: dry/itchy) (turgor for dehydration)
-Edema: fluid in interstitial space

Question 4

Arterial Insuffieciencies cause

Answer 4

insuffiecient blood supply causing ischema

Question 5

arterial insuf risks

Answer 5

1. vascular insuf
2. uncontrolled blood sugar in diabetes melicus
3. limited joint mobility
4. improper footware

Question 6

arterial insufficient charateristics

Answer 6

-punched out appearance
-smooth wound edges
-pain relieved by dangling
-cool, pale, shiny, thin skin
-minimal hair growth and wound drainage

Question 7

venous insufficient

Answer 7

pooling of blood causing increased pressure in veins

Question 8

venous insufficient risks

Answer 8

1. varicose veins
2. DVT
3. incompetent valves
4. muscle weakness in legs
5. immobility
6. pregnancy

Question 9

venous insuff characteristics

Answer 9

-shallow and superficial
-irregular shape
-pain from edema, phelbitis, or other infection
-usually in lower legs/ankles (pain relief by elevating)
-Dependent rubor (discolortion)

Question 10

PE (Pulmonary Embolism S&S)

Answer 10

-Dizzy, cough, heart palpitations, leg pain/swelling, sharp chest pain, SOB
-Treat w/ blood thinners

Question 11

What is one of the causes of a PE?

Answer 11

DVT: pain, swelling, ache, warm/red skin

Question 12

solar lentigines

Answer 12

flat brown spots due to UV rays

Question 13

actinic keratoses

Answer 13

Pre-cancerous
Silvery, scaly plaque

Question 14

seborrheic keratoses

Answer 14

Dark, greasy, stuck on, warty
Begin; sun exposure

Question 15

melanoma

Answer 15

Fast growing
Cancerous, deadly

Question 16

discoloration

Answer 16

1. cyanosis: 2° to decreased tissue perfusion, hypoxemia, shock, chronic bronchitis, heart failure, lips 1st things
2. erythema: 2° to hyperemia (excess blood) (blood rushes to certain spot)
   fever, inflammation, blushing, allergic reaction, venous stasis, CO poisoning

Question 17

clubbing

Answer 17

caused by hypoxemia
normal angle is 60-180, if above 180 it’s clubbed

Question 18

changes in elderly

Answer 18

1. low elasticity/vascularity
2. thin skin
3. dry skin (poor turgor)
4. loss of fat
5. loss of collagen (wrinkles)
6. decrease sweat glands= high stroke risk

Question 19

how do we compare skin?

Answer 19

***Always compare side-to-side

Question 20

What is a murmur?

Answer 20

• blowing/swooshing sound that happens due to difference in pressure from one side of valve to other
  -Narrowed Valve: stenosis
  -Leaky Valve: regurgitation

Question 21

Grades of mummurs (thrill or no thrill)

Answer 21

I/VI = Barely audible
*II/VI = Easily audible but faint
*III/VI = Moderately loud, easy to hear, & without thrill
*IV/VI = Loud with a thrill
*V/VI = Very loud with thrill
*VI/VI = Very loud with thrill, heard with stethoscope lifted off chest wall

Question 22

Which valves/vessels cause murmurs

Question 23

slide 8/9 blakeman

Question 24

APETM

Question 25

Early signs of HF

Answer 25

-edema
-JVD

Question 26

Apical pulse assessment, abnormalities in apical pulse
*See p. 150 in pocket guide regarding abnormalities
*(↑force, ↑duration: what might that mean?)

Question 27

slide 16 heart sounds

Question 28

Example of ventricular gallop

Question 29

atrial gallop (difference)

Question 30

Orthopnea, dypsnea

Question 31

Thrill: definition, what causes it, is it
normal (slide 28 of lecture)

Question 32

Bruit: what is it/what causes it

Question 33

Angina: clincial presentation

Question 34

What causes s1/s2 sounds?