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NUR3100 PATHOPHYSIOLOGY > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Recovery of AKI

A

Diuresis: excessive urine production; may cause excessive loss of water & electrolytes (creatinine)

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2
Q

Paraplegia

A
  • Loss of motor and/or sensory function in thoracic, lumbar, or sacral spine
  • Arm functioning is spared
  • Depending on level of injury; functioning of trunk, legs, & pelvic organs may be impaired
  • T1-T12: full UE control
  • L1-L5: hip & knee movement
  • S1-S5: full leg, foot, ankle control bowel, bladder, & sexual funcs
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3
Q

Intrarenal - Acute Kidney Injury (AKI)

A
  • Conditions that damage renal structures
  • Causes: ischemia (glomerulonephritis & pyelonephritis; sepsis, toxins from massive infections, nephrotic meds)
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4
Q

Benign Prostatic Hypertrophy (BPH) Clinical Manifestations

A
  • Weak stream
  • Difficulty emptying bladder
  • Urgency
  • Dysuria
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5
Q

Prerenal - Acute Kidney Injury (AKI)

A
  • Dcrd blood flow without ischemic injury
  • Causes: hypovolemia (hemorrhage, dehydration, shock), hypotension (poor perfusion)
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6
Q

Parkinson’s Disease Clinical Manifestations

A
  • Tremor
  • Pill Rolling (thumb&forefinger)
  • Rigidity: jerky, ratchet-like movements, difficulty swallowing; drooling
  • Bradykinesia: shuffle gait, freeze in place
  • Mask-like face: facial movements limited
  • Autonomic nervous system dysfunction
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7
Q

Common Clinical Manifestations of CVA/TIA (7)

A
  • Face drooping
  • Arm weakness
  • Speech difficulty (slurred, aphasia)
  • Sudden severe headache
  • Visual disturbances (loss in 1 eye)
  • Loss of balance/coordination
  • N/V
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8
Q

Concentrations of Intracellular Electrolytes

A
  • Small amnts of Sodium (Na), Chloride (Cl), Bicarbonate, & Phosphorus (P)
  • Almost no Calcium (Ca)
  • Moderate amnts of Magnesium (Mg)
  • Large amnts of POTASSIUM (K)
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9
Q

C3 Injury

A

C1-C3 injury requires mechanical ventilation

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10
Q

Acute Cystitis Clinical Manifestations

A
  • Urinary frequency, urgency
  • Suprapubic pain
  • Hematuria, dyspareunia
  • Urine cloudy w/ odor
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11
Q

Hypokalemia Causes

A
  • Renal losses
  • Inadequate intake
  • GI losses: severe N/V, diarrhea
    (K<3.5 mEq/L)
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12
Q

CKD Complications

A
  • Azotemia: accumulation of nitrogen waste, incrd lvls of blood urea nitrogen (BUN)
  • Uremia: urea in blood; “uremic state”, weakness, fatigue, nausea
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13
Q

Hypernatremia Clinical Manifestations

A
  • Thirst, dcr urine output; temp elevation, dry mucous membranes
  • Neuro: brain cells shrink; dcrd reflexes, headache, seizures
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14
Q

Post-Concussive Syndrome

A
  • Lasts days to months
  • Irritability, insomnia, impaired judgement, persistent headache, dizziness, attention deficits, anxiety, depression
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15
Q

Hyperkalemia

A
  • Potassium (K)>5.0 mEq/L
  • Incrd K intake & absorption, shift of K from cells into ECF & dcrd K output
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16
Q

Stress Incontinence

A

Incr intra-abdominal pressure causes urine loss

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17
Q

Guillain-Barre Syndrome (GBS) Clinical Manifestations

A
  • Progressive ascending muscle weakness of limbs (ground to brain)
  • Mild weakness to symmetric flaccid paralysis ventilator dependence
  • May cause autonomic dysfunction
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18
Q

