Pathophysiology Final Exam Rasmussen SU2020

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What is the priority assessment for potassium imbalance? - ANSWER Look at the heart first; arrhythmias; Kis responsible for muscle contractions What is the function of aldosterone - ANSWER -Regulat... e the concentration of sodium ions in urine -maintains BP What are the assessment findings during a stress response? - ANSWER Alarm, resistance, and exhaustion GAS (general adaptation syndrome) Elevated HR, elevated BP, pupil dilation, airways dilate, elevated BS, fight or flight Where is ATP made? - ANSWER mitochondria What is the difference between a sign and a symptom? - ANSWER -Sign is the effect of a health problem observed by someone else -Symptom is the effect noticed and experienced by the individual with the health problem What is the purpose of the stress response? - ANSWER To return the body to balance, allostasis to achieve homeostasis What are the effects of the release of catecholamines during a stress response? - ANSWER Increase heart rate Constrict blood vessels Relaxes bronchial smooth muscle (dilates the airway for more o2) Inhibits insulin and elevates glucose for ATP Dilates pupils Decreases peristalsis Increase BP Catecholamines are neurotransmitters (epinephrine, norepinephrine) for fight or flight How does a vaccine improve immunity? - ANSWER The immune system makes. The antibodies then destroy the vaccine germs just as they would the disease germs — like a training exercise. Then they stay in your body, giving you immunity. Passive immunity- transfer of antibodies, breast milk, or placenta Active immunity- after the disease (vaccine) What are examples of malignant cells? - ANSWER Carcinoma- epithelial origin, most common Sarcoma- nerve, bone and muscle origin Leukemia- white blood cells Lymphoma- lymph nodes Melanoma- skin Hepatoma- liver What are the characteristics of benign tumors? - ANSWER does not have the immediate potential to kill the host does not invade adjacent tissue or spread (Does not metastasize) area of growth well-encapsulated closely resemble the tissue of origin grow slow What are phagocytic monocytes called? - ANSWER Macrophages What are the risk factors for cancer? - ANSWER Nonmodifiable- genetics age compromised immune system abnormality in tumor suppressor gene Modifiable- tobacco use obesity sun exposure (skin cancer) Sexual exposure to HPV (cervical cancer) What are prostaglandins? - ANSWER a hormone that causes vasodilation and increased permeability at the site of injury They control processes such as inflammation, blood flow, the formation of blood clots, and the induction of labor. cause pain by enhancing the sensitivity of pain receptors Where are prostaglandins produced? - ANSWER They are often produced in tissue and diffused only a short distance to act on cells in that tissue. They arise from the cyclooxygenase pathway (The cyclooxygenase (COX) enzyme system is the major pathway catalyzing the conversion of arachidonic acid into prostaglandins (PGs)) What effects do prostaglandins have? - ANSWER a hormone that causes vasodilation and increased permeability at the site of injury They control processes such as inflammation, blood flow, the formation of blood clots, and the induction of labor. cause pain by enhancing the sensitivity of pain receptors What are the assessment findings for inflammation? - ANSWER Redness- increased blood blow Swelling (edema)- increased fluid and protein Heat- increased blood flow Pain Loss of function Allergies cause high levels of what? - ANSWER IgE Describe type 1 hypersensitivity - ANSWER -Immediate Hypersensitivity -IgE Mediated -Strong genetic or hereditary link -Treatments- antihistamines, B adrenergics, corticosteriods, desensitization Describe type 2 hypersensitivity - ANSWER -tissue specific -cytotoxic or IgG/IgM mediated Often immediate response but can occur over time What are complications of compartment syndrome? - ANSWER Blood vessels collapse Impeding blood flow leading to hypoxia and edema Necrosis Pain, paralysis, pallor, paresthesia, pulselessness What is granulation tissue and how is it described? - ANSWER -New connective tissue forming on the surface of a wound during the healing process -Highly vascular, very fragile, very susceptible to infection What are the symptoms of atopic dermatitis? - ANSWER Makes skin red and itchy; Complex genetic disease resulting from gene-gene and gene-environment interaction Highest incidence in children under 5 Pruritis always present Usually on face, scalp or extensor surfaces of extremities erythema, papule, lichenification What type of injury