Patho Exam 2: Evolve Questions Flashcards
How soon are ECG changes visible after hypoxia
30 to 60 seconds
Who would be at highest risk for developing pulmonary embolism (PE)?
72 year old male who is recovering from hip replacement surgery in the hospital
This occurs with activity and is often limited and resolves with rest
- Stable angina
Where do aortic blood flow problems occu?
- From the left ventricle to the aorta.
A 30 year old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. he experiences respiratory failure. which of the following lab values would the nurse expect
elevated PaCO2
A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. A nurse recalls this condition is caused by
Decreased inspired oxygen
Expiratory stridor
a monophonic wheeze
Arteriosclerosis plaque is caused by
collagen over a fatty streak that is composed of a large number of lipid-laden foam cells that deposit on the vessel wall.
Which is the MOST common complication of an AMI?
arrythmia
Clinical Manifestation of Pulmonary Edema
- dyspnea
- crackless
- dullness of percuss at lung bases
- pink frothy sputum
- hypercapnia
A 60 year old male undergoes surgery for a bone fracture. what nursing measure would be most effective for preventing pulmonary embolism (PE) in this patient?
prevent deep vein thrombosis
A 10 year old male is brought to the ER with prolonged bronchospasm and severe hypoxemia. the most likely diagnosis on the chart is
Status asthmaticus
a blood clot that remains attached to a vessel wall.
Thrombus
has a rumbling-decrescendo murmur.
Mitral stenosis
a diffuse, inflammatory obstruction of the small airways or bronchioles
Bronchiolitis
Airway hyper-responsiveness in asthma is related to
exposure to an allergen causing mast cell degranulation
abnormal permanent enlargement of gas-exchange airways (acini) accompanied by destruction of alveolar walls without obvious fibrosis.
Emphysema
what is the most common cause of pulmonary edema?
- left sided heart failure
- increasing pressure of left chambers of the heart
cause a release on renin
- decrease in the amount of sodium delivered to the kidney.
- beta-adrenergic stimuli
- low potassium concentration
An 80 year old female is in the hospital for a bone fracture. while there she develops a large, nonlethal pulmonary embolus. What is the result of the obstruction of pulmonary blood flow>
pulmonary hypertension
while reviewing lab results, the help confirm a diagnosis of cystic fibrosis in a 1-year old child which substance will be present in the child’s sweat
sodium chloride
Define Emphysema
- abnormal permanent enlargement of gas-exchange airways (acini) accompanied by destruction of alveolar walls without obvious fibrosis.
A cough in an infant can be a sign of
- infection
- foreign body
- obstruction.
A 53 year old male with a 20 year history of smoking is diagnosed with emphysema. Why the patient’s airways are obstructed?
Loss of elastic recoil
Which structures are considered part of the acinus?
- Respiratory bronchioles
- Alveolar ducts
- Alveoli
Define Open Pneumothorax
- air pressure in the pleural space equals barometric pressure
- b/c air that is drawn into the pleural space during inspiration is forced back out during expiration
Hypoxemia and cyanosis are generally caused by
- lesions that cause right ventricular outflow tract obstruction
- defects involving mixing of saturated and unsaturated blood
- transposition of the great arteries
- deoxygenated blood flowing into systemic circulation
indicates there was trauma to the chest resulting in the collapse of the lung
Secondary pneumothorax
artery travels in the coronary sulcus between the left atrium and the left ventricle?
Circumflex
caused by cell death and necrosis secondary to trauma or pressure-induced oxygen deficiency
Venous Stasis Ulcers
an inflammatory disease of the peripheral arteries that tends to occur in young men who are heavy smokers
Thromboangiitis obliterans
Cyanosis definition
- bluish discoloration of the skin & mucous membranes,
- caused by increasing amounts of desaturated or reduced hemglobin in the blood.
A 42 year old female presents with dyspnea, rapid, shallow breathing, inspiratory crackles, decreased lung compliance, and hypoxemia. tests reveal a fulminate form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury.
Acute Respiratory Distress Syndrome (ARDS)
What can commonly occur in an infants airway?
Obstruction
A patient has been diagnosed with a pericardial effusion resulting in the presence of frank blood. Which condition is associated with a bloody effusion?
- Coagulation defect, trauma, and aneurysms
Characteristic associated with hypertension?
- Family history positive for hypertension
- High dietary sodium
- Glucose intolerance
- Obesity
A yougn patient is admitted to the pediatric unit with cystic fibrosis (CF) exacerbation. the nurse monitors the patient closely because the main cause of death in a child with CF is
respiratory failure
Which part of the heart is responsible for electrical impulse stimulation?
SA Node
A patient is diagnosed with an antidiuretic hormone-producing lung tumor. What is the most likely diagnosis?
small cell carcinoma
A 23-year-old patient presents with severe chest pain that worsens with respiratory movements and with lying down. What is the most appropriate intervention?
Administer analgesics
Define Paroxysmal Nocturnal Dyspnea
- attacks of SOB & coughing that occur at night.