Meningitis Patho

A
  • Pneumococcal or meningococcal bacteria
  • Microorganisms in CSF release endoroxins
  • Inflamm of brain tissue & CSF (purulent exudates)
  • Inflamm of vascular syst = congestion & infarction
  • Meninges thicken & adhesions form = impinge cranial nerves, impair outflow of CSF = hydrocephalus
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19
Q

Hyponatremia

A
  • Na<135 mEq/L
  • Loss of Na, water intoxication; dcr in Na in ECF, water moves into cells - cells swell
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20
Q

Hypovolemia Treatments

A

Crystalloids (IV solutions) & colloids (incr osmotic pressure); replace fluids & electrolytes

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21
Q

CKD Causes

A
  • Diabetic nephropathy
  • Uncontrolled HTN
  • Glomerulonephritis
  • PKD (Polycystic Kidney Disease)
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22
Q

Mixed Incontinence

A

Mix of stress & urge, CM of both

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23
Q

Most Common Kidney Stone (renal calculi)

A

Calcium oxalate

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24
Q

Autonomic Dysreflexia Clinical Manifestations Above Level of Injury

A
  • Bradycardia
  • Vasodilation
  • Flushed & profuse sweating
    HTN will cause brain to lower BP bc of baroreceptors by dcring CO (bradycardia), vasodilation to lower BP; blood will pool = flushing & sweating
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25
Q

Neurogenic Bladder Incontinence

A

Loss of nervous system control of bladder

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26
Q

Urge Incontinence

A

Loss of urine with strong urge to void (overactive bladder) - neural control or smooth muscle problem

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27
Q

Incrd ICP Late Clinical Manifestations

A
  • Worsening tissue hypoxia: lethargy > stupor > coma
  • HTN
  • Bradycardia
  • Abn. resp. patterns
  • Pupils large & unreactive (one side): brain herniation
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28
Q

What is Increased Cranial Pressure (ICP)

A

Incr in one compartment places pressure on another; disrupts tissue perfusion
Can be caused by an incr in brain tissue, fluids, or brain tumor

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29
Q

Postrenal - Acute Kidney Injury (AKI)

A
  • Urine outflow blocked
  • Causes: bilateral ureteral obstruction/bladder obstruction (BPH/tumor), stones
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30
Q

Quadriplegia

A
  • Damage in cervical spine; impairment of function from neck down
  • C3: resp. arrest; loss phrenic nerve
  • C3-C5: resp. insufficiency of diaphragmatic innervation
  • C6 & T8: loss of intercostal innervation; weak cough
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31
Q

Fluid Excess Treatments

A
  • Diuretics: reduce fluid buildup in the body by incring urine production
  • Dialysis: removes waste products & excess fluid from the blood
32
Q

Meningitis Clinical Manifestations

A
  • Sudden onset headache & fever
  • Stiffness of neck (nuchal rigidity)
  • Others related to meningeal inflamm & incrd ICP
33
Q

Renal Calculus Clinical Manifestations

A
  • Pain (back/flank, groin, lower abdomen)
  • N/V
  • Hematuria
34
Q

Spinal Cord Injury (SCI) Patho

A
  • Damage to neural elements of spinal cord
  • Most SCIs involve damage to vertebral column or supporting ligaments & to spinal cord
35
Q

Hypovolemia

A
  • Loss of water & electrolytes from ECF w/ near normal water/electrolyte proportions
  • Loss of volume in blood vessels
36
Q

Risk Factors for Incrd ICP

A
  • Hemorrhage: (brain bleed or CVA), blood leaks out of intravascular space incring blood to >10%
  • Brain tumor: incrs brain tissue to >80%
  • Hydrocephalus: excess CSF or obstruction of CSF
  • Anything causing cerebral edema (brain swelling)
37
Q

Concussion

A
  • Force to brain (TBI) causes temporary axonal disturbance
  • Diagnosed based on CMs
  • Headache, dizziness, sleepiness, memory loss/amnesia, confusion, N/V, balance problems
38
Q

