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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
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.
Aldosterone
26
Prevents excess exertion of Na+ by the kidneys and prevents K+ from getting too high
Aldosterone
27
______ activated when blood flow or pressure to the kidneys decreases.
Renin-Angiotensin-Aldosterone System. (RAAS)
28
The Lab reports the following ABG results for your patient: pH: 7.33 PaCO2: 40mm HG HCO3: 20 mEq/L
Metabolic acidosis
29
What patient would be most likely to have decreased intravascular oncotic pressure? A patient with:
Liver failure
30
A hallmark EKG characteristic of the patient with hyperkalemia is the presence of:
Tall, peaked T waves
31
A nursing home patient has been admitted with water intoxication. What will his admission orders most likely include?
Monitor neurological status
32
When planning care for a dehydrated patient, the nurse remembers the principle of water balance is closely related to _____ balance.
Sodium (Na+)
33
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:
Respiratory acidosis
34
A patient who has had prolonged vomiting has a blood gas drawn with the following results: PH: 7.42 PaCO2: 51 HCO3: 33
Fully compensated metabolic alkalosis
35
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?
Respiratory alkalosis
36
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
Partially compensated metabolic acidosis
37
If your patient has hyerphosphatemia, he is likely to also have what secondary electrolyte disturbances:
Hypocalcemia
38
A nurse is preparing to teach about erythropoietin. Which information should the nurse include? Erythropoietin is produced by the body in the:
Kidneys
39
A patient has a lack of intrinsic factor because of a gastric resection surgery. They are at risk for which form of anemia?
Pernicious anemia
40
In polycythemia vera, painful pruritis occurs secondary to:
Release of histamine from excessive mast cells
41
Erythrocytes are vital to which primary function in the body?
Carrying oxygen to tissues
42
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)?
Microcytic, hypochromic
43
Filgastim and oprelvekin should not be given to which of the following patients?
Cancer of the bone marrow
44
Which of the following is NOT TRUE regarding folate (folic acid) deficiency?
Folate deficiency results in normochromic, normocytic anemia
45
Blood loss of approximately ___________ mL leads to serious adverse effects such as hypovolemic shock.
1000 mL.
46
Iron deficiency anemia is most likely to occur in a patient with a history of:
Bleeding ulcers
47
A patient complains of intolerable nausea and heartburn from taking an oral iron preparation. What should the nurse instruct the patient to do?
Consult with the provider
48
Cyanocobalamin is usually given
By injection
49
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:
An Rh negative mom has an Rh positive baby
50
Use of larger doses of ________ to achieve hemoglobin levels of >11g/dL is associated with increased risk of hypertension, MI, stroke, and heart failure.
Epoetin
51
In chronic leukemia, the predominant cell is:
Mature, but doesn't function normally
52
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?
Heart rate 120 beats/minute
53
Hemolytic anemia is characterized by excessive red blood cell destruction and compensatory:
Increased erythropoietin from the kidney
54
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?
Iron Deficiency Anemia
55
Ferritin levels are directly related to the amount of available ______ stored in the body.
Iron.
56
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?
Mean corpuscular volume (MCV) of 120 fL (high).
57
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
Bleeding, Clotting, and Death.
58
Composition of blood
Aprox. 45% blood cells 55% Plasma 92% water 7% Plasma proteins 1% Other
59
Life span of platelets
4-10 days
60
Erythrocytes
Red Blood cells Carry O2 to tissues
61
Thrombocytes
Platelets Contribute to clotting
62
Leukocytes
White blood cells Participate in immune response/fighting infections.
