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pathophysiology > Final Study Guide > Flashcards

Final Study Guide Flashcards

1
Q

WBC count

A

5,000 – 10,000

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2
Q

Platelet Count

A

150,000 – 400,000

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3
Q

Na normal value and function

A

135-145
“Excites”
Affects brain and nervous system
= changes in LOC/ seizures

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4
Q

Mg normal value and function

A

1.5-3.0
“calms”
Affects deep tendon reflexes
and smooth muscle

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5
Q

K normal value and function

A

3.5-5.0
“Excites”
Affects heart

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6
Q

Ca normal value and function

A

8.5-10.5
“Calms”
Affects nerves and muscles

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7
Q

ABG values

A

Ph: 7.35-7.45
PCO2: 35-45
HCO3: 22-26
PaO2: 80-100
SaO2: >95%

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8
Q

Blood sugar value

A

70- 130 mg/dL

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9
Q

Average Heart rate
Blood pressure
respirations
pulse

A

Heart rate: 60-100
Blood pressure: 120/80
Resp: 12-18
Pulse: 60-100

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10
Q

PT tests for

A

Clotting time test

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11
Q

PTT test for

A

Heparin

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12
Q

INR is used to detect affects of

A

Coumadin

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13
Q

BNP is used to look for

A

Heart failure

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14
Q

BUN test is used to detect

A

normal range <20
test for kidney damage

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15
Q

Troponin test is used to detect

A

myocardial infarction

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16
Q

CK/MB is used to detect

A

myocardial infarction

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17
Q

What does an elevated neutrophil count indicate

A

An acute (bacterial) infection

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18
Q

SIRS is initiated by what

A

a triggering event

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19
Q

All of the following are signs of systemic inflammation except:
Temperature above 101
elevated CRP level
Redness and edema at the injured site
WBC lab results of 17,000

A

Redness and edema at the injured site (SHARP: acute)

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20
Q

ABG value for Asthma Pt

A

Respiratory acidosis

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21
Q

ABG value for rapid breathing Pt

A

Respiratory alkalosis

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22
Q

ABG value for vomiting Pt

A

metabolic alkalosis

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23
Q

ABG value for diarrhea Pt

A

metabolic acidosis

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24
Q

ABG value for renal failure Pt

A

metabolic acidosis

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25
Q

S/S for PUD

A

Erosion of the stomach lining caused by H.Pylori
S/S
-epigastric or chest pain that starts about 2 hours after eating or in the middle of the night after the stomach lining is emptied.

-Pain relieved by eating

-Either heal themselves or get worse to the point of internal bleeding

Dangers of peptic ulcers: anemia, profuse bleeding, and stomach cancer

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26
Q

All are true about Coumadin except:
“avoid garlic, ginger, or ginseng they cause bleeding”
“Don’t take aspirin or ibuprofen for pain”
“You will need to have your blood drawn for a PTT test”
“Epistaxis and petechiae are signs that coumadin levels are too high”

A

“you will need to have your blood drawn for PTT test”
PTT test for heparin

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27
Q

All of the following are s/s of myxedema crisis except:
swelling of soft tissue
mental confusion
bulging eyeballs (exophthalmos)
low blood levels of thyroid hormones

A

bulging eyeballs (exophthalmos)
Myxedema is a sign of hypothyrodisim, exophthalmos is a sign of hyperthyroidism

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28
Q

What does bright red streaking of blood in the stool indicate

A

Non-emergent.
Hematochezia.
usually caused by hemorrhoid or anal fissure

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29
Q

3 Things to know about DIC

A

Occurs in 3 stages: Triggering, Clotting, and Hemorrhaging

Is life-threatening

s/s: bleeding from 3 unrelated spots

tests: low platelet count, and d-dimer test

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30
Q

Does FAS extend throughout pregnancy

A

(fetal alcohol syndrome)
Yes, it does

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31
Q

What is a hypertonic solution used for

A

Used for rapid fluid replacement, and for when tissue is over-hydrated

ex: 3% saline, 6% saline

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32
Q

What does an elevated lymphocyte count indicate

A

A chronic (viral) infection

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33
Q

What indicates an:
uncompensated
compensated
partially compensated
ABG value

A

Uncompensated: PH is out of wack and one other value is also out of wack

compensated: PH is normal and the others are out of wack

partially compensated: all are out of wack

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34
Q

What would you expect your HCT and sodium to be if you’re dehydrated?