Myasthenia Gravis (MG) Clinical Manifestations

A
  • Fluctuating weakness of skeletal muscle groups (no sensory)
  • Commonly involves facial & throat muscles
  • 90% only involves eyes & eyelids (ptosis) & dysphagia
  • Better in AM; worse as day progresses
39
Q

CKD Labs

A
  • GFR: <60ml/min/1.73m(2)
  • Serum BUN: elevated
  • Serum Creatinine: elevated, >1.2mg/dL
  • Proteinuria: elevated
40
Q

Postictal State

A
  • Period immediately following a seizure
  • Recovery after intense brain stimulation
  • 5-30mins
  • Unconsciousness/deep sleep, headaches, confusion, dysphagia, memory loss, HTN
41
Q

Mechanism of Action of ADH

A
  • Released by pituitary gland when high osmolarity detected in ECF
  • Acts on distal tubules of kidney to retain H2O
  • Dcrs osmolarity
42
Q

Nocturnal Enuresis Incontinence

A

“Bed wetting” loss of urine during sleep

43
Q

Hypokalemia

A
  • Potassium (K) < 3.5 mEq/L
  • Dcrd K intake & absorption, a shift of K from ECF into cells & incrd K output
44
Q

Hypovolemia Causes & High Risk

A
  • Dehydration, shock, & hemorrhage
  • Very young, very old, very ill
45
Q

Seizure Patho

A

Sudden, transiet disruption in brain electrical function caused by abnormal excessive discharges of neurons

46
Q

Tonic Phase

A
  • Immediate loss of consciousness
  • Sharp tonic contraction of muscles w/ extension of extremities
  • Incontinent of bowel & bladder
  • Cyanosis if airway is compromised
47
Q

Amyotrophic Lateral Sclerosis (ALS) Patho

A

Autoimmune - destruction of motor neurons in brain & spinal cord (5% genetic)
Men > Women (50s-60s)

48
Q

Hyponatremia Causes

A
  • Excess ADH/hypotonic fluids/diuretics
  • Vomiting/diarrhea/sweating
    (Na<135 mEq/L)
49
Q

Overflow Incontinence

A

Leakage associated with retention (enlarged prostate)

50
Q

Cervical Cancer Prevention

A
  • Gardasil vaccine
  • Screen pelvic exam / PAP smears every 3 yrs
51
Q

Benign Prostatic Hypertrophy (BPH) Risk Factors

A
  • Older age (1/3 of men >50yrs, 90% by 85yrs)
  • African American
  • Family hx
  • Obesity
52
Q

Nephrotic Syndrome Patho

A

Damage to Bowman’s capsule incrs permeability of glomerulus = loss of serum protein

53
Q

Risk Factors for Seizures

A
  • Genetic predisposition
  • Acute febrile state*
  • Head trauma*
  • Cerebral edema*
  • Abrupt withdrawal of anti-epileptic drugs
  • Infection
  • Metabolic disorder
  • Cerebrovascular disease*
  • Exposure to toxins
  • Brain tumor
  • Hypoxia
  • Acute drug & ETOH withdrawal
  • F&E imbalances
54
Q

Myasthenia Gravis (MG) Patho

A
  • Antibody-mediated (autoimmune) loss of acetylcholine receptors (AChR) in neuromuscular junction
  • Abnormal thymus in 70% of pts
  • Female to male; 3:2
55
Q

Hyperphosphatemia Causes

A
  • Impaired kidney excretion
  • Hypoparathyroidism
    (P >4.5 mg/dL)
56
Q

Clonic Phase

A

Rhythmic bilateral contraction & relaxation of extremities

57
Q

Concentrations of Extracellular Electrolytes

A
  • Large amnts of SODIUM (Na) & Chloride (Cl)
  • Moderate amnts of bicarbonate
  • Small amnts of Calcium (Ca), Phosphorus (P), Magnesium (Mg), & Potassium (K)
58
Q

Hypernatremia Causes

A
  • Retained: kidney disease
  • Water Loss: diarrhea, burns, low intake
59
Q

Hemorrhagic CVA

A
  • 13% of strokes
  • More fatal due to brain bleed that can incr ICP
  • Commonly caused by a rupture of intracerebral vessel, hemorrhage causes hematoma; edema
60
Q

Which Lab Value Shows Early Renal Damage?

