NUR 6512 FINAL EXAM WITH CORRECT QUESTIONS AND ANSWERS

NUR 6512 FINAL EXAM WITH CORRECT QUESTIONS AND ANSWERS


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