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NSG 306 Pathopharmacology I > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

A patient with an elevated potassium level is likely to exhibit:

A

Peaked T-Waves on an EKG

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2
Q

Most abundant Cation in the Intracellular fluid (ICF)

A

Potassium

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3
Q

The concentration gradient of this cation between the Extracellular Fluid (ECF) and Intracellular Fluid (ICF) is essential for generation of electrical impulses.

A

Potassium

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4
Q

Elevated Potassium levels can cause:

A

Abnormal electrical conduction in the heart and life-threatening dysrythmias

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5
Q

Decreased Potassium can cause:

A

No symptoms if mild

Dysrhythmias if moderate or severe; also Constipation, fatigue, muscle weakness or spasms, muscle damage and paralysis

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6
Q

Which electrolyte is most prevalent in the extracellular fluids, particularly in the intravascular space?

A

Sodium (Na)

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7
Q

Electrolyte needed for generation of electrical signals in the body

A

Sodium (Na)

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8
Q

The Na+/K+ pump located in the cellular membrane keeps Na+ _____ the cell and K+ _____ the cell

A

Outside; Inside

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9
Q

Symptoms of a Na+ imbalance:

A

Lethargy

Confusion

Weakness

Swelling

Seizures

Coma

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10
Q

Hydrostatic pressure is an important influence in the movement of water and nutrients across the fluid compartments of the body. In the situation where a patient had an elevated blood pressure, what effect would an increased hydrostatic pressure in the vascular space have on fluid and electrolyte movement?

A

The pressure would push fluid into the interstitial space causing edema.

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11
Q

Hydrostatic pressure _____ water between the interstitial and capillary spaces

A

Pushes

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12
Q

Osmotic (Oncotic) pressure _____ water between the interstitial and capillary spaces

A

Pulls

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13
Q

Increased blood volume and stretching of the heart tissue causes the cells lining the atria and ventricles to secrete:

A

Atrial Natriuretic Peptide (ANP)

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14
Q

Hormone secreted to increase blood volume and BP:

A

Atrial Natriuretic Peptide (ANP)

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15
Q

How does Atrial Natriuretic Peptide (ANP) have the opposite effect of aldosterone?

A

Inhibits the absorption of Na+ and increases glomerular filtration causing an increase in urine output

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16
Q

ANP decreases what

A

Circulating blood volume and blood osmolarity.

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17
Q

Atrial Natruiretic Peptide (ANP) and B-type natriuretic Peptide (BNP) are secreted from the cardiac atria and ventricles respectively. ANP signals in an endocrine and paracrine manner to _____ and _____. BNP acts locally to _____.

A

Decrease BP, cardiac Hypertrophy; reduce ventricular fibrosis

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18
Q

A measurement of PaCO2 indicate the effectiveness of:

A

Lung ventilation

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19
Q

Lab reports the following blood gas results for your patient:

PH: 7.67

PaCO2: 53MM HG

HCO3: 37 mEq/L

A

Uncompensated Respiratory Alkalosis

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20
Q

The kidneys respond to acid-based disturbances by:

A

Excreting and reabsorbing hydrogen or bicarbonate

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21
Q

The Lab reports the following blood gas results for your patient:

PH: 7.3

PaCO2: 50 mm HG

HCO3: 34 mEq/L

A

Fully compensated respiratory acidosis

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22
Q

Rapid Breathing causes the body to:

A

Get rid of carbon dioxide

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23
Q

Secretion of aldosterone results in:

A

Increased blood volume

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24
Q

Secreted by the adrenal cortex when the ECF Na+ level is decreased; it prevents Na+ and H2) loss

A

Aldosterone

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25
Q

Acts on kidney nephrons and triggers them to reabsorb Na+ and H2) from the urine back into the blood, increasing blood osmolarity and blood volume.

A

Aldosterone

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26
Q

Prevents excess exertion of Na+ by the kidneys and prevents K+ from getting too high

A

Aldosterone

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27
Q

______ activated when blood flow or pressure to the kidneys decreases.

A

Renin-Angiotensin-Aldosterone System. (RAAS)

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28
Q

The Lab reports the following ABG results for your patient:

pH: 7.33

PaCO2: 40mm HG

HCO3: 20 mEq/L

A

Metabolic acidosis

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29
Q

What patient would be most likely to have decreased intravascular oncotic pressure? A patient with:

A

Liver failure

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30
Q

A hallmark EKG characteristic of the patient with hyperkalemia is the presence of:

A

Tall, peaked T waves

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31
Q

A nursing home patient has been admitted with water intoxication. What will his admission orders most likely include?

