NR 304 Final Exam
Arteries - answer active blood flow
veins - answer passive blood flow - do not have a pulse, returns to the heart via
movement through the skeletal muscles
femoral pulse site - answergroin
popliteal pulse site - answerback of knee
radial pulse site - answerLocated at the wrist on the thumb side
dorsalis pedis pulse site - answertop of foot
posterior tibial pulse site - answeron medial surface of ankle near ankle bone
ischemia - answerLack of blood supply, causes pain
necrosis - answerlong term lack of blood supply, tissue death
axillary lymph nodes - answerlocated under the arms in the armpits
cervical lymph nodes - answerlocated along the sides of the neck
Epitrochlear lymph nodes - answerEpitrochlear lymph nodes- drains from the hand and
forearm
inguinal lymph nodes - answerlocated in the inguinal (groin) area of the lower abdomen
Children and Lymph Nodes - answernodes can be enlarged with no pain/infection
Pregnancy and PV - answerdependent edema, varicose veins
peripheral artery disease - answerA form of peripheral vascular disease in which there
is partial or total blockage of an artery, usually one leading to a leg or arm. 50% of
cases are African Americans. RF: smoking, HTN, diabetes
intermittent claudication - answerwhen walking, muscle needs more O2 blood, and you
have any kind of occlusion, when walking pain is increased
Pulse Scale - answer0: absent
1+: weak
,2+: normal
3+: increased, full, bounding
Allen test - answerdetermining the patency of the radial and ulnar arteries by
compressing one artery site and observing return of skin color as evidence of patency of
the other artery, determine if radial artery has been damaged, press radial artery then
see if ulnar artery perfuses to hand
venous ulcers - answerbleed, medial malleolus
arterial (ischemic) ulcers - answerdoes not bleed, has a necrotic black crust, lateral
malleolus
neuropathic ulcer - answerdestroys nerve endings, burning pain/numbness
Edema Scale - answer• 1+ Mild pitting, slight indentation, no perceptible swelling of the
leg
• 2+ Moderate pitting, indentation, subsides rapidly
• 3+ Deep pitting, indentation remains for a short time, leg looks swollen
• 4+ Very deep pitting, indentation lasts a long time, leg is very swollen
Doppler ultrasound - answerdetermine location of pulse
Raynaud's disease - answerautoimmune, sporadic vasoconstriction then relaxation,
happens in hands/toes usually
Lymphadema - answerenlarged lymph nodes, hard edema
Varicose veins - answerabnormally swollen, twisted veins with defective valves; most
often seen in the legs
DVT - answerinflammatory process, swelling, redness, heat, pain, happens from
venastasis, pooling of blood in calf
-tachycardia, low grade temp
-women on birth control who smoke are at a higher risk, and also those who are
dehydrated since blood is more viscous
-Do not perform homan's sign test (flexing foot back)
anneurysm - answercan be born with or develop, serious with abdominal aorta/coronary
arteries/brain
Decreased Arterial Flow - answerdoesn't work well around gravity, blue then pallor
Decreased Venous Flow - answerbrown, using muscles improves
,What happens when valves of the veins do not work right - answeredema/varicose
veins
arterial insufficiency - answernot getting enough arterial blood flow = ischemic pain,
usually happens on one leg, leg appears shiny, hairless, red/blue then pallor, limb gets
cool, pain gets better when resting since the limb doesn't need as much O2 blood flow
(intermittent claudication), gravity works for it when legs are down, causes impotence in
males, can affect nails/toes
venous insufficiency - answerconstant, achy, fullness, pain. Pain gets better by moving.
When you stand/sit pain gets worse. Gravity works against when legs are down. Usually
happens on both legs, skin turns red/brown, starts below the knee to the ankle, skin is
scaly, can get slits in skin (weeping edema), there is no cure, no change in skin temp.
