Discussion: Palpation of Arterial Pulses

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Discussion: Palpation of Arterial Pulses

Discussion: Palpation of Arterial Pulses

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HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle bilaterally.ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit.PSYCH: Normal affect. Cooperative.Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98. A:Primary Diagnosis: Proximal subungual onychomycosisDifferential Diagnosis:  Irritant Contact Dermatitis, Lichen Planus, Nail PsoriasisSpecial Lab: Fungal culture confirms fungal infection. Please see below:      Now that you have identified the treatment for onychomycosis and labs for baseline and follow up therapy.

Q For Week 6, please address the following:

1-  Specify when to refer the patient after therapy and why? Provide rationale.

2- According to the recommended guidelines, what are the non-pharmacological approaches to  Onychomycosis ?3-Provide patient education. Keep in mind the past medical history of this patient

hypertension ,, diabetes mellitus 2 , salt intake , obesity

Palpation of arterial pulses: Carotid, Brachial,  Radial, Femoral, Popliteal, Dorsalis pedis,  Posterior tibial.Define arterial blood pressure

Define arterial blood pressure

Which variables contribute to the characteristics of the pulses?

A pregnant patient (32 weeks’ gestation) is having difficulty with dependent edema and painful varicosities. What can you suggest to help this patient’s problem?

What should you do if you have trouble finding the patient’s pulse?

Describe the scale of 0 to 4 with regard to the amplitude of the pulse

If a patient experiences pain in the calf muscles, which artery is probably obstructed?

What two values are recorded for the blood pressure?

What is the mechanism behind cardiac tamponade?

Where are the most common places for venous ulcers to appear?

TB is a 56-year-old female patient with Raynaud phenomenon. Her past medical history includes spinal stenosis, systemic lupus erythematosus, bipolar disorder, and overactive bladder.

A-Differentiate the primary and secondary types of Raynaud phenomenon.

B-In the patient’s initial presentation what would be the chief complaint if the patient had primary Raynaud phenomenon? Secondary Raynaud phenomenon?

C-Based on TB’s presentation, what assessment results would you expect to find? What if is she had primary Raynaud phenomenon?

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