A

would expect them to be high, dehydration = low plasma level = high concentration of HCT and Na

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35
Q

Characteristics of Hodgkin’s Lymphoma

A

-Presence of Reed-Sternberg cells
-Highly curable

s/s: painless swollen lymph nodes, weight loss, bone marrow damage

Tx:
Radiation therapy - localized
Chemotherapy – generalized
Immunotherapy (MAB drugs)
Bone marrow [stem cell] transplant

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36
Q

Complications of too many NSAIDS

A

they interfere with normal blood clotting
can lead to bleeding s/s

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37
Q

What does low Hgb count indicate

A

anemia

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38
Q

If a Dr. is asking for MCV, MCH, MCHC, RDW what is he asking for

A

He is testing for anemia

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39
Q

is pernicious anemia a cause of a low WBC count

A

no it is a lack of intrinsic factor = lack of B12 absorption = B12 helps make RBC

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40
Q

Immunity for varicella zoster (chicken pox) can be acquired how

A

Either naturally or artificially

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41
Q

Example of type 3 hypersensitivity

A

Immuno complex reaction
-Lupus
-Glomerulonephritis
-rheumatoid arthritis

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42
Q

What PPE would be used for the following:
Multidrug-resistant wound infection
Tuberculosis
Chicken Pox (varicella zoster)
meningitis

A

Contact
airborne
airborne
droplet

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43
Q

Difference between host and vector

A

Host: incubates and is where the agent reproduces

Vector: how the agent transmits/ Infects others

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44
Q

What is not correct in a myocardial infarction
“You will have permanent EKG changes due to scar tissue in your heart muscle”
“Your CRP levels will be monitored to assess for cardiac inflammation”
“Troponin levels are the first to raise in your blood after a heart attack”
“Elevated BNP indicates you have a prior attack”

A

Elevated BNP indicates you have a prior attack. BNP indicates heart failure not MI

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45
Q

S/s of left-sided heart failure

A

Left = lung
respiratory distress
* Exertional and nocturnal dyspnea
* Hemoptysis (blood-tinged sputum)
* Orthopnea
* Cough
* Cyanosis

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46
Q

Verapamil drug family

A

Calcium-channel blocker

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47
Q

s/s of arterial thrombus

A

5 P’s
pulse low or absent
no edema
pale or mottled color
cool to cold temp
sharp or numb pain

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48
Q

What is the highest nursing priority with septic shock

A

Circulation!

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49
Q

s/s for a pulmonary embolism

A

SOB
Chest pain
hypoxia
cough
pain on deep breath

50
Q

Pleural effusion vs Pleural edema

A

effusion: is in the space, is able to be drained with a needle

Edema: in the tissue itself cannot be drained with needle

51
Q

Emphysema may include any of the following changes except
-loss of elastic recoil after each breath
-increased PaO2
-increased lung compliance making it more difficult to take a breath
-permanent damage due to the inflammatory process in the lungs

A

Increased Pa02

52
Q

When is a person most likely to develop atelectasis

A

soon after surgery or in patients who have limited mobility in the hospital (secretions build up in the lungs due to immobility).

Atelectasis= air sac cannot expand

53
Q

all the following are true statements about lung cancer except
-lung cancer most commonly metastasizes to the kidneys
-tumors in the lungs can compress nerves or veins
-small-cell lung cancer is very aggressive and commonly metastasized to the brain
-lung tumors can increase the patient’s metabolism and cause muscle wasting

A

Lung cancer most commonly metastasizes to the kidneys.

54
Q

How does kidney failure cause anemia

A

Kidneys produce erythropoietin which create RBC. Kidney failure = no erythropoeitin = no RBC

55
Q

Nephrotic syndrome s/s

A

Nephrotic = only protein in urine

s/s edema, lack of protein in the blood = no water being pulled from tissue = pitting edema

56
Q

2 ACE inhibitors

A

anything that ends in pril
-captopril
-lisinopril
etc.