63
Leukocytes: Granulocytes
Neuophils Basophils Eosiphils
64
Leukocytes: Agranulocytes
Monocytes Lymphocytes
65
An increase in RBCs could mean:
Polycythemia
66
an increase in WBCs could mean:
infection, inflammation, malignancy
67
An increase in platelets/coagulation factors
Hypercoagulable state (risk of clots and strokes)
68
Decrease in RBCs could mean:
Anemia
69
Decrease in WBCs could mean:
Immunodeficiency
70
Decrease in platelets/coagulation factors
Hypocoagulable state (risk of bleeding)
71
Anemia
Reduction in the total number of red blood cells in the circulating blood or reduction in the quality or quantity of hemoglobin
72
Causes of Anemia
Not enough production of RBCs Excess destruction of RBCs Blood loss
73
Mild Anemia
Hemoglobin 10.0 g/dL-12.0g/dL (women) 13.5 g/dL (men)
74
Moderate Anemia
Hemoglobin 8.0-10.0 g/dL
75
Severe Anema
Hemoglobin 6.5-7.9 g/dL
76
Life-threatening Anema
Hemoglobin less than 6.5 g/dL
77
Pernicious Anemia
Vitamin B12 deficiency Risk factors: older adults, Family trends, Gastric resection, Alcoholism, Long term use of PPI
78
Iron Deficent Anemia
Iron deficiency anemia will have microcytic (small) and hypochromic (pale, low color) cells.
79
Iron Deficent Anemia risk factors/causes:
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
In acute leukemia, the predominant cell is:
the cells are undifferentiated or immature (usually blast cells).
81
Aplastic Anemia
Disorder of stem cell in bone marrow Insufficient production of RBC Related to: cytotoxic agents/drugs, radiation, antibiotics
82
Hemolytic Anemia
RBCs are destroyed faster than they carn be replaced
83
three groups of drugs for thromboembolic deisorders
Anticoagulants: suppressing the production of fibrin Antiplatelets: Inhibit platelet aggregation Thrombolytics: Promote lysis of fibrin
84
Ferrous sulfate
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
Iron Dextran
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
Sodium Ferric Gluconate Complex and Iron Sucrose
Alternatives to Iron dextran May cause Hypotension and cramps
87
Cyanocobalamin
Thera. Drug for anemia purified form of vit B12
88
Folic Acid
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
Anticoagulants
Heparins Vitamin K antagonist Direct Thrombin Inhibitors Direct Factor XA Inhibitors Antiplatelets
90
Heparin and Heparin deriviatives
Rapitd anticoagulation Adverse events: hemorrhage, hypersensitivity. thrombocytopenia Contraindications: low platelets, uncontrolled bleeding Antidote: Protamine sulfate
91
Low Molecular Weight Heparin (LMWH)
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
Warfarin
Anticoagulant with delayed onset Long term prophylaxix and treatment of thrombosis may cause hemorrhage Drug and food interactions Antidote Vit K
93
Direct Thrombin Inhibitors
DVT prophylaxis and treatement and prevention of stroke due to afib Administration orally may cause bleeding and GI disturbances Antidote Idarucizumab
94
Direct factor XA inhibitors
DVT prophylaxis and treatement and prevention of stroke due to afib Administration orally may cause bleeding and GI disturbances Antidote Andexanet
95
Antiplatelets
Asprin Clopidogrel
96
Thrombolytics
Used to prevent MI strokes, massive Pulmonary Embolism May cause bleeding and fever Monitor aPTT PT Hgb and Hct
97
Desmopressin (DDAVP)
Used in mild forms of hemophilia A, bleeding caused by trauma and surgery IV or intranasal administration
98
Antihemophilic Factor VII
Used mainly for hemophilia A Slow IV push or infusion may cause headache itching skin rash and sensititivity
99
Factor IX (Christmas Factor)
Unsed mainly for Hemophilia B
100
Erythropoietic Growth Factos
Epoetin alfa used for anemia due to chemo and HIV med administered subq or IV
101
Sodium Na+
Most abundant cation in the ECF when out of balance pt may experience lethargy, confusion, weakness, swelling, seizures, and coma
102
Potassium K+
Most abundant cation in the ICF
103
EKG changes with potassuim changes
hypokalemia (ST depression) and hyperkalemia (Tall peaked T wave)
104
Calcium Ca++
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
Magnesium Mg++
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
Cl-
Most abundant anion in the ECF
107
Phosphate PO4-
Found in every cell in the body but stored mainly in bones and teeth
108
Fluid Volume Deficit (FVD) Types
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
Normal pH of blood in human arterial body
(acidic) 7.35-7.45 (basic)
110
Normal PaCO2 (respiratory) in human arterial blood
(acidic) 45-35 (basic)
111
Normal HCO3 (Metabolic) in human arterial blood
(acidic) 22-26 (basic)

NSG 306 Pathopharmacology I (4 decks)

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