pulse - answerrhythm, rate, symmetry, amplitude/strength
arterial occlusion - answer-extreme coolness
-pain
-loss of sensation
-hair loss and skin changes
-pallor
-pulselessness
arterial insufficiency - answer-intermittent claudation (pain brought on by exercise and
relieved with rest)
-hair loss on toes and shiny skin
-impotence
-pain (gnawing, sharp or stabbing and increases with exercise, relieved with rest)
-decreased pulses
-rusty discoloration due to blood leaking out of vessel and difficulty being reabsorbed
-skin ulcers on pressure points, toes, and lateral malleoli
-necrosis
-bluish/red feet with dependence and pallor with elevation
-sensory and motor loss
-thickened, yellow toenails
-cool skin
venous insufficiency - answer-pitting edema due to fluid leaking into tissue due to
incompetent valves
-pain (aching or feeling of fullness and increases with standing/sitting and improves with
elevating legs or walking)
-varicosities may be present
-possible leg ulcers on medial malleoli
-normal temperature
-skin thickened with brown discoloration of ankles and flaky
, deep vein thrombosis - answer-edema (only on one leg)
-pain - no pain or sharp, intense pain/tenderness
-red skin area
-warmth
-mass
-low grade fever
-tachycardia
Peripheral Neuropathy - answer-burning skin
-numbness
-loss/decreased sensation
GERD - answer(pyrosis) - failure of pyloric valve, dont eat before bed or in middle of
night, dont lie down after eating for at least 30 mins
What causes peptic ulcers? - answerH. pylori - loves acid
Small Bowel - answer-small in diameter, huge in length 20ft
-where most digestion/breakdown ocurrs
-where enzymes from pancreas go
-most of absorption of nutrients ocurrs
large bowel - answer-shorter but larger diameter
-condense stool into formed stool (pulls water out)
-where you metabolize fats to absorb vit. D
E.coli - answer-essential bacteria that breaks down food in bowel
-if it is any other placer than the gut, it can kill you
-in wound = infection
-bladder = UTI
-lungs = dangerous pneumonia
C. Diff - answer-if you take antibiotics you kill e.coli in gut, so you have an overgrowth of
other microbes (importance of probiotics)
-when you kill all this bacteria you get C.diff - terrible bacteria that can kill you
-explosive diarrhea, highly contagious, gown/glove precautions, horrible smell
-can prevent C. Diff by probiotics - can have yogurt with live cultures or need probiotic
with 50 million bacteria
Peristalsis - answerInvoluntary waves of muscle contraction that keep food moving
along in one direction through the digestive system.
hyperactive peristalsis - answerdiarrhea
slowed peristalsis - answerconstipation, any type of narcotic slows peristalsis a lot and
can even cause a bowel obstruction/impaction
Arteries - answer active blood flow
veins - answer passive blood flow - do not have a pulse, returns to the heart via
movement through the skeletal muscles
femoral pulse site - answergroin
popliteal pulse site - answerback of knee
radial pulse site - answerLocated at the wrist on the thumb side
dorsalis pedis pulse site - answertop of foot
posterior tibial pulse site - answeron medial surface of ankle near ankle bone
ischemia - answerLack of blood supply, causes pain
necrosis - answerlong term lack of blood supply, tissue death
axillary lymph nodes - answerlocated under the arms in the armpits
cervical lymph nodes - answerlocated along the sides of the neck
Epitrochlear lymph nodes - answerEpitrochlear lymph nodes- drains from the hand and
forearm
inguinal lymph nodes - answerlocated in the inguinal (groin) area of the lower abdomen
Children and Lymph Nodes - answernodes can be enlarged with no pain/infection
Pregnancy and PV - answerdependent edema, varicose veins
peripheral artery disease - answerA form of peripheral vascular disease in which there
is partial or total blockage of an artery, usually one leading to a leg or arm. 50% of
cases are African Americans. RF: smoking, HTN, diabetes
intermittent claudication - answerwhen walking, muscle needs more O2 blood, and you
have any kind of occlusion, when walking pain is increased
Pulse Scale - answer0: absent
1+: weak
,2+: normal
3+: increased, full, bounding
Allen test - answerdetermining the patency of the radial and ulnar arteries by
compressing one artery site and observing return of skin color as evidence of patency of
the other artery, determine if radial artery has been damaged, press radial artery then
see if ulnar artery perfuses to hand
venous ulcers - answerbleed, medial malleolus
arterial (ischemic) ulcers - answerdoes not bleed, has a necrotic black crust, lateral
malleolus
neuropathic ulcer - answerdestroys nerve endings, burning pain/numbness