A

Monitor neurological status

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32
Q

When planning care for a dehydrated patient, the nurse remembers the principle of water balance is closely related to _____ balance.

A

Sodium (Na+)

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33
Q

A 64 year old male with a long history of smoking complains of excessive tiredness, shortness of breath, and overall ill feeling. Lab results reveal decreased pH increased CO2, and normal bicarbonate ion. These findings help confirm the diagnosis of:

A

Respiratory acidosis

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34
Q

A patient who has had prolonged vomiting has a blood gas drawn with the following results:

PH: 7.42

PaCO2: 51

HCO3: 33

A

Fully compensated metabolic alkalosis

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35
Q

A nurse is caring for a client who is having a panic attack and begins to hyperventilate. The client reports dizziness and circumoral tingling and numbness. What is the immediate acid base imbalance the client is experiencing?

A

Respiratory alkalosis

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36
Q

A 33 year old male with type 1 diabetes mellitus presents with an elevated blood sugar and blood gas of:

Ph: 7.32

PaCO2: 33

HCO3: 19

A

Partially compensated metabolic acidosis

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37
Q

If your patient has hyerphosphatemia, he is likely to also have what secondary electrolyte disturbances:

A

Hypocalcemia

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38
Q

A nurse is preparing to teach about erythropoietin. Which information should the nurse include? Erythropoietin is produced by the body in the:

A

Kidneys

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39
Q

A patient has a lack of intrinsic factor because of a gastric resection surgery. They are at risk for which form of anemia?

A

Pernicious anemia

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40
Q

In polycythemia vera, painful pruritis occurs secondary to:

A

Release of histamine from excessive mast cells

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41
Q

Erythrocytes are vital to which primary function in the body?

A

Carrying oxygen to tissues

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42
Q

A client with iron-deficiency anemia is scheduled for a complete blood count. The nurse anticipates that the report will show which characteristics of the red blood cells (RBCs)?

A

Microcytic, hypochromic

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43
Q

Filgastim and oprelvekin should not be given to which of the following patients?

A

Cancer of the bone marrow

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44
Q

Which of the following is NOT TRUE regarding folate (folic acid) deficiency?

A

Folate deficiency results in normochromic, normocytic anemia

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45
Q

Blood loss of approximately ___________ mL leads to serious adverse effects such as hypovolemic shock.

A

1000 mL.

46
Q

Iron deficiency anemia is most likely to occur in a patient with a history of:

A

Bleeding ulcers

47
Q

A patient complains of intolerable nausea and heartburn from taking an oral iron preparation. What should the nurse instruct the patient to do?

A

Consult with the provider

48
Q

Cyanocobalamin is usually given

A

By injection

49
Q

A pregnant patient is told that she will need to take RhoGam to prevent hemolytic disease of the newborn. Hemolytic disease of the newborn occurs when:

A

An Rh negative mom has an Rh positive baby

50
Q

Use of larger doses of ________ to achieve hemoglobin levels of >11g/dL is associated with increased risk of hypertension, MI, stroke, and heart failure.

A

Epoetin

51
Q

In chronic leukemia, the predominant cell is:

A

Mature, but doesn’t function normally

52
Q

A client presents to the emergency department with severe menstrual bleeding where she is soaking three to four pads/hour. Following assessment, which of the following findings indicates that her body is trying to increase its cardiac output?

A

Heart rate 120 beats/minute

53
Q

Hemolytic anemia is characterized by excessive red blood cell destruction and compensatory:

A

Increased erythropoietin from the kidney

54
Q

A patient presents to the office for an annual check-up and discloses that she has been craving eating chalk. Which condition should the patient be evaluated for?

A

Iron Deficiency Anemia

55
Q

Ferritin levels are directly related to the amount of available ______ stored in the body.

A

Iron.