classification is injury of the fascia? - ANSWER Inert soft tissue injury What is a first degree burn? - ANSWER -only superficial tissue destruction in the outermost layers of the epidermis, with no associated compromise of the function of the skin -local discomfort, erythema, and mild systemic responses such as headache, chills, nausea, and vomiting -Erythema, a thermovascular response that occurs in first-degree burns in the absence of direct trauma to the dermis, is probably related to the release of tissue contents into the superficial circulation -First-degree burns are generally self-limiting, require no fluid resuscitation -Therapy generally includes simple analgesia (inability to feel pain) -typically heal in 3 to 6 days without scarring or pigmentation changes. What is a second degree burn? - ANSWER epidermis and partial thickness of the dermis are involved. area is painful and blisters are present What is a third degree burn? - ANSWER may also involve the entire epidermis, the dermis, and the underlying subcutaneous tissue -Immediately after injury, these areas appear white, cherry red, or black -Deep blisters may be present under a dry layer of dehydrated skin -Superficial blood vessels coagulated by the heat of injury may be visible through the skin as thrombosed veins. What is the clinical manifestation of rheumatoid arthritis? - ANSWER Pain or aching in more than one joint. Stiffness in more than one joint. Tenderness and swelling in more than one joint. Malaise (feeling of discomfort) fatigue ( tiredness or lack of energy) diffused musculoskeletal pain What is muscular dystrophy? - ANSWER progressive weakening and wasting of the muscles. What is a serious complication of GERD? - ANSWER Barrett esophagus- normal squamous epithelium of the distal esophagus, exposed chronically to acid reflux, is replaced by columnar tissue -carries a significant risk for esophageal cancer -patients with Barrett esophagus should undergo regular endoscopic screening for cancer, along with pharmacologic control of their reflux Gastroesophageal reflux disease (GERD) is the backflow of gastric contents into the esophagus What is hyperemesis gravidarum? and what are two potential complications? - ANSWER Excessive vomiting in pregnant women Severe dehydration and electrolyte imbalance, hepatic and renal damage, encephalopathy, and ultimately death may ensue if the vomiting cannot be controlled. What is the main cause of acute pancreatitis? - ANSWER -Gallstones- duct obstruction -biliary tract disease-diseases affecting the bile ducts, gallbladder and other structures involved in the production and transportation of bile -Alcoholism What are examples of inflammatory bowel disorders? - ANSWER Crohn's disease and Colitis What is hematuria? - ANSWER blood in the urine What is intussusception? - ANSWER The telescoping or invagination of one part of the intestinal tract into another What is pyelonephritis and what causes it? - ANSWER Infection of the kidneys caused by UTI; E.coli What are concerns with herpes virus 1 and 2? - ANSWER Virus enters the lymphatic system and creates lesions; associated pain with lesions What bacteria causes most cases of cystitis? - ANSWER E. Coli What are the two main conditions responsible for chronic kidney disease? - ANSWER Diabetes and hypertension What is the purpose of dialysis for patient with kidney disease? - ANSWER Filter blood, remove waste, prevents build up of excess sodium and water What is the type of incontinence caused by an increase in intra abdominal pressure? - ANSWER Stress urinary incontinence What are possible complications from having human papilloma virus (HPV)? - ANSWER cervical cancer What organisms would be associated with pelvic inflammatory disease (PID)? - ANSWER Neisseria gonorrhoeae -Chlamydia trachomatis What are the clinical findings of acute glomerulonephritis? - ANSWER Coffee colored urine Men with BPH suffer from what complication? - ANSWER Urinary tract obstruction What is the complication in type 1 diabetes when fats are being broken down for energy? - ANSWER Diabetic keto acidosis What electrolyte disorder is associated with SAIDH? - ANSWER Hyponatremia (low sodium) What are the clinical manifestations of hypothyroidism? - ANSWER Weakness, lethargy, cold intolerance, decreased appetite, bradycardia, narrowed pulse pressure, weight gain, goiter, skin is cool and dry, constipation, depression, difficulty concentrating Primary- High TSH/ Low T3/T4 Secondary- Low TSH/ Low T3/T4 What causes diabetes insipidus? - ANSWER lack of ADH, excessive water loss through urine What condition leads to excessive amounts of the growth hormone