57
Q

All the following are true except
-antidiuretic hormone (ADH) decreases fluid retention
-aldosterone’s function is to spare sodium, thereby causing fluid retention
-angiotensin compensates for shock by causing vasoconstriction
-the kidney’s release renin in response to decreased perfusion

A

ADH decreases fluid retention
*ADH increases fluid retention

58
Q

What are the s/s of acute tubular necrosis

A

central nervous system: change in LOC, confusion, delirium

oliguria or anuria (severe kidney damage)

full body edema

cardiac problems

fixed specific gravity

59
Q

What are the risk factors of cholecystitis

A

6 F’s
forty
fertile
female
fat
family hx
fair

60
Q

All of the following are true about chronic gastroesophageal reflux disease except
A flatter pillow at night will prevent heartburn
-go to the emergency department if you develop CP
-GERD can cause throat cancer if left untreated
-when you lift weights it’s best to not hold your breath during exertion

A

a flatter pillow at night will prevent heartburn

61
Q

What are the s/s of liver disease

A

jaundice of skin and sclera (aka, icterus)
intense pruritus due to icterus

62
Q

The difference between the 3 hepatitis

A

Hepatitis A: Oral fecal route, there is a vaccine.
Hepatitis B: Blood/ body fluid borne, there is a vaccine, can cause liver cancer
Hepatitis C: Blood/ body fluid borne, no vaccine available, may develop liver cancer

63
Q

What are the similarities and differences between IBS and UC and Chron’s

A

IBS: a collection of symptoms, that causes no damage to the GI tract

UC: Large intestine only, affect mucosal region only

Chron’s disease: skip lesions and affects the entire bowel wall thickness

64
Q

What causes dehydration in diabetes

A

Excess sugar in the urine takes water with it from tissues.

65
Q

What is the treatment for diabetes insipidus

A

Medication and ISOTONIC fluid replacement to
reverse dehydration (possibly hypotonic if tissue
dehydration is severe

66
Q

Inadvertent damage to the parathyroid glands may cause what

A

tetany and positive Chvostek’s sign

67
Q

What are the differences between Addison’s disease and Cushing’s disease

A

Both to do with adrenal gland and cortisol production
Addison’s: hyposecretion, bronze skin, low b/p, low an, high potassium

Cushing’s: hypersecretion, moon face, buffalo hump, high b/p, high Na, low potassium

68
Q

What vital signs are expected with pheochromocytoma

A

Tumor of the adrenal medulla that secretes excessive catecholamines (epinephrine/ norepinephrine/ dopamine) resulting in hypertension, tachycardia, hyperglycemia, hypermetabolism, and weight loss

69
Q

Based on the lab values: blood sugar 680, ketones 4.0, BUN 28, hematocrit 60, you know all the following statements are correct except
-the patient will be given insulin by IV infusion
-giving IV fluids is essential to reverse dehydration
-an arterial blood gas test will most likely indicate acidosis
-these findings indicate the patient’s diagnosis is a hyperglycemic hyperosmolar state

A

These findings do not indicate HHS but rather DKA because of the high measures of everything PLUS the presence of ketones

70
Q

What vital signs do you expect of a pt with increased ICP

A

Hypertension (Widening Pulse Pressure - the difference
between the Systolic and Diastolic B/P increases)
-Bradycardia (reflexive slowing of the heart to compensate for
increased B/P)
-Hypoventilation (Respiration slows down) → Hypercapnia
(↑ CO2) which causes vasodilation leading to worse cerebral edema and increased ICP

71
Q

What are the s/s of meningitis

A

Nuchal rigidity
throbbing headache
fever
photophobia
projectile vomiting
altered LOC
increased ICP
red purpuric or blotchy rashes that do not blanch
kernig’s sign and or brudzkinski’s sign

72
Q

A person with a complete spinal cord injury at the level of T4 would have complete use of what limbs and be at risk for what

A

would have use of his arms but not his legs and be at risk of developing autonomic dysreflexia

73
Q

What is the term for when the brain tissue is displaced past the midline toward the other side

A

herniation

74
Q

Difference between hemorrhagic and ischemic stroke

A

hemorrhagic stroke: hypertension, aneurysm, or ruptured vessels, blood in cerebral spinal fluid. Rx: stop bleed, decrease ICP and vasospasm no anticoags

Ischemic: thrombi cause arterial occlusion = most common, has hx of TIAs, Rx: decrease edema and ICP

75
Q

Human papillomavirus infection is associated with what type of cancer

A

HPV is associated with cervical cancer

76
Q

what are the s/s of trichomoniasis

A

Green, frothy, foul smelling discharge

77
Q

Testicular cancer

A

those with history of undedcended testicles as an infant are at highest risk, it has a high cure rate
Rx: orchiectomy