56
Q

Macrocytic (megaloblastic) anemias caused by folic acid or vitamin B12 deficiencies can seriously affect RBC production. Which of the following lab results would correlate with this diagnosis?

A

Mean corpuscular volume (MCV) of 120 fL (high).

57
Q

A patient is diagnosed with Disseminated Intravascular Coagulation (DIC) as a result of sepsis. The nurse knows this patient is at risk for: SELECT ALL THAT APPLY
Group of answer choices
Bleeding
Pernicious anemia
Clotting
Death

A

Bleeding, Clotting, and Death.

58
Q

Composition of blood

A

Aprox.

45% blood cells

55% Plasma
92% water
7% Plasma proteins
1% Other

59
Q

Life span of platelets

A

4-10 days

60
Q

Erythrocytes

A

Red Blood cells

Carry O2 to tissues

61
Q

Thrombocytes

A

Platelets

Contribute to clotting

62
Q

Leukocytes

A

White blood cells

Participate in immune response/fighting infections.

63
Q

Leukocytes: Granulocytes

A

Neuophils

Basophils

Eosiphils

64
Q

Leukocytes: Agranulocytes

A

Monocytes

Lymphocytes

65
Q

An increase in RBCs could mean:

A

Polycythemia

66
Q

an increase in WBCs could mean:

A

infection, inflammation, malignancy

67
Q

An increase in platelets/coagulation factors

A

Hypercoagulable state (risk of clots and strokes)

68
Q

Decrease in RBCs could mean:

A

Anemia

69
Q

Decrease in WBCs could mean:

A

Immunodeficiency

70
Q

Decrease in platelets/coagulation factors

A

Hypocoagulable state (risk of bleeding)

71
Q

Anemia

A

Reduction in the total number of red blood cells in the circulating blood or reduction in the quality or quantity of hemoglobin

72
Q

Causes of Anemia

A

Not enough production of RBCs

Excess destruction of RBCs

Blood loss

73
Q

Mild Anemia

A

Hemoglobin 10.0 g/dL-12.0g/dL (women) 13.5 g/dL (men)

74
Q

Moderate Anemia

A

Hemoglobin 8.0-10.0 g/dL

75
Q

Severe Anema

A

Hemoglobin 6.5-7.9 g/dL

76
Q

Life-threatening Anema

A

Hemoglobin less than 6.5 g/dL

77
Q

Pernicious Anemia

A

Vitamin B12 deficiency

Risk factors: older adults, Family trends, Gastric resection, Alcoholism, Long term use of PPI

78
Q

Iron Deficent Anemia

A

Iron deficiency anemia will have microcytic (small) and hypochromic (pale, low color) cells.

79
Q

Iron Deficent Anemia risk factors/causes:

A

Common causes of iron deficiency anemia include: loss of blood from GI bleeds, heavy menses, peptic ulcers, and those with a lack of iron in the diet, such as vegans. There is an increased risk for infants, adolescents, and pregnant patients.

80
Q

In acute leukemia, the predominant cell is:

A

the cells are undifferentiated or immature (usually blast cells).

81
Q

Aplastic Anemia

A

Disorder of stem cell in bone marrow

Insufficient production of RBC

Related to: cytotoxic agents/drugs, radiation, antibiotics

82
Q

Hemolytic Anemia

A

RBCs are destroyed faster than they carn be replaced

83
Q

three groups of drugs for thromboembolic deisorders

A

Anticoagulants: suppressing the production of fibrin

Antiplatelets: Inhibit platelet aggregation

Thrombolytics: Promote lysis of fibrin

84
Q

Ferrous sulfate

A

Thera. Anti-anemic drug

Iron supplement

Administered via IV, Z-track IM

Oral tabs (do not crush)

Black Box Warning: Non-intential overdoses of rion containing products are a leading cause of fatal poisoning in children

