NR 200 Peripheral Vascular Exam 30 Questions with Answers,100% CORRECT

NR 200 Peripheral Vascular Exam 30 Questions with Answers Neck Vessel IPPA - CORRECT ANSWER Inspection - General for pulsation, location - Jugular Venous Pressure/Jugular Venous Distention (JVD) Palpation - C ...

NR 200 Peripheral Vascular Exam 30 Questions with Answers Neck Vessel IPPA - CORRECT ANSWER Inspection - General for pulsation, location - Jugular Venous Pressure/Jugular Venous Distention (JVD) Palpation - Carotid Pulse - Hepatojugular Reflex (if necessary) Percussion (none) Auscultation - Jugular (none) - Carotid (three locations) Jugular Venous Pressure - CORRECT ANSWER An estimate of central venous pressure Total number should be 5-10 Anything greater than ten is considered JVD (jugular venous distention) Neck Vessel Palpation/Percussion - CORRECT ANSWER Carotid - Pulsation present at +2 - One side at a time - Lower 1/3 of the neck only - Coincides with ventricular systole Jugular Vein - Should not have a pulse - Hepatojugular Reflex can be utilized to locate the jugular vein for the measurement of Jugular venous pressure No percussion of either vessel Carotid Palpation - CORRECT ANSWER Hepatojugular Reflex - CORRECT ANSWER A test in which the examiner presses gently on the liver to increase venous return. Pulsation increases for a few beats and then returns to normal less than 3 cm above the sternal angle Peripheral Vascular Palpation - CORRECT ANSWER Pulse location/grading Edema Turgor Temperature *Homan's sign* (controversial, not advised in most areas anymore, but may still see in some centers and in some textbooks) Allen test Manual Compression Test Capillary Refill Palpable Peripheral Pulses - CORRECT ANSWER Brachial Pulse - CORRECT ANSWER beating or throbbing felt over the brachial artery, usually palpated in the antecubital space Radial Pulse - CORRECT ANSWER beating or throbbing felt over the radial artery, usually palpated over the groove along the thumb side of the inner wrist Femoral Pulse - CORRECT ANSWER pulse of the femoral artery felt in the groin Popliteal Pulse - CORRECT ANSWER Pulse felt at the back of either knee; lower part of femoral artery Posterior Tibial pulse - CORRECT ANSWER The pulse just behind the medial malleolus of the ankle Dorsalis Pedis Pulse - CORRECT ANSWER pulse located on top of the foot Arterial Pulse Evaluation - CORRECT ANSWER Pulse deficit: difference between the apical rate and the peripheral Weak, thready pulse=low cardiac output Bounding pulse=hyperkinetic states Pulsus alternans Pulsus paradoxus Edema - CORRECT ANSWER Usually not detectable until interstitial fluid (fluid between the cells) is 30% above normal - Bilateral -Unilateral - Anasarca Nonpitting or graded 0 (absent) to +4 (deep, visible, mark remains) Bilateral Edema - CORRECT ANSWER Heart failure Chronic venous insufficiency Unilateral Edema - CORRECT ANSWER Venous blockage Lymph blockage Infectious process Anasarca Edema - CORRECT ANSWER Generalized edema Seen in: severe heart failure, cirrhosis/liver failure, nephrotic syndrome Skin Turgor - CORRECT ANSWER Lift fold of skin between thumb, finger Best location is over sternum or clavicle Expected response is "brisk recoil" Decreased (tenting)=dehydration - The skin fold slowly returns to original position Allen test - CORRECT ANSWER will turn white, when released will turn back pink - fails if not pinked up Cannulation of the Radial Artery - CORRECT ANSWER Manual Compression Test - CORRECT ANSWER Test for varicose Vein No varicose vein: no wave felt Varicose Vein: wave felt Venous Problem vs. Arterial Problem - CORRECT ANSWER Diagnostic Testing is often needed, which is ordered by a practitioner, however, there are definitely telltale signs of both Never "intervene" until an actual diagnosis is confirmed and there are physician orders The wrong intervention can make things much worse Thrombophlebitis - CORRECT ANSWER Superficial venous clot Rubor Heat Calf enlargement May have pain to the calf area close to surface Deep Vein Thrombosis (DVT) - CORRECT ANSWER Deep clot Often asymptomatic Check calf sizes daily, may be only sign and very subtle Patient will have risk factors -subtle kill Venous Insufficiency - CORRECT ANSWER Normal pulses Normal color in other areas Edema Brown pigment around the ankles Ulcers medial malleolus changes skin color -creates ulcers The Four "P" Continuum of Acute Arterial Disease = arterial clot - CORRECT ANSWER Pain Pallor Poikilothermia Pulselessness (4 Ps) Arterial Insufficiency - CORRECT ANSWER Color: dusky dependent, pale elevated Temperature: cool Skin: shiny, taut, hairless Capillary refill: greater than 2 seconds Nails: thick, positive profile sign Decreased sensation Potentially decreased motor ability Chronic Arterial Occlusive Disease=Raynaud's Disease - CORRECT ANSWER Intermittent arteriolar vasoconstriction that causes coolness, pallor, and pain of the fingers and/or toes Can result in ulcerations and gangrene (rare) Avoid extremes in temperature and stress NO SMOKING Documentation example (healthy) - CORRECT ANSWER Skin warm, dry, intact. Turgor with brisk recoil. All peripheral pulses palpable and equal bilaterally at +2. No edema noted. Carotid +2, no bruits auscultated. JVP estimated to be +3.