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Nurs 228 Chapter 21
Health Assessment in Nursing: Peripheral Vascular
| Question | Answer |
|---|---|
| What is intermittent claudication, are what is it manifested by? | Acute leg cramps (typically in calf) on exertion relieved by short periods of rest. It it considered a sign of arterial disease. |
| T/F Waking up with leg cramps would more likely be a sign of venous disease than arterial. | False; cramping while sleeping is a sign of arterial occlusion disease. |
| When would leg pain be a sign of a venous disease? | When is occurs after long periods of standing. |
| When doing a visual inspection of skin, what are the S/S of arterial deficiency? | Cold, pale, clammy, thin, and / or shiny skin. Hair loss. |
| When doing a visual inspection of skin, what are the S/S of venous deficiency? | Warm skin, possibly red-blue color, brown pigmentation around ankles. thickened and tough. |
| What could peripheral edema be a S/S of? | Either an obstruction of lymphatic flow, or venous insufficiency (many causes). (p. 388) |
| T/F As lymphedema (LE) worsens, one's edema becomes less and less likely to have pitting. | True: with LE, stage 1, and possibly stage 2 have some pitting, also swelling can be relieved w/ elevation. In stage 3 no pitting will be present, and elevating will be ineffective. |
| What are characteristics of edema associated lymphedema? | Generally non-pitting, bilateral (not always), w/o skin ulceration or pigmentation. |
| What are characteristics of edema associated with venous insufficiency? | Usually pitting, unilateral (not always), w/ ulcers and pigmentation |
| What does the Allen test look for? | Patency of radial and / or ulnar arteries; client makes a fist while assessor occludes artery, then the color is observed for recovery time (S/B 3-5 seconds) |
| Pitting edema would be a result of what kind of SYSTEMIC issues? | CHF, hepatic cirrhosis, renal failure, etc. |
| Pitting edema would likely be a result of what kind of LOCAL issues? | Venous stasis; could be from obstruction, long periods of standing, surgical procedure, etc. |
| What does dependent rumor mean, and what is it manifested by? | Dependent refers to lower extremity being affected by gravity (not elevated), and rubor is redness related to inflammation. |
| What does dependent cyanosis mean, and what is it manifested by? | Dependent refers to lower extremity being affected by gravity (not elevated), and cyanotic means blue in color. |
| What is thrombophlebitis? | Superficial venous thrombosis (vs. deep vein thrombosis) causing swelling / inflammation. |
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scottheadrick
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