Edema Scale - answer• 1+ Mild pitting, slight indentation, no perceptible swelling of the
leg
• 2+ Moderate pitting, indentation, subsides rapidly
• 3+ Deep pitting, indentation remains for a short time, leg looks swollen
• 4+ Very deep pitting, indentation lasts a long time, leg is very swollen
Doppler ultrasound - answerdetermine location of pulse
Raynaud's disease - answerautoimmune, sporadic vasoconstriction then relaxation,
happens in hands/toes usually
Lymphadema - answerenlarged lymph nodes, hard edema
Varicose veins - answerabnormally swollen, twisted veins with defective valves; most
often seen in the legs
DVT - answerinflammatory process, swelling, redness, heat, pain, happens from
venastasis, pooling of blood in calf
-tachycardia, low grade temp
-women on birth control who smoke are at a higher risk, and also those who are
dehydrated since blood is more viscous
-Do not perform homan's sign test (flexing foot back)
anneurysm - answercan be born with or develop, serious with abdominal aorta/coronary
arteries/brain
Decreased Arterial Flow - answerdoesn't work well around gravity, blue then pallor
Decreased Venous Flow - answerbrown, using muscles improves
,What happens when valves of the veins do not work right - answeredema/varicose
veins
arterial insufficiency - answernot getting enough arterial blood flow = ischemic pain,
usually happens on one leg, leg appears shiny, hairless, red/blue then pallor, limb gets
cool, pain gets better when resting since the limb doesn't need as much O2 blood flow
(intermittent claudication), gravity works for it when legs are down, causes impotence in
males, can affect nails/toes
venous insufficiency - answerconstant, achy, fullness, pain. Pain gets better by moving.
When you stand/sit pain gets worse. Gravity works against when legs are down. Usually
happens on both legs, skin turns red/brown, starts below the knee to the ankle, skin is
scaly, can get slits in skin (weeping edema), there is no cure, no change in skin temp.
pulse - answerrhythm, rate, symmetry, amplitude/strength
arterial occlusion - answer-extreme coolness
-pain
-loss of sensation
-hair loss and skin changes
-pallor
-pulselessness
arterial insufficiency - answer-intermittent claudation (pain brought on by exercise and
relieved with rest)
-hair loss on toes and shiny skin
-impotence
-pain (gnawing, sharp or stabbing and increases with exercise, relieved with rest)
-decreased pulses
-rusty discoloration due to blood leaking out of vessel and difficulty being reabsorbed
-skin ulcers on pressure points, toes, and lateral malleoli
-necrosis
-bluish/red feet with dependence and pallor with elevation
-sensory and motor loss
-thickened, yellow toenails
-cool skin
venous insufficiency - answer-pitting edema due to fluid leaking into tissue due to
incompetent valves
-pain (aching or feeling of fullness and increases with standing/sitting and improves with
elevating legs or walking)
-varicosities may be present
-possible leg ulcers on medial malleoli
-normal temperature
-skin thickened with brown discoloration of ankles and flaky
, deep vein thrombosis - answer-edema (only on one leg)
-pain - no pain or sharp, intense pain/tenderness
-red skin area
-warmth
-mass
-low grade fever
-tachycardia
Peripheral Neuropathy - answer-burning skin
-numbness
-loss/decreased sensation
GERD - answer(pyrosis) - failure of pyloric valve, dont eat before bed or in middle of
night, dont lie down after eating for at least 30 mins
What causes peptic ulcers? - answerH. pylori - loves acid
Small Bowel - answer-small in diameter, huge in length 20ft
-where most digestion/breakdown ocurrs
-where enzymes from pancreas go
-most of absorption of nutrients ocurrs
large bowel - answer-shorter but larger diameter
-condense stool into formed stool (pulls water out)
-where you metabolize fats to absorb vit. D
E.coli - answer-essential bacteria that breaks down food in bowel
-if it is any other placer than the gut, it can kill you
-in wound = infection
-bladder = UTI
-lungs = dangerous pneumonia
C. Diff - answer-if you take antibiotics you kill e.coli in gut, so you have an overgrowth of
other microbes (importance of probiotics)
-when you kill all this bacteria you get C.diff - terrible bacteria that can kill you
-explosive diarrhea, highly contagious, gown/glove precautions, horrible smell
-can prevent C. Diff by probiotics - can have yogurt with live cultures or need probiotic
with 50 million bacteria
Peristalsis - answerInvoluntary waves of muscle contraction that keep food moving
along in one direction through the digestive system.
hyperactive peristalsis - answerdiarrhea
slowed peristalsis - answerconstipation, any type of narcotic slows peristalsis a lot and
can even cause a bowel obstruction/impaction
