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Nur 2100 (Exam 3)
Terms in this set (98)
hemodynamic (blood flow) changes in aging adults
increase in systolic BP
LV wall thickens
diastolic BP decreases
what happens in a dysrhythmias?
Presence of supraventricular and ventricular dysrhythmias increase
what is common in dysrhythmias?
ectopic (abnormal) beats
what happens to the myocardium in dysrhythmias?
myocardium is thicker and less compliant
older patients are much more likely to have _____ _____
what is pulse pressure?
systolic minus diastolic
if HR is > 60, it could be a sign of ___
what happens to the peripheral bv as you age?
they become more rigid
arteriosclerosis causes what to rise?
_____ is under-diagnosed and under treated, yet it is a large cause of morbidity and mortality in the US
an ABNORMAL finding in older adults
S/S of atelectasis
Decrease or absent sounds
Tracheal deviation towards affected side
What symptoms does patient A have that are related to atelectasis? (select all that apply)
B) 18 rpm
C) Pulse of 110 per minute
D) Tenderness on one side of chest
E) Smokes a pack a day
A) Cough (trying to get something out of lungs)
C) Pulse of 110 per minute (expect a high pulse)
D) Tenderness on one side of chest
E) Smokes a pack a day (this causes atelectasis)
S&S of chronic venous insufficiency
skin color changes on affected leg
What causes vericose veins?
valve in vein does not prevent back flow
who is at risk for vericose veins?
standing a lot
sitting a lot
who is at risk for an acute venous DVT?
people not anti-coagulating
another term for crackles
When assessing the lungs of 67-year-old women, the nurse hears fine crackles when auscultating. Which of the following is true of fine crackles heard in the lungs? Select all that apply.
A. They are adventitious sounds due to secretions of alveoli that are not fully aerated
B. Can be described as inspiratory versus expiratory, loudness, pitch, and location on the chest wall.
C. They are continuous popping sounds heard over expiration.
D. Are heard only in the periphery and are usually in dependent portions of the lungs
E. Are pathologic
The nurse is preforming an assessment on the lungs and thorax of an 86-year-old male. Which one of the following processes isn't a normal finding in the aging process?
A.) Decreased Vital Capacity
B.) Lungs that are more Rigid and Harder to Inflate
C.) Unequal Chest Expansion
D.) Dyspnea with exertion beyond their normal workload
S/S of dyspnea
nasal flaring (more common in kids)
what happens to the costal cartilages of an aging adult?
they calcify and become less mobile
what happens to the respiratory muscles in an aging adult?
what happens to vital capacity in an aging adult?
maximum air that a person can expel from lungs after first filling of lungs to maximum
what will happen to the residual volume in an aging adult?
amount of air remaining in lungs after the most forceful expiration
what will happen to the lower lungs in an aging adult?
sound will become diminished
s/s of pneumonia
pleuritic chest pain
hemoptysis (blood tinged sputum)
What causes pneumonia?
CO2 and bacteria take up space in the lungs
low-pitched, clear, hollow sound that predominates in healthy lung tissue in the adult
makes platelets slippery
how ofter should BP be checked by a health professional?
every 3 months
52 years x 2 packs =
104 pack hx
example of high pitched (sibilant) wheezing
example of low pitched (sonorous rhonchi) wheezing
Given patient's history and diagnosis, which of the following will she possibly experience in the future? Select all that apply
A) Unintended weight loss (due to patient not wanting to eat; takes too much energy)
B) Unintended weight gain
C) Heart disease (ability to breathe decrease)
what can cause kyphosis?
who is at greater risk for developing kyphosis?
women after menopause
what should women who have gone through menopause take?
vit. d (helps absorb the calcium)
an outward curvature of the thoracic spine
closure of AV valves
Where is S1 heard the loudest?
apex of the heart
closing of semilunar valves
S2 is best heard where?
base of heart
S2 is the end of ____
normal carotid pulse sound
brisk up stroke and down stroke
behind the knee
posterior tibial pulse
should feel tapping in the groove between the malleolus and the Achilles tendon
dorsalis pedis pulse
lateral to and parallel the the extensor tendon of the big toe
Normal D-dimer level
small protein fragment of fibrin degradation, and the measurement of circulating D-dimer
D-dimer levels can help diagnose ___ and ____
normal PT values
what does PT assess?
measures how long it takes for plasma to clot
what does PTT measure?
the time it takes for your blood to clot
normal PTT values
what does INR measure?
how well your blood clots
normal INR value
Normal RBC count
Normal Hgb levels
Normal troponin level
normal Ck-MB level
reasons for low Ck-MB level
reasons for low Troponin level
reasons for low Hgb
reasons for low RBC count
bone marrow failure
sudden sharp stabbing pain relived often by sitting or leaning forward and worsens when lying down or with inspirations
S/S of pericarditis
cardiac-like chest pain with exertion
in chest region
S/S of pulmonary hypertension
lower extremity edema
S/S of COPD
clubbing of nails
do you want a pulse ox of 100%?
What is an assessment finding that may suggest the patient has COPD? Select all the apply.
A. Clubbing of the nails (profile sign >160 degrees; squishy and white nails)
B. Sores of the mouth
C. Hair loss
D. Unexplained weight loss
E. Tripod Position
Causes of arterial ulcer
an open wound on the lower legs or feet caused by poor arterial blood flow
wound that results from inadequate return of blood from an extremity
pressure like pain lasting 3-5 minutes precipitated by activity and often resolved with rest and/or nitroglycerin
acute coronary syndrome
Parts of the sternum
what does the angle of louis connect?
manibrium and body of sternum
where is the angle of louis located?
where is the costal margin located?
bottom of rib cage
Vertebra prominence - C7
Inferior angle of scapula (T7/8)
start listening above clavicles and continue listening all the way down to the costal angle
Normal A-P diameter
AP diameter of patient with COPD
1:1 (barrel chest)
Palpable vibration felt in the chest wall
CAN TOUCH, DO NOT AUSCLITATE
Ask patient to say a word. Should make same vibration on both sides
How many sets of ribs are there?
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