MCCN SDAP X - Pathophysiology Exam 4 Blueprint With
Complete Solutions (A+)
Describes a vascular arterial ulcer. ANSWER Pale ulcers are there due to lack of arterial
blood flow
Non bleeding obstructed
Non healing need blood supply to heal a wound
Painful unless neuropathy is present ischemic nerves conduct poorly if at all
Can become infected - short term keep sterile & uninfected
Explains the S/S of arterial ulcer. - ANSWER Ulcers are caused by poor circulation,
arteriosclerosis or venous insufficiency, and may or may not be painful. The patient
generally has a swollen leg and may feel burning or itching. There may also be a rash,
redness, brown discoloration or dry, scaly skin.
Varicose Veins, describes:
development mechanisms, manifestations, diagnosis, and treatment-ANSWER Aging
may cause your veins to lose their elasticity and stretch. The veins also may lead to the
venous valves weakening and preventing blood that should be circulating towards your
heart.
The blood pools in your veins, and the veins become enlarged and varicose. The veins
appear blue because they contain deoxygenated blood, which is on its way back to the
lungs to be re-oxygenated.
Physical examination to determine the severity of the varicose veins and an ultrasound
to check on functionality.
Treatment options include wearing compression stockings, exercise, or procedures to
close or remove the affected veins.
,Defines chronic venous insufficiency. - ANSWER Disease of the LE, manifested by
venous hypertension representing a sustained increase in venous blood pressures.
Describes the volume and pressure principle as it relates to varicose veins and venous
insufficiency. - ANSWER Increased volume and pressure in the blood vessels can place
strain on the valves in the veins in the legs; this causes an impairment of the ability of
the veins in the legs to return blood to the heart causing outpouchings and valve defects
in the veins of the LE; this leads to varicose veins and venous insifficiency.
Lists risk factors for varicose veins - ANSWER People who are over 50, women who
have been pregnant are at a higher risk due to the venous stasis.
Describes the etiology for signs and symptoms for varicose veins - ANSWER Veins
enlarge due to incompetency of valves which inhibits the force of contraction in the
muscles with the direction of blood flow.
Discusses stasis dermatitis and stasis ulcers as complications of chronic venous
insufficiency. - ANSWER In advanced venous insufficiency, the impaired tissue nutrition
causes stasis dermatitis and the development of stasis ulcers. Minor injury leads to
ulcers that are difficult to heal, usually located medially over the ankle and lower leg.
Distinguishes pericardial pain from symptoms of angina or MI. - ANSWER Pericardial
pain is due to inflammation, not ischemia. It is exacerbated by anything that increases
venous return or increasing pressure in the thorax, such as deep breathing, coughing,
or swallowing.
Uses CLASS ACT to describe the pain of pericarditis. - ANSWER C - Sharp, knife-like
chest pain
L - retrosternal or referred pain
A - deep breathing, coughing, swallowing, anything that increases venous return or
thoracic pressure
S - severe pain
, T - Abrupt onset
Discusses the etiologies of:
pericarditis
pericardial friction rub. - ANSWER Pericarditis: Viral is most common but also could be
bacterial, trauma, autoimmune, or radiation
Pericardial friction rub: Layers of pericardium rub together when inflamed (like
sandpaper) can hear in stethoscope
Recognizes the triad of S/S associated with pericarditis. - ANSWER Chest pain
EKG changes
Friction rub
Discussion of NSAID use in the treatment of pericarditis - ANSWER Some individuals
with mild symptoms will self-medicate with NSAIDS to reduce inflammation and this is
often sufficient
Definition of pericardial effusion - ANSWER Fluid in the pericardial space
Identification of S/S related to pericardial effusion - ANSWER Dizziness, shortness of
breath
Explanation of how heart sounds may be different - ANSWER Muffled or distant heart
sounds because of fluid surrounding heart
Identifies the role of EKG or chest CT Scan in the diagnosis of pericardial effusion. -
ANSWER Abnormal EKG, CT scan shows fluid around the heart
Describes the effect of rapidly developing effusion on the cardiac output. - ANSWER
Decreases cardiac output due to pressure from effusion --> cardiac tamponade
Complete Solutions (A+)
Describes a vascular arterial ulcer. ANSWER Pale ulcers are there due to lack of arterial
blood flow
Non bleeding obstructed
Non healing need blood supply to heal a wound
Painful unless neuropathy is present ischemic nerves conduct poorly if at all
Can become infected - short term keep sterile & uninfected
Explains the S/S of arterial ulcer. - ANSWER Ulcers are caused by poor circulation,
arteriosclerosis or venous insufficiency, and may or may not be painful. The patient
generally has a swollen leg and may feel burning or itching. There may also be a rash,
redness, brown discoloration or dry, scaly skin.