78
Q

Prostate cancer

A

The most common male cancer in men over 50
Early stage: No initial s/s so prostate cancer has usually metastasized before discovered
Late stage: s/s can be similar to s/s of BPH (urgency, frequency, nocturia, hematuria, or blood In ejaculate)

DX: combo of PSA and DRE (PSA can be high in BPH and prostatitis)

79
Q

What are the risks for developing priaprism

A

Sickle cell disease, cancers, neurologic disorder, can be caused by stroke or spinal cord injury

80
Q

What does menometrorrhagia mean and what could it indicate

A

abnormally heavy bleeding at irregular intervals

can indicate uterine cancer

81
Q

What are the s/s and treatment for the compartmental syndrome

A

Pain that can not be relieved by pain medication
Increased pain and numbness or tingling (paresthesia) are the EARLY SIGNS. Decreased pulses or
capillary refill, decrease in temp (cold) and color changes (pale or cyanotic) are LATE signs. Paralysis of the limb is the LAST sign. Compartments of the Lower Leg

tx: fasciotomy

82
Q

Systemic lupus erythematosus is characterized by all the following except
-symptoms can be managed with steroids and immunosuppressant drugs
-the onset of lupus is always sudden with constant and consistent symptoms
-facial redness called a “butterfly rash” is a distinct sign of lupus
-the formation of autoantibodies and immune complexes are present in the body

A

The onset of lupus is always sudden,

Lupus is an autoimmune disease it is not suddenly onset

83
Q

What is not correct about scoliosis
-scoliosis of the spine is damaging to the heart and lungs
-scoliosis usually becomes more prominent when the child reaches puberty
-this problem can shorten the person’s life to about 40 years of age
-correction of this condition involves a minor surgery with little potential for complications

A

Correction of this condition involves more than a minor surgery

84
Q

which of the following is an incorrect statement about osteogenesis imperfect
-a child with OI may have blue sclera due to the inability of their body to synthesize collagen
-babies with OI can sustain fractures during the birthing process
-OI is primarily caused by maternal drug use during pregnancy
-children with OI have incomplete development of bones and ligaments resulting in smaller stature

A

OI is not caused by maternal drug use during pregnancy it is a hereditary diseae

85
Q

All of the following are risk factors of osteoporosis except
family hx of osteoporosis
smoking, cola drinks, alcohol
menopausal women
hypercalcemia

A

hypercalcemia is not a rf

hypocalcemia is a rf

86
Q

The syndrome of inappropriate adh is characterized by what

A

SIADH= salt is absent = drowning head or soaked inside

etiology: brain problem: injury/ stroke/ cancer

patho: increased ADH leads to water retention which leads to fluid overload and dilutional hyponatremia

s/s: concentrated urine, hyponatremia, cerebral edema

tx: hypertonic solutions

87
Q

Heartburn that radiates to the jaw and between shoulder blades could mean what

A

myocardial infarction

88
Q

What is not true about asthma
-the smooth muscle surrounding the alveoli constricts, limiting oxygenation
-the mucosa lining experiences severe inflammation
-the goblet cells within the mucosa lining produce excessive amounts of mucous
-too much carbon dioxide is exhaled due to hyperventilation and the patient experiences respiratory alkalosis

A

Too much carbon dioxide is not exhaled, when with asthma you have decreased respirations

89
Q

What are the s/s of chronic bronchitis

A

hypersecretion of mucous. increase mucus production and the size & number of mucous glands along with damage to cilia that prevents movement of mucous out of the bronchus. Once clogged with mucus, the lungs are then vulnerable to
viral and bacterial infections, which over time distort and permanently damage the lungs’ airways.

Dx: cough for 3 months 2 years in a row

90
Q

what is the most important concern in uncontrolled seizures

A

ABCs
sodium imbalance?
oxygen to brain?

91
Q

What are the s/s of hypoglycemia, when is it most common?

A

CNS changes due to brain using glucose as its only source of energy, irritability, etc.

Cold and clammy needs some candy

Can occur when insulin lowers blood glucose too far.

