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statistics for nursing a practical approach
Fundamentals Of Nursing: Standards And Practices 2nd Edition Sue C. DeLaune, Patricia Kelly Ladner - Solutions
3. Describe common invasive and noninvasive diagnostic procedures.
2. Describe the common specimen collection methods.
1. Discuss the relevant client teaching guidelines for the care of the client before, during, and after diagnostic testing.
6. Are bronchial breath sounds upon auscultation of the lung periphery normal?
5. What normal sounds should you hear when you percuss the posterior aspect of the apex of the right lung?
4. What hemodynamic function is compromised when the lips and nail beds have a bluish discoloration?
3. Mrs. Gray is 55 years old and had a right mastectomy 9 months ago. What implications would the mastectomy have on your assessment (vital signs and examination)?
2. You are assigned to care for Mr. Warren, a 77-year-old client in a long-term care facility. When you enter his room to take his vital signs, you note that the fan is on high speed and blowing directly over him. He is sweating, and the bed linens are damp. What type of reading would you expect to
1. Ms. Reynolds is 33 years old; her vital signs measurements are: OT-37.0°C (98.6°F), P-96/min., R-22/min., and BP 144/90. Which of these measurements are outside the normal ranges?
The physical examination is done in a sequential, head-to-toe fashion to ensure a thorough assessment of each system; when you gain proficiency
The primary purpose of draping the client is to prevent unnecessary exposure during the examination;feelings of embarrassment will elicit tension and restlessness and will decrease the client’s ability to cooperate.
Because the client will experience some anxieties regarding the examination it is important for the nurse to keep the client informed while performing the examination.
The physical examination provides a complete picture of the client’s physiological functioning; when combined with a health and psychosocial assessment it forms a database to direct decision making.
Before checking a blood pressure, review the client’s chart for brachial artery contraindications and make sure that the client has not exercised or eaten for the past 30 minutes.
When assessing ventilation, ascertain the rate, depth, and rhythm of ventilatory movement.
Clinical data regarding the efficacy of blood circulation to an extremity are obtained by assessing all the characteristics (rate, quality, rhythm, and volume) of the peripheral pulses.
All pieces of equipment used to measure the vital signs and perform a physical assessment should be maintained to function accurately.
The normal values and variations in vital signs measurement are usually based on age.
There are several factors that cause changes in one or more of the vital signs: age, sex, exercise and metabolism, anxiety and stress, postural and diurnal variations, hormones, pain, medications, and alterations in physiological functions.
Blood pressure is the measurement of pressure pulsations exerted against the blood vessel walls during cardiac systole and diastole. It is measured in terms of millimeters of mercury (mm Hg).
The pulse is caused by the stroke volume ejection and distension of the walls of the aorta, which creates a pulse wave as it travels rapidly toward the distal ends of the arteries.
Hemodynamic regulation is the body’s physiological function of blood circulation to maintain an appropriate environment in all the tissue fluids.
Thermoregulation is the body’s physiological function of heat regulation to maintain a constant internal body temperature.
The assessment of physiological functioning provides specific data regarding the client’s current condition.
Baseline values establish the norm; variations from normal may indicate possible problems with the client’s health status.
Change in level of consciousness
Emotional lability
Irritability
Aphasia
Vague behavioral complaints (by significant others if client unaware or denies behavioral changes)
Confusion
Memory deficits
Suspected brain lesion (new seizures, headaches, behavioral changes)
Known brain lesion (stroke, tumors, trauma)
Instruct the client to report any findings that deviate from normal such as lumps and nodules, especially if they are nonmobile.
Instruct the client to perform the examination during a warm shower using the thumb and first two fingers to gently feel each testicle and the epididymis. The testicles should move freely within the scrotum and have a smooth surface; the epidiymis should be softer.
Review the anatomy of the scrotum by describing that the testicles are ovoid structures that feel firm and rubbery and that the epididymis, located behind the testicles, is softer and feels rope-like.
Explain to the client that monthly TSE will allow for early detection of testicular cancer.
Ask the client if monthly TSE is performed.
Tinea cruris: erythematous plaques with scaling, papular, lesions with sharp margins caused by fungal infections of the groin
Chancroid: tender, ulcerated, exudative, papular lesion with an erythematous halo surrounding edema and a friable base that results from small breaks in epidermal tissue and inoculation of Hemophilus ducreyi
Candidiasis: multiple, discrete, flat pustules with scaling and surrounding edema that are superficial mycotic infections of moist cutaneous sites associated with diabetes mellitus, deficiencies in systemic immunity, and antibiotic therapy
Configuration: pattern that the murmur makes over time; described as crescendo (soft to loud), decrescendo (loud to soft), crescendo-decrescendo(soft to loud to soft
Pitch: high, medium, or low (auscultated with the bell of stethoscope for low-pitched murmurs and the diaphragm for high-pitched murmurs).
Quality: sound produced (harsh, rumbling, blowing, or musical).
Intensity: the loudness or intensity (see the display for a grading of murmurs).
Timing: phase in the cardiac cycle. If the murmur occurs simultaneously with the pulse, it is a systolic murmur. If the murmur is not related to the pulse, it is a diastolic murmur.
