*NURSING > Study Notes > NR-304 Physical Assessment Study Guide – Exam 1[rated A+] (All)

NR-304 Physical Assessment Study Guide – Exam 1[rated A+]

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 There is an increased pulse rate with fever  Lymphatic system o At birth it is well developed o Grows rapidly until 10 to 11 years of age o Lymph nodes are relatively large and often palpab... le Pregnant (BP changes throughout, varicosities)  Need to monitor blood pressure throughout pregnancy o Vasodiation due to hormone change o There is hyotension during the third trimester o Preeclampsia may result in hypertension  Preeclampsia is when a pregnant woman develops high blood pressure and protein in the urine after the 20th week (late 2nd or 3rd trimester) of pregnancy.  Varicosities in the legs and the rectal area o This is because the uterus obstructs the iliac veins and inferior vena cava  This causes an increase in the venous pressures of the lower legs. Geriatric (Systolic BP & pulse changes; enlargement of calf veins; lymph nodes)  There is an increase in blood pressure, especially the systolic o Arteriosclerosis - peripheral blood vessels more rigid  Decrease in pulse with some irregularities  Progressive enlargement of calf veins o You have an increased risk for deep vein thrombosis (DVT)  Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. o possible pulmonary embolism (PE) 3  Pulmonary embolism is when one or more pulmonary arteries in your lungs become blocked. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the legs o DVT and PE cause prolonged bed rest, immobility, and CHF o Low-dose anticoagulation (ASA 80-160mg) reduces risk  There is a loss of lymph tissue o There are less lymph nodes and a decrease in size of the nodes Subjective Leg pain or cramps – differences between acute and chronic arterial and venous pain (see handout) Claudication distance; 6 Ps; Leriche syndrome; risk factors/conditions  Claudication distance – number of blocks or stairs climbed to produce pain; relieved by rest  To relieve arterial pain you dangle your legs over a ledge  To relieve venous pain raise your legs up  Night leg pain is common with aging  Restless leg syndrome, muscle cramping or rest pain associated with vascular disease. In addition, some patients suffer from restless leg syndrome pain at night, worsening with rest and relief with motion of the legs. One diagnoses restless leg syndrome by history and physical examination  Nocturnal cramping is much more common in older patients. As noted earlier, nocturnal cramping is typically associated with dehydration, low calcium, low sodium, low potassium or low magnesium, which one may assess by standard laboratory studies and treat by appropriate supplement therapy.  Leriche's syndrome is the term used for a group of symptoms that are caused by a certain type of peripheral arterial disease of the legs. In Leriche's syndrome, blood flow in the aorta is blocked in the stomach area. This blocks blood flow to the legs. In men, blood flow to the penis is also blocked. [Show More]

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