Mrs Joyce Collins

Question 1

You are a practice nurse working in a GP surgery. 73 year old widow, Joyce, presents to you for a blood pressure check. She has a past medical history of a myocardial infarction (heart attack) 8 years ago, has rheumatoid arthritis and also type 2 diabetes. She tells you she has increasing right calf pain on walking. Her feet are always cold and she would also like you to look at a lesion on her right lower leg that will not heal

• what patient condition would we most likely expect a Capillary refill longer than two seconds?

Answer 1

Peripheral vascular disease

Question 2

What is a myth about pain in the older adult?

Answer 2

Elderly people who are confused or cognitively impaired do not have pain

Question 3

What represents the break in sounds between the first and second sounds when auscultating Joyce’s blood pressure?

Answer 3

Auscultatory gap

Question 4

You are having difficulty auscultating Joyce’s heart sounds specifically S1 and S2, what could you do to help?

Answer 4

Palpate the carotid pulse while auscultating the heart

Question 5

What type of pain would be associated with arthritis?

Answer 5

Chronic