in adulthood? - ANSWER Acromegaly What is the difference between type 1 and type 2 mellitus? - ANSWER Type 1- no insulin production Type 2- no response to insulin, which later reduces insulin production Abnormal functioning of the parathyroid gland can lead to which electrolyte imbalance? - ANSWER calcium Glascow Coma Scale- How do you calculate the scale? - ANSWER Add up each category for final score Eye response, verbal response, motor response What is decoricate posturing? - ANSWER Abnormal flexor response of the arms & wrists; the legs & feet extend & internally rotate (arms bent onto chest with fists) (like a bunny) Sign of severe damage to the brain (usually damage to one or both of corticospinal tract) Types of brain injury i.e. focal, coup, contre coup etc. - ANSWER Focal (Coup)- localized to the site of impact to the skull; extent of the damage is quite variable; damage may be superficial or extend deep into the brain matter. (pg.903) (i.e. focus on 1 site/direction) GSW, baseball bat, 'blows to the head'. Stroke could be a focal injury as a specific part of the brain is affected. Polar (Coup-contrecoup) occur as a consequence of the brain shifting within the skull and meninges during the course of an acceleration-deceleration movement, resulting in local injury at two opposite poles of the brain; most commonly occur in MVA (pg.903) (north & south poles → head moving forward & back) Diffuse injuries: occur when the movement of the brain within the cranial cavity causes widespread neuronal damage; the brain is often subject to shifting and rotational forces during injury; the combined force causes stretching and shearing of the axonal white matter, known as a diffuse axonal injury; pts with severe diffuse axonal injury frequently are comatose from the time of injury; recovery may be limited to a severely disabled or vegetative state. (pg.903), shaken baby syndrome. What is the impact of hypoxia on brain cells? - ANSWER Hypoxia is a lack of oxygen at the cellular level When oxygen supply is decreased, not only is oxidative phosphorylation impaired, but also the low supply of stored glucose restricts anaerobic production of ATP. Brain cells tolerate loss of ATP for several minutes; about 5 to 10 minutes of complete occlusion is necessary for irreversible brain damage in humans. (pg.892) What is the difference between a hemorrhagic stroke and a thromboembolic stroke? - ANSWER Hemorrhagic stroke: due to bleeding in the brain from a torn or ruptured blood vessel Thromboembolic stroke: due to an artery that is blocked by a thrombus (clot) that forms there What is the impact of increased intracranial pressure? - ANSWER occlusion of blood vessels, LOC decreases, pupil reactivity decreases, altered respiratory patterns and unresponsive to stimulation What is the area of the brain surrounding the area of infarct after a stroke called? - ANSWER The penumbra (pg.906) What is reperfusion injury? - ANSWER tissue damage caused when blood supply returns to the tissue after a period of ischemia or lack of oxygen The secondary injury that occurs after reestablishing blood flow (pg.894) What is the priority assessment for a patient on a ventilator? - ANSWER Airway patency What are clinical manifestations of a patient with a DVT and a PE? - ANSWER DVT: pain & swelling, (calf pain when walking) PE: sudden onset of chest pain and SOB, increased respiratory rate What forms can carbon dioxide travel through the blood? - ANSWER Dissolved in plasma (5 to 10%) Bicarbonate (60%to 70%) Carbamino on the hemoglobin molecule (20%to 30%) ch.21(p.467) What is the process of moving air into the lungs called? - ANSWER ventilation What is cor pulmonale? What causes it? - ANSWER Abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels. Pulmonary hypertension is the most common cause Right heart failure that occurs without left heart failure. Caused by pulmonary disease such as COPD, CF, or acute respiratory distress syndrome (ARDS) What is a pneumothorax? - ANSWER Accumulation of air in the pleural space Where is the brains respiratory center? - ANSWER Medulla oblongata and the Pons What is the purpose of surfactant? - ANSWER to reduce surface tension to keep the alveolus from collapsing during respiration Decrease surface tension to allow gases to exchange properly What is the appropriate nurse interventions for emphysema? - ANSWER Administer bronchodilators and oxygen, and educate the pt to stop smoking Teach purse lip breathing; Lung exhalation (smell the flowers; blow out the candles) What is the purpose of a rescue inhaler for asthma patients? - ANSWER It helps to expand a person's airways during