A
  • Glomerular filtration rate <60ml/min/ 1.74m(2)
  • Microalbuminuria > 30mg/day
61
Q

Hyperkalemia Causes

A

Renal failure; excess intake, intracellular release

62
Q

Ischemic CVA

A
  • 87% of strokes
  • More treatable; easier to treat an emboli
  • Obstruction = no oxygen due to thrombosis (atherosclerotic plaque) or embolism (blood clot)
63
Q

Incrd ICP Early Clinical Manifestations

A
  • Change in LOC: restless, irritability, confusion, drowsiness
  • Headache
  • Pupils small & sluggish
64
Q

Multiple Sclerosis Patho

A

Autoimmune - inflammation & destruction of CNS myelin with plaque formation and gliosis (scarring); nerve conduction interrupted

65
Q

Basilar Skull Fracture Clinical Manifestations

A
  • Headache
  • CSF otorrhea (ear) or rhinorrhea (nose)
  • Facial nerve palsy
  • Periorbital ecchymosis (raccoon eyes)
  • Mastoid ecchymosis (battle sign)
66
Q

Hyponatremia Clinical Manifestations

A
  • GI: N/V, abdominal cramping; diarrhea
  • MS: muscle cramps, weakness
  • Neuro: brain swelling ; headaches, seizures
    (Na<135 mEq/L)
67
Q

Nephrotic Syndrome Clinical Manifestations

A
  • Heavy proteinuria (>3.5g/day): high urine protein
  • Hypoalbuminemia: low serum protein
  • Severe edema: loss of protein & salt and water retention
  • Hyperlipidemia: compensatory synthesis of proteins by liver
68
Q

Hypernatremia

A
  • Na>145 mEq/L
  • Excess Na or loss of water; water leaves cells - cell shrinks (cellular dehydration)
69
Q

Chronic Kidney Disease (CKD) Patho

A

Gradual dcr in renal function that is not reversible; result of loss of nephrons & progressive decline in renal function
GFR < 60 ml/min for 3+ months

70
Q

“Third-Spacing”

A

Loss or trapping of ECF into transcellular space (serous cavities); pleural space, peritoneal cavity, percardial sac, joint cavities, bowels, interstitial space

71
Q

Pathophysiologic Mechanisms of Edema Formation

A
  • Incr capillary filtration pressure; incr vascular vol (heart failure), venous obstruction (liver failure)
  • Dcr capillary colloidal osmotic pressure; incr loss of serum proteins (kidney disease), dcr production proteins (liver)
  • Incr capillary permeability; inflamm, allergies, ascites
  • Produce obstruction to lymph flow; surgical removal of lymph nodes, tumor obstruction
72
Q

Risk Factors for Pelvic Inflammatory Disease (PID)

A
  • <25yrs
  • Multiple sex partners
  • STIs
73
Q

Guillain-Barre Syndrome (GBS) Patho

A

Acute onset immune-mediated demyelination of nerves following influenza-like illness

74
Q

Hypokalemia Clinical Manifestations

A
  • Weakness
  • Muscle cramps & pain
  • Polyuria
  • Hypotension
  • EKG changes; dysrhythmias, cardiac arrest
75
Q

Autonomic Dysreflexia

A

Triggered by an impacted or over-distended bladder

76
Q

Best Way to Measure Fluid Status

A
  • Daily Weights (gain & loss)
  • Rapid gain or loss of 1 kg (2.2lbs) = 1L of fluid
  • Edema not apparent until 5-10lbs excess fluid

NUR3100 PATHOPHYSIOLOGY (5 decks)

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