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Brachial Pulse and Skin Assessment: Anatomy, Lesions, and Diagnoses, Exams of Nursing

Comprehensive information on various topics related to brachial pulse assessment and skin conditions. It covers different types of apocrine glands, assessment techniques for newborns, skin conditions such as atrophy, basal cell carcinoma, and malignant lesions like kaposi's sarcoma. The document also discusses various types of vascular lesions, assessment techniques, and differentiating between discrete and confluent lesions. Additionally, it covers cranial stenosis, edema grading, and pulse grading.

Typology: Exams

2023/2024

Available from 03/01/2024

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Nurs 190 Physical Assessment
- ans-
Acromegaly - ans- enlargement of the extremities
Annular Lesions - ans- Circular, begins in center and spreads to periphery. Its only one
circle
Antecubital parts of the arm - ans- Brachial pulse
Apocrine glands - ans- made of water salts, proteins and fatty acids. Usually located in
areas with hair follicles like groin, axillary region.
Assessment of newborns - ans
Atrophy - ans- translucent, dry paper like sometimes wrinkled skin resulting from
thinning or wasting of skin due to loss of collagen and elastic.
basal cell carcinoma - ans- Most common and least severe type of skin cancer; often
characterized by light or pearly nodules.
- Usually starts as a skin-colored papule with a pearly translucent top and overlying
telangiectasia (broken blood vessel). Then develops rounded, pearly borders with
central red ulcer or looks like a large open pore with central yellowing.Most common
form of skin cancer; slow but inexorable growth.
Bullae - ans- a fluid-filled sac or lesion that appears when is trapped under a thin layer
of skin.
Classic migraine - ans- head ache preceded by aura, patient sees spots and flashes of
lights accompanied by nausea or vomiting, tingling and numbness of face and
extremities.
Cluster headache - ans- Onset is sudden usually onside of the face spreading upward
behind one eye that last a few minutes to few hours with several episodes for days or
months.
Confluent Lesions - ans- Lesions run together (hives)
Cranial stenosis - ans- premature fusion of cranial bones
stunt brain growth
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Nurs 190 Physical Assessment

  • ans- Acromegaly - ans- enlargement of the extremities Annular Lesions - ans- Circular, begins in center and spreads to periphery. Its only one circle Antecubital parts of the arm - ans- Brachial pulse Apocrine glands - ans- made of water salts, proteins and fatty acids. Usually located in areas with hair follicles like groin, axillary region. Assessment of newborns - ans Atrophy - ans- translucent, dry paper like sometimes wrinkled skin resulting from thinning or wasting of skin due to loss of collagen and elastic. basal cell carcinoma - ans- Most common and least severe type of skin cancer; often characterized by light or pearly nodules.
  • Usually starts as a skin-colored papule with a pearly translucent top and overlying telangiectasia (broken blood vessel). Then develops rounded, pearly borders with central red ulcer or looks like a large open pore with central yellowing.Most common form of skin cancer; slow but inexorable growth. Bullae - ans- a fluid-filled sac or lesion that appears when is trapped under a thin layer of skin. Classic migraine - ans- head ache preceded by aura, patient sees spots and flashes of lights accompanied by nausea or vomiting, tingling and numbness of face and extremities. Cluster headache - ans- Onset is sudden usually onside of the face spreading upward behind one eye that last a few minutes to few hours with several episodes for days or months. Confluent Lesions - ans- Lesions run together (hives) Cranial stenosis - ans- premature fusion of cranial bones stunt brain growth

Different types of Assessment techniques - ans- INPECTION is the technique used initially in physical assessment.

  • AUSCULATION is the use of your stethoscope
  • PERCUSSION use of your fingertips, the middle finger tips or blunt percussion which is the use of the palm of your hands with your fist type twice.
  • PALPATION use the finger pads or metacarpophalangeal joints of the hand. Different types of vascular lesions - ans Differentiate amongst the following - ans Discrete Lesions - ans- Distinct, individual lesions that remain separate Femoral pulses would be located - ans- inguinal area fetal alochol syndrome - ans Finger pads used to assess - ans- pulses, edema, lymph nodes, light palpation Fissure - ans- Linear breaks in the skin that go deeper than the epidermis into the dermis. They can be painful and can be caused by excessive dryness For an infant that the skin appears white and hair is pale blond and iris's of the eye are pink what condition does this child have? - ans- The child has absence of color Goniometer - ans- used to asses the degree of joint flexion and extension. Grouped Lesions - ans- Clusters of lesions Herpes zoster - ans- painful lesions along the nerve path ways How do you asses for clubbing of the fingers? - ans- You have the client bring the dorsal aspect of the corresponding finger together to create a mirror image. The normal findings would be a diamond space between the fingers and the angle of the nail bed is one 160 degrees. More than 160 degrees would be a sign of clubbing. How do you grade edema - ans+1 = minimal edema of LE, 2mm +2 = marked edema of LE, 4mm +3 = Edema of LE, face, hands, and sacral area, 6mm +4 = Generalized massive edema (ascites), 8mm
  • graded 0-4 + and its by two's How do you grade pulses - ans- 0-4+
  • 0 non palpable pulse
  • 1+ weak and thready
  • 2+ Normal