an asthma attack. Rescue inhalers dispense a type of medication called a bronchodilator, which expands, or dilates, the airways, known as bronchioles. What are the clinical manifestations for bronchitis? - ANSWER Cough, wheezing, SOB, tightness in chest, whistling/squeaking sound when you breathe What is polycythemia vera? - ANSWER too many red blood cells; blood thicker than normal What causes pulmonary hypertension? - ANSWER -A sustained increase in pulmonary artery pressure above 25 mm Hg sys What lung disease causes destructive changes of the alveolar walls and enlargement of the distal air sacs? - ANSWER Emphysema What is the adequate management of asthma? - ANSWER Avoid triggers, whether it is dust, mold, or animal dander. Epinephrine, subcutaneous terbutaline, aminophylline, corticosteroids, and oxygen therapy may be appropriate treatments for a person suffering from an asthmatic attack. For less serious reactions, the use of bronchodilators, such as albuterol, is appropriate as well as an allergy medication. For long term asthma control, corticosteroids, leukotriene modifiers, combination inhalers, and theophylline may be the appropriate treatment methods . What is the priority nurse intervention for a large wound? - ANSWER Apply pressure to stop bleeding What is the impact of a myocardial infarction? - ANSWER Decreases cardiac output lowered ejection fraction What lab values would a complete blood count (CBC) include? - ANSWER Red blood cells, which carry oxygen White blood cells, which fight infection Hemoglobin, the oxygen-carrying protein in red blood cells Hematocrit, the proportion of red blood cells to the fluid component, or plasma, in your blood Platelets, which help with blood clotting What is the priority assessment of a patient with pneumonia? - ANSWER Perform a respiratory assessment every 4 hours, physical examination, and ABG measurements What is the significance of the hemoglobin? - ANSWER (protein in your red blood cells) carries oxygen to your body's organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs What is polycythemia vera? - ANSWER A rare blood disease in which your body makes too many red blood cells. The extra red blood cells make your blood thicker than normal. As a result, blood clots can form more easily Compare hodgkin vs. non hodgkin disease - ANSWER Non-Hodgkin does not have Reed-Sternberg cells. Hodgkin does have Reed-Sternberg cells. What is homeostasis and what are the 3 main parts of hemostasis? - ANSWER The term hemostasis means arrest of bleeding or prevention of blood loss after a blood vessel is injured (pg 298) 1) vasoconstriction to reduce blood loss 2) platelet plug formation (scab) 3) coagulation What is hematemesis? - ANSWER Vomiting blood Vomiting of stomach contents mixed with blood, or the regurgitation of blood only What is erythropoietin (EPO)? - ANSWER The hormone from the kidney that stimulates erythrocyte production (pg 263) What are erythrocytes and what are their functions? - ANSWER Red blood cells Transport oxygen to the tissues and participate in both removing carbon dioxide from the tissues and buffering blood pH (pg 262) What is the purpose of doing blood coagulation studies? - ANSWER It measures your blood's ability to clot, and how long it takes to clot. Testing can help your doctor assess your risk of excessive bleeding or developing clots (thrombosis) somewhere in your blood vessels. What is the role of the liver in clotting? - ANSWER It is responsible for producing most coagulation factors Synthesize clotting factors Activates plasma What is the priority assessment for a CHF patient? - ANSWER Lung sounds What is the priority assessment for a patient experiencing chest pain? - ANSWER EKG What are the types of risk factors for patients with a hx of hypertension? - ANSWER Modifiable (weight, diet) and non-modifiable (age, ethnicity) What causes hypovolemic shock? - ANSWER absolute loss of fluid hemorrhage overuse of diuretics dehydration from vomiting/ The liquid portion of the blood (plasma) is too low The most common is severe blood loss (aka hemorrhagic hypovolemic shock) What causes septic shock? - ANSWER Gram-negative bacteria, fungal infections What is angina pectoris? - ANSWER chest pain caused by inadequate flow of blood and oxygen to the heart, ischemia How do providers determine the causes of acute coronary syndrome (ACS)? - ANSWER ECG and biomarkers used for diagnosis Increased CK-MB and troponin I and T What are the effects of heart failure? - ANSWER Fluid overload Intravascular and interstitial fluid volume overload Decreased tissue perfusion SOB, fatigue, weakness, edema, orthopnea What