NUR 6512 FINAL EXAM LATEST UPDATED 2024
Varicosity Findings In Pregnant Women - With increasing cardiac output beginning in
the 1st trimester, the
... [Show More] 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 [Show Less]