Thrombophlebitis: inflammation of a vein with a formed blood clot
Myocardial infarction: necrosis of the heart muscle
Ischemia: local and temporary lack of blood supply to the heart
Coronary artery disease: any abnormal condition that may affect the arteries of the heart
Congestive heart failure: circulatory congestion caused by a cardiac disorder
Bundle branch block: conduction abnormality of the cardiac impulse through the bundle of His fibers
Buerger’s disease (thromboangiitis obliterans): an occlusion of a medium to small artery in the leg or foot that becomes inflamed and thrombotic
Atrial fibrillation: rapid, random contractions of the atria with irregular ventricular beats
Arteriosclerosis: buildup of plaques in the inner layers of the walls of large-to-medium-sized arteries
Angina: pain in the chest, neck, and/or arm resulting from myocardial ischemia
Aneurysm: localized (aortic) abnormal dilation of a blood vessel wall
Thrombophlebitis: inflammation of a vein with a formed blood clot
Myocardial infarction: necrosis of the heart muscle
Ischemia: local and temporary lack of blood supply to the heart
Coronary artery disease: any abnormal condition that may affect the arteries of the heart
Congestive heart failure: circulatory congestion caused by a cardiac disorder
Bundle branch block: conduction abnormality of the cardiac impulse through the bundle of His fibers
Buerger’s disease (thromboangiitis obliterans): an occlusion of a medium to small artery in the leg or foot that becomes inflamed and thrombotic
Atrial fibrillation: rapid, random contractions of the atria with irregular ventricular beats
Arteriosclerosis: buildup of plaques in the inner layers of the walls of large-to-medium-sized arteries
Angina: pain in the chest, neck, and/or arm resulting from myocardial ischemia
Aneurysm: localized (aortic) abnormal dilation of a blood vessel wall
Pneumothorax: collection of air in the pleural space that causes lungs to collapse
Pneumonia: inflammation of the lungs
Pleurisy: inflammation of the pleura
Pleural effusion: accumulation of fluid in interstitial and air spaces of lungs
Hemothorax: accumulation of blood and fluid in the pleural cavity
Empyema: accumulation of pus in a body cavity such as a pleural cavity
Emphysema: loss of alveolar elasticity and decreased gas exchange
Bronchiectasis: dilatation and destruction of the bronchial walls
Atelectasis: collapse of lung tissue and decreased gas exchange
Asthma: recurring episodes of labored breathing, wheezing on expiration, and a productive cough of viscous mucoid bronchial secretions
Aortic aneurysm: localized dilatation of the aortic wall
Stridor: heard predominantly on inspiration as a continuous crowing sound
Pleural friction rub: heard on either inspiration or expiration over the anterior lateral lungs as a continuous creaking, grating sound
Wheezes: heard predominantly on expiration all over the lungs as a continuous sonorous wheeze(low-pitched snoring) or sibilant wheeze (highpitched musical sound)
Crackles: heard predominantly on inspiration over the base of the lungs as an interrupted fine crackle(dry, high-pitched crackling, popping sound of short duration) that sounds like a piece of hair being rolled between the fingers in front of the ear or a coarse crackle (moist, low-pitched
The physical examination is done in a sequential, head-to-toe fashion to ensure a thorough assessment of each system; when you gain proficiency
The primary purpose of draping the client is to prevent unnecessary exposure during the examination;feelings of embarrassment will elicit tension and restlessness and will decrease the client’s ability to cooperate.
Because the client will experience some anxieties regarding the examination it is important for the nurse to keep the client informed while performing the examination.
The physical examination provides a complete picture of the client’s physiological functioning; when combined with a health and psychosocial assessment it forms a database to direct decision making.
Before checking a blood pressure, review the client’s chart for brachial artery contraindications and make sure that the client has not exercised or eaten for the past 30 minutes.
When assessing ventilation, ascertain the rate, depth, and rhythm of ventilatory movement.
Clinical data regarding the efficacy of blood circulation to an extremity are obtained by assessing all the characteristics (rate, quality, rhythm, and volume) of the peripheral pulses.
All pieces of equipment used to measure the vital signs and perform a physical assessment should be maintained to function accurately.
The normal values and variations in vital signs measurement are usually based on age.
There are several factors that cause changes in one or more of the vital signs: age, sex, exercise and metabolism, anxiety and stress, postural and diurnal variations, hormones, pain, medications, and alterations in physiological functions.
Blood pressure is the measurement of pressure pulsations exerted against the blood vessel walls during cardiac systole and diastole. It is measured in terms of millimeters of mercury (mm Hg).
The pulse is caused by the stroke volume ejection and distension of the walls of the aorta, which creates a pulse wave as it travels rapidly toward the distal ends of the arteries.
Hemodynamic regulation is the body’s physiological function of blood circulation to maintain an appropriate environment in all the tissue fluids.
Thermoregulation is the body’s physiological function of heat regulation to maintain a constant internal body temperature.
The assessment of physiological functioning provides specific data regarding the client’s current condition.
Baseline values establish the norm; variations from normal may indicate possible problems with the client’s health status.
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