are the clinical manifestations of rt sided heart failure? - ANSWER Fatigue Peripheral venous pressure Ascites Enlarged liver and spleen Secondary to COPD Distended jugular veins anorexia and complaints of GI distress Weight gain Dependent edema What is the role of the lymphatic system in reducing edema? - ANSWER Fluid balance Picks up excess fluid and returns it to the bloodstream What is the difference between a MI and unstable angina? - ANSWER MI- complete occlusion, pain relieved by rest Unstable angina- partial blockage, pain not relieved by rest What occurs in the late stages of shock? - ANSWER Organ failure What are some hypertension management techniques? - ANSWER Low sodium diet DASH Diet Exercise Weight loss Alcohol moderation Stress reduction Drug Therapy: diuretics, hypertensives What are the two organs most affected by uncontrolled hypertension? - ANSWER Heart and eyes What is decerebrate posturing? - ANSWER The arms extend with external rotation of the wrists; the legs & feet extend & rotate internally (AKA abnormal extension) (arms straight by side with wrist bent outward in a fist) (pg.901) (damage to the upper brain stem) Extensor response: Hands pushed to sides and body hyper-extended. Arms are stiffly extended, adducted & hyperpronated. Hyperextension of the legs with plantar flexion of the feet. (May indicate more serious damage.) "extensor = All E's" What is the process called where damaged tissue heals? - ANSWER Regeneration A client has arrived in the clinic with dysmenorrhea. What would the nurse expect to assess? - ANSWER pain in the pelvic area and in the upper thighs. A disorder of unknown cause → Idiopathic - ANSWER True Signs of Cushings- all that apply - ANSWER Depression, Anxiety, and Irritability. severe fatigue headache, hirsutism Which of the following is not a function of the kidney? - ANSWER albumin production (produced by the liver) When potassium intake is less than potassium output (or when potassium shifts from plasma into cells) - ANSWER hypokalemia Septic shock is most commonly caused by: - ANSWER gram negative bacteria Avoid massive vitamin D supplementation and drink lots of fluids to prevent kidney damage - ANSWER teaching for hypercalcemia Besides immunity, what other function does the lymphatic system serve - ANSWER fluid balance Platelets and WBCs are stored here, and old RBCs are recycled. - ANSWER spleen Which of the following statements about interferon is correct? - ANSWER Interferon binds to surface receptors of cells in area of infection In which geographical region would one suspect higher cases of polycythemia? - ANSWER mountains Injecting a vaccine of a dead or weakened pathogen imparts which type of immunity? - ANSWER Artificial active Normal potassium levels - ANSWER 3.5-5.0 mEq/L What chromosome is associated with chronic myeloid leukemia? - ANSWER Philadelphia Holds 1/3 of the body's water - ANSWER extracellular fluid 135-145 mEq/L - ANSWER normal sodium levels A client produces too much antidiuretic hormone (ADH). Which of these is the priority assessment? - ANSWER BP Which space does fluid enter to cause edema - ANSWER interstitial compartment Treats hives, pruritis and swelling - ANSWER histamines and prostaglandins Macrophage is a type of white blood cell which is a phagocyte. - ANSWER True Allergies are associated with elevated - ANSWER eosinophils Which is true of anaplasia? - ANSWER lack of differentiated features in a cancer cell Oncogene is associated with the initiation of cancer - ANSWER True Which of these localizes in lymph tissues and often disseminates to other sites? - ANSWER lymphoma In a client with Type 1 diabetes, what source of tissue is accessed to promote energy production? - ANSWER adipose Wound edges that are approximated signify the wound is infected? - ANSWER false What is the origination of stem cells in an allogenic transplant? - ANSWER closely matched relative Ecchymosis means - ANSWER bruising Purpura means - ANSWER medium bruise Tumors "new growth" not all are life threatening; benign or malignant- Describes - ANSWER Neoplasm Patient is receiving tube feedings and free water is ordered. What is the patient at risk for it is not given - ANSWER hypernatremia Which of the following are hypertension management techniques? Select all that apply. - ANSWER Diuretics, Diet modification; Antihypersensitives Type 2 diabetes is characterized as: - ANSWER peripheral tissue insulin resistance What differentiates hemorrhage in the subarachnoid space from an epidural hematoma? - ANSWER Subarachnoid symptoms can be slow and insidious. [Show More]

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