NR304 EXAM 1 LATEST 2023 ACTUAL EXAM

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Remain alert for generalized edema, plus hypertension, which suggests preeclampsia, a dangerous obstretric condition Expect diffuse bilateral pitting edema in lower extremities, especially at the end of the day & into 3rd trimester Nearly 80% of pregnant women have some peripheral edema because of increased water retention Varicose veins in legs also common in 3rd trimester

NR304 EXAM 1 LATEST 2023 ACTUAL EXAM

COMPLETE EXAM QUESTIONS AND CORRECT

DETAILED ANSWERS (VERIFIED ANSWERS)

|ALREADY GRADED A+

• Signs of DVT (clinical manifestations) – 2 questions

○ Unilateral swelling of the affected leg ○ Tenderness to severe pain ○ Possibly warmth & redness (accompanying inflammation) ○ Possibly superficial venous dilation

• Effects of smoking

○ Bilateral cool feet ○ Strongest risk for peripheral vascular disease ○ Risk for arterial ulcers ○ Risk for atherosclerosis

• Assessing peripheral blood flow

○ Modified Allen Test → → → ○ Doppler ○ Capillary refill

• Peripheral vascular system assessment for different age groups

○ Infants & Children (normal vs. abnormal findings)

Transient acrocyanosis & skin mottling at birth Pulse force should be normal & symmetric Force should be same in upper & lower extremities Weak pulses occur with vasoconstriction of diminished CO Full, bounding pulses occur with patent ductus arteriosus from the large left-to-right shunt Diminished or absent femoral pulses but normal upper-extremity pulses suggest coarctation of aorta Palpable lymph nodes occur often (healthy) They are small, firm (shotty), mobile, nontender May be sequelae of past infections Vaccinations can produce local lymphadenopathy Note characteristics of palpable nodes (local/generalized) Enlarged, warm, tender nodes indicate current infection Look for source of infection ○ Pregnanacy (normal vs. abnormal findings)

○ Older adults (normal findings) ■ The dorsalis pedis & posterior tibial pulses may become more difficult to find ■ Trophic changes associated with arterial insufficiency 1 / 3

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● Thin, shiny skin ● Thick-ridged nails ● Loss of hair on legs

• Why/how would you use a Doppler?

○ Why?■ Doppler flow studies can ensure collateral flow that is quantifiable 2 / 3

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■ To detect a weak peripheral pulse ■ To monitor BP in infants or children ■ To measure a low BP or BP in a lower extremity ○ How?■ Probe magnifies sounds from the heart & blood vessels ■ Position the person supine, with legs externally rotated so you can reach medial ankles easily ■ Place a drop of coupling gel on the end of the handheld transducer ■ Place transducer over a pulse site at about a 90-degree angle ■ Apply very light pressure & located the pulse site by the swishing, whooshing sound

• Signs of PAD

○ Ankle-Brachial Index (ABI) of 0.90 or less ■ 0.90 - 0.71 → mild PAD ■ 0.70 - 0.41 → moderate PAD ■ 0.40 - 0.30 → severe PAD ○ Pain Profiles ■ Location ● Deep muscle pain (usually in calf, but may be lower leg or dorsum of foot) ■ Character ● Intermittent claudication (feels like

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