92
Q

Any of the following findings would be present in hypovolemic shock except
heart rate of 55 beats per minute
blood pressure 85/50
respirations 36 per minute
heart rate 115 beats per minute

A

The heart rate of 55 beats per minute, bradycardiac is not typical rather it is tachycardia that is associated with hypovolemic shock

93
Q

What are the differences between peripheral arterial occlusive disease and deep vein thrombosis

A

PAO: 5 P’s, low or no pulse, cold temp, pale or mottled, pain is sharp and numb

DVT: SHARP, pulse is present, edema, pink or red color, hot temp, pain is aching or throbbing

93
Q

what tests are used to diagnose an MI

A

Troponin and CK-MB

94
Q

Chemical mediators are released from endothelial cells in blood vessels during inflammation

A

True

95
Q

what is the biggest concern about systemic inflammatory response syndrome

A

circulation

96
Q

what is the most appropriate precaution to take to prevent transmission of TB

A

airborne precaution, N95 masks

97
Q

the primary purpose of the inflammation response is to what?

A

remove the injury-causing agent

98
Q

What are the potential problems of decreased leukocyte formation

A

increase risk of infection

99
Q

what is the difference between benign and malignant growths

A

Benign, solid borders, doesn’t metastasize, is a simple growth, pushes on surrounding organs

Malignant, non solid borders, metastasized, non palpable, sluffs off

100
Q

s.s of autonomic dysreflexia

A

injury of T6 and above
below the injury it is vasoconstriction, pale, chicken skin, clammy

above injury it is vasodilated, red, flushed, warm

101
Q

what can trigger the inflammation process

A

necrosis, the contents of the cell is excreted and cause an inflammatory response

102
Q

what nursing interventions would likely be implemented to prevent increased intracranial pressure

A

raise the head of the patient
protect the airway, suction nearby
check frequently

103
Q

what are the s/s and treatment of hyperparathyroidism

A

muscles are too calm, pathological fractures, (Same as Hypercalcemia –“calms too much”) lethargy, drowsiness, N/V, decreased deep tendon reflexes (DTR). And, as stated above, there is a greater risk for fractures because calcium has moved out of the bone into the blood

104
Q

What is the highest priority in managing Crohn’s disease

A

Complications of Crohn’s Disease: Chronic
inflammatory condition of the bowel. The bowel wall becomes congested, thickened, leading development of abscesses and fistulas. Scar tissue interferes with the movement of chyme through the intestine and perforation or obstruction can occur. The chronic inflammation can lead to significant problems such as

  1. Malabsorption = anemia als omalabsorption of calcium = bone weakness
105
Q

what bacteria is usually present in peptic ulcer disease

A

H. Pylori

106
Q

What is the cause of ascites

A

Free Fluid in the abdomen caused by two problems:
#1- Portal hypertension increases capillary hydrostatic pressure (“PUSHES”
fluid out of vessels into the gut) and,
#2 – damaged liver does not synthesize serum protein  decreased oncotic
pressure (no protein in vessels to “PULL” the fluid out of the gut back into the veins).

107
Q

What does cancer in situ of the cervix mean

A

in situ means it is in the same layer of cells from which it originated so the cancer is still in the cervix

108
Q

examples of chronic inflammatory response

A

rheumatoid artheritis
lupus
heart disease

109
Q

precautions for Clostridium difficile

A

contact precautions (gloves gown etc)

110
Q

meningitis precautions

A

droplet precautions mask and eye wear

110
Q

Testicular torsion

A

urgent need for prompt and aggressive surgical treatment

111
Q

s/s of candidiasis

A

thick white (creamy) or “clumpy” or “cottage-cheese looking” vaginal discharge, itching, redness, burning
pain with urination, dyspareunia

112
Q

BHP and prostatitis can show high signs of what

A

Positive signs of prostate-specific antigen (PSA) levels

113
Q

All of the following are correct about stds except
-a distinguishing feature of Trichomoniasis infection is green, foul-smelling vaginal discharge
-herpes simplex 2 can be found in either the mouth or genital area
-chlamydia and gonorrhea are often found together in the same person
-the tertiary stage (gumma formation) of syphilis is the most contagious of the three stages

A

The tertiary stage of syphilis is the only stage which is not contagious

114
Q

what are some examples of the damaging effects of edema

A

a. Impaired blood flow (and O2 delivery)
b. Reduced local healing of tissue
c. Metabolic wastes cannot easily leave cells so
toxins build up.
d. Increases workload on the heart as it tries to
move fluid through the blood veins. More
pressure is required to push the excess fluid
which raises B/P → chronic hypertension.

115
Q

Neutrophil count

A

47% - 63%

116
Q

lymphocyte count

A

24% - 40%

117
Q

hematocrit

A

37 – 50 %

118
Q

hemoglobin

A

12 – 16.5

pathophysiology (14 decks)

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