Author Question: The nurse is assessing for inflammation in a dark-skinned person. Which technique is the best? a. ... (Read 39 times)

shofmannx20

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The nurse is assessing for inflammation in a dark-skinned person. Which technique is the best?
 
  a. Assessing the skin for cyanosis and swelling
  b. Assessing the oral mucosa for generalized erythema
  c. Palpating the skin for edema and increased warmth
  d. Palpating for tenderness and local areas of ecchymosis

Question 2

The nurse is assessing a patient who has liver disease for jaundice. Which of these assessment findings is indicative of true jaundice?
 
  a. Yellow patches in the outer sclera
  b. Yellow color of the sclera that extends up to the iris
  c. Skin that appears yellow when examined under low light
  d. Yellow deposits on the palms and soles of the feet where jaundice first appears



johnharpe

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Answer to Question 1

ANS: C
Because inflammation cannot be seen in dark-skinned persons, palpating the skin for increased warmth, for taut or tightly pulled surfaces that may be indicative of edema, and for a hardening of deep tissues or blood vessels is often necessary.

Answer to Question 2

ANS: B
The yellow sclera of jaundice extends up to the edge of the iris. Calluses on the palms and soles of the feet often appear yellow but are not classified as jaundice. Scleral jaundice should not be confused with the normal yellow subconjunctival fatty deposits that are common in the outer sclera of dark-skinned persons.



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