Drug-Drug interaction and drug food interaction may affect absorption

85
Q

Iron Dextran

A

Given in Pts who have experienced intolerable or ineffective oral dosing

Given via IV

May cause anaphylactic reaction, hypotension, persistent pain with IM injection

86
Q

Sodium Ferric Gluconate Complex and Iron Sucrose

A

Alternatives to Iron dextran

May cause Hypotension and cramps

87
Q

Cyanocobalamin

A

Thera. Drug for anemia

purified form of vit B12

88
Q

Folic Acid

A

Used for Megaloblastic (macrocytic anemia due to folic acid deficiency

Prevents neural tube defect in pregnancy

supplement for poor nutrition related to alcohol use

Can mask manifestations of B12 deficiency

89
Q

Anticoagulants

A

Heparins

Vitamin K antagonist

Direct Thrombin Inhibitors

Direct Factor XA Inhibitors

Antiplatelets

90
Q

Heparin and Heparin deriviatives

A

Rapitd anticoagulation

Adverse events: hemorrhage, hypersensitivity. thrombocytopenia

Contraindications: low platelets, uncontrolled bleeding

Antidote: Protamine sulfate

91
Q

Low Molecular Weight Heparin (LMWH)

A

prevention and treatment of DVT and ischemic complications

Administered subQ based on body weight

may cause bleeding, immune mediated thrombocytopenia, sever neurologic injury

Antidote Protamine sulfate

92
Q

Warfarin

A

Anticoagulant with delayed onset

Long term prophylaxix and treatment of thrombosis

may cause hemorrhage

Drug and food interactions

Antidote Vit K

93
Q

Direct Thrombin Inhibitors

A

DVT prophylaxis and treatement and prevention of stroke due to afib

Administration orally

may cause bleeding and GI disturbances

Antidote Idarucizumab

94
Q

Direct factor XA inhibitors

A

DVT prophylaxis and treatement and prevention of stroke due to afib

Administration orally

may cause bleeding and GI disturbances

Antidote Andexanet

95
Q

Antiplatelets

A

Asprin

Clopidogrel

96
Q

Thrombolytics

A

Used to prevent MI strokes, massive Pulmonary Embolism

May cause bleeding and fever

Monitor aPTT PT Hgb and Hct

97
Q

Desmopressin (DDAVP)

A

Used in mild forms of hemophilia A, bleeding caused by trauma and surgery

IV or intranasal administration

98
Q

Antihemophilic Factor VII

A

Used mainly for hemophilia A

Slow IV push or infusion

may cause headache itching skin rash and sensititivity

99
Q

Factor IX (Christmas Factor)

A

Unsed mainly for Hemophilia B

100
Q

Erythropoietic Growth Factos

A

Epoetin alfa

used for anemia due to chemo and HIV med

administered subq or IV

101
Q

Sodium Na+

A

Most abundant cation in the ECF

when out of balance pt may experience lethargy, confusion, weakness, swelling, seizures, and coma

102
Q

Potassium K+

A

Most abundant cation in the ICF

103
Q

EKG changes with potassuim changes

A

hypokalemia (ST depression) and hyperkalemia (Tall peaked T wave)

104
Q

Calcium Ca++

A

Most abundant cation in the body

increased Ca++ can cause kidney stones, abdominal pain, depression, and cardiac dysrythmias

decreased Ca++ may cause weakness, muscle spasms, and cardiac dysrhythmias

105
Q

Magnesium Mg++

A

required for relaxation of smooth muscles, contraction of skeletal muscles, stimulation of neurons in the brain

increased Mg++ can cause cardiac dysrhythmias, muscle weakness, N&V, Breathing difficulties (Ofen accompanied with increased Ca++ and K+)

Decreased Mg++ may cause cardia dysrhythmias, muscle weakness, muscle cramps, confusion, hallucinations (Often accompanied with decreased K+)

106
Q

Cl-

A

Most abundant anion in the ECF

107
Q

Phosphate PO4-

A

Found in every cell in the body but stored mainly in bones and teeth

108
Q

Fluid Volume Deficit (FVD) Types

A

Isotonic Dehydration: loss of water and Na+

Hypotonic Dehydration: loss of more Na+ than H2O (Na+ deficiency in ECF)

Hypertonic Dehydration: Loss of more H2O than Na+

109
Q

Normal pH of blood in human arterial body

A

(acidic) 7.35-7.45 (basic)

110
Q

Normal PaCO2 (respiratory) in human arterial blood

A

(acidic) 45-35 (basic)

111
Q

Normal HCO3 (Metabolic) in human arterial blood

A

(acidic) 22-26 (basic)

NSG 306 Pathopharmacology I (4 decks)

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