Lichenification - ans- Prolonged, intense scratching eventually thickens the skin and produces tightly packed sets of papules; looks like surface of moss (or lichen) Locate the ten locations of the lymph nodes - ans- what is the lymph node at the base of the skull? Occipital Location of different pulses - ans- behind the knees is your popliteal pulse Malignant Melanoma - ans- cancerous growth composed of melanocytes Medial part of the wrist is your - ans- Radial pulses Metacarphalangeal joints and ulnar part of the hand used - ans- to palpate moderate and deep palpation Milia are the papules - ans- are located like white heads nose and cheeks of the baby disappear after 3-4wks. On percussion of a solid organ like liver or heart what kind of sound will you hear? - ans- Dullness On percussion of the abdomen what kind of sound will you hear? - ans- Tympanic or drum like sound On percussion of the bone what kind of sound will you hear? - ans- Flat and very short On percussion of the lungs what will you hear? - ans- You will hear a resonance sound if the lungs are filled with air, you will hear hyperresonance Order of occurrence for herpes zoster - ans- First you will have paresthesia then

  • redness and swelling
  • then vesicles
  • then weeping blisters
  • crusted lesions
  • post herpetic neuralgia Papule (maculopapular) - ans- Something you can feel such as a mole, caused by superficial thickening in epidermis Parts of the hand used for assessment - ans- dorsal part of the hand is used to assess skin temperature Port-wine stain - ans- a flat lesion, purple red, irregular shaped, when patient cries it deepens in color.

Review the different types of primary lesions - ans- Macules a patch of skin that is altered in color but usually not elevated

  • Papule (maculopapular): An elevated solid lesion, up to 0.5 cm in size, circumscribed and firm. It can appear in various colors.
  • Vesicle; A fluid- filled blister less than 0.5 cm in size
  • Bullae; a fluid-filled sac or lesion that appears when is trapped under a thin layer of skin.
  • Wheal; an irregular-shaped, solid, elevated area that can vary in color and its transient Skin is composed of epidermal and dermal layer - ans- Epidermal is the top part of the skin, dermal is the second layer that has nerve endings, hair follicles and blood vessels.
  • Subcutaneous tissue, muscle and bone

Skinfold calipers - ans- used to asses subcutaneous thickness Stadiometers - ans- measures height of the patient Stage 4 - ans- Four layers are involved lesions go deeper into the muscles and bone. Stage 111 - ans- Three layer of the skin are involved, lesions, opening, in epidermis going through the dermis and subcutaneous tissue. Stage II - ans- lesion goes now into the dermis, two layers are involved, epidermis and dermis. Tenia pedis - ans- AKA athletes foot Terminal hair - ans- Thick hair found on the scalp, eyebrow, axillary region, pubic hair, legs, face and chest of the male individual. The first activity in nursing process is - ans- to collect subjective data The normal findings for adults - ans- lymph nodes are not palpable The normal findings for children - ans- may be palpable and are considered normal for them. The skins finding for a client a client with cirrhosis of the liver would be ..... - ans- jaundice or yellowing of the skin The technique on how to asses the lymph nodes would be...... - ans- Gentle circular motion Three types of abdominal palpations - ans- light palpation, which is the safest, depth is 0.5- 1cm, use only one hand.

What is tension headache? - ans- the onset is gradual, also known as muscle contraction headache. The pain is steady maybe unliteral or bilateral typically ranges from cervical region to the top of the head, What is the best technique in assessing skin turgor? - ans- Pinching below the clavicle or median aspect of the wrist. What is the indication of non healing wounds in the head of a patient when doing assessment. - ans- Especially if its more than several months is a sign of malignancy or melanoma. What is the lymph node that is before your ears? - ans- Preauricular What is the lymph node that is deeply embedded in the deep sternomastoid muscles? - ans- Deep cervical chain What is the lymph nodes that is above your clavicles? - ans- Supra clavicular What is the most appropriate action of the nurse to protect examiner and client against the spread of infection - ans- Wash hands before and after every physical client encounter What is vitiligo? - ans- Patchy and pigmented areas over the face, neck, hands, feet and skinfolds. What kind of lesions is psoriasis - ans- plague lesions What question should you ask patients suspected with Lyme disease? - ans- Lyme disease is caused by tick bites, so you would ask have you been hiking or camping lately. What type of shape is ring worm? - ans- annular lesions Wheal - ans- an irregular-shaped, solid, elevated area that can vary in color and its transient When a patient suddenly refuses your exam what should you as a nurse? - ans- Document what was done and and what was refused. Which part of your stethoscope is used for listening to high pitch sounds? - ans- Diaphragm ( larger side) Which part of your stethoscope is used for listening to low pitch sounds? - ans- the bell, especially to hear heart mummers and brewing Wood lamp - ans- to asses fungal infection on the skin