Varicose Veins, describes:
development mechanisms, manifestations, diagnosis, and treatment-ANSWER Aging
may cause your veins to lose their elasticity and stretch. The veins also may lead to the
venous valves weakening and preventing blood that should be circulating towards your
heart.
The blood pools in your veins, and the veins become enlarged and varicose. The veins
appear blue because they contain deoxygenated blood, which is on its way back to the
lungs to be re-oxygenated.
Physical examination to determine the severity of the varicose veins and an ultrasound
to check on functionality.
Treatment options include wearing compression stockings, exercise, or procedures to
close or remove the affected veins.
,Defines chronic venous insufficiency. - ANSWER Disease of the LE, manifested by
venous hypertension representing a sustained increase in venous blood pressures.
Describes the volume and pressure principle as it relates to varicose veins and venous
insufficiency. - ANSWER Increased volume and pressure in the blood vessels can place
strain on the valves in the veins in the legs; this causes an impairment of the ability of
the veins in the legs to return blood to the heart causing outpouchings and valve defects
in the veins of the LE; this leads to varicose veins and venous insifficiency.
Lists risk factors for varicose veins - ANSWER People who are over 50, women who
have been pregnant are at a higher risk due to the venous stasis.
Describes the etiology for signs and symptoms for varicose veins - ANSWER Veins
enlarge due to incompetency of valves which inhibits the force of contraction in the
muscles with the direction of blood flow.
Discusses stasis dermatitis and stasis ulcers as complications of chronic venous
insufficiency. - ANSWER In advanced venous insufficiency, the impaired tissue nutrition
causes stasis dermatitis and the development of stasis ulcers. Minor injury leads to
ulcers that are difficult to heal, usually located medially over the ankle and lower leg.
Distinguishes pericardial pain from symptoms of angina or MI. - ANSWER Pericardial
pain is due to inflammation, not ischemia. It is exacerbated by anything that increases
venous return or increasing pressure in the thorax, such as deep breathing, coughing,
or swallowing.
Uses CLASS ACT to describe the pain of pericarditis. - ANSWER C - Sharp, knife-like
chest pain
L - retrosternal or referred pain
A - deep breathing, coughing, swallowing, anything that increases venous return or
thoracic pressure
S - severe pain
, T - Abrupt onset
Discusses the etiologies of:
pericarditis
pericardial friction rub. - ANSWER Pericarditis: Viral is most common but also could be
bacterial, trauma, autoimmune, or radiation
Pericardial friction rub: Layers of pericardium rub together when inflamed (like
sandpaper) can hear in stethoscope
Recognizes the triad of S/S associated with pericarditis. - ANSWER Chest pain
EKG changes
Friction rub
Discussion of NSAID use in the treatment of pericarditis - ANSWER Some individuals
with mild symptoms will self-medicate with NSAIDS to reduce inflammation and this is
often sufficient
Definition of pericardial effusion - ANSWER Fluid in the pericardial space
Identification of S/S related to pericardial effusion - ANSWER Dizziness, shortness of
breath
Explanation of how heart sounds may be different - ANSWER Muffled or distant heart
sounds because of fluid surrounding heart
Identifies the role of EKG or chest CT Scan in the diagnosis of pericardial effusion. -
ANSWER Abnormal EKG, CT scan shows fluid around the heart
Describes the effect of rapidly developing effusion on the cardiac output. - ANSWER
Decreases cardiac output due to pressure from effusion --> cardiac tamponade