- Awakens the person from sleep, and may be quite frightening.
when constrictions and dilations destroy the bronchi.
Varicose
Airway Obstruction is most likely to occur in which age group?
- in infants.
- This is due to their smaller airway and smaller diameter.
- more cartilage and collapse easily.
- A cough can be a sign of infection, foreign body, or obstruction.
a 53 year old male with a 20 year history of smoking is diagnosed with emphysema. when the nurse is asked what causes this, what is the nurse’s best response? changes in his lungs are caused by
Alpha-1-antitrypsin deficiency
Which statement regarding cellular injury of the myocardium is correct?
Myocardial cells remain viable if blood flow returns within 20 minutes.
definition of cardiac preload?
Pressure generated by the end-diastolic volume
an increase in parasympathetic nervous stimulation and a decrease in sympathetic nervous stimulation
Vasogenic Shock
a harsh, vibratory sound of variable pitch due to turbulent flow through the partially obstructed airway
Stridor
A patient presents with chest pain that occurs at rest. Abnormal vasospasm of the coronary arteries is detected. What is the most likely cause of the chest pain?
- Prinzmetal angina
- produces pain at rest and is common in women
What is the appropriate term for the “thick filaments of myosin that constitute a central dark band”?
A Band
Which term describes the occlusion of a blood vessel from a bolus of circulating matter in the bloodstream?
Embolus
This type of shock is due to infection
Septic
a decrease in blood volume due to hemorrhage
Hypovolemic Shock
a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?
- alveolocapillary membrane injury causing a massive inflammatory response
Which structure is the source of nutrients for the blood vessels?
vasa vasorum
This reflex facilitates blood pressure changes and heart rate changes.
baroreceptor reflex
Which diagnosis finding is characteristically present when the parietal pleura is infected?
Friction Rub
Normal Heart Rate for a newborn?
100 - 180
What is the process called where carbon dioxide (CO2) is exchanged for oxygen?
Respiration
medical condition places a client at a higher risk for developing chronic upper airway obstruction?
- Congenital malformation
- Subglottic stenosis
veins have pooled blood.
Varicose
when the bronchi become large and balloon like.
saccular
What two factors determine cardiac output?
Heart rate and stroke volume
a thrombus formation occurring mainly in the lower extremities
Deep Vein Thrombosis
chest pain, usually substernal chest discomfort
Angina Pectoris
A geneticist is discussing cystic fibrosis (CF). which information should be included? CF is an ____ disease
autosomal recessive
inadequate alveolar ventilation in relation to metabolic demands
Hypoventilation
A patient has rheumatic fever. Which valve is most commonly affected?
Mitral
A patient has symmetrically dilated airways. Which type of bronchial dilation is this?
Cylindrical
While planning care for a child with asthma, which of the following is characteristic of asthma
Prolonged Expirations
the leading cause of death in the first year of life
Congenital Heart Disease
what is the most common cause of pulmonary edema?
- left sided heart failure
- increasing pressure of left chambers of the heart
This interval is the time when the entire ventricular myocardium is depolarized?
The ST interval
Which condition can cause of hypercapnia?
- Disease of the medulla
- Large airway obstruction
- Thoracic cage abnormalities
- Depression of Respiratory Center
often referred to as the cardioinhibitory center
Parasympathetic Excitation
Which receptor monitors pH, PaCO2, and PaO2 of arterial blood?
Chemoreceptors
Define Paroxysmal Nocturnal Dyspnea
- attacks of SOB & coughing that occur at night.
- Awakens the person from sleep, and may be quite frightening.
A 28 year old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions.
hemoptysis
A patient has impaired blood flow from the left atrium to the left ventricle. Which valvular problems does this describe?
Mitral Stenosis
Describe AutoRegulation
- Blood vessels regulate their own blood flow.
- In coronary circulation, pressure is between 60 mmHg and 180 mmHg
- ensures constant coronary blood flow
- process originates in vascular smooth muscles of the arterioles
Define and embolus
detaches from the wall of a vessel and circulates within the vascular system until it reaches a vessel small enough for it to occlude
The inflammation caused by a thrombus
Thrombophlebitis
A newborn has respiratory distress syndrome, what is a predisposing factor
Premature Birth
What is the effect of angiotensin II?
Vasoconstriction, causes the stimulation of aldosterone
A patient with PND is most likely to have
left ventricular failure
Arteriosclerosis is:
thickening and hardening of the vessel wall
A condition in which blood has pooled, producing distended and palpable vessels, is referred to as a:
Varicose Veins
to prevent sudden infant death syndrome, the nurse should instruct parents to
always lay infants down on their backs to sleep
Surfactant
- a lipid protein mix produced by type II cells.
- is found in the lining of the alveoli
- reduces surface tension
What complication occurs secondary to hypertension?
Congestive heart failure
caused by altered hemodynamics
Secondary hypertension
has a crescendo-decrescendo murmur
Aortic stenosis
caused by an infection of staphylococcus aureus
Infective Endocarditis
asthma is thought to be caused by
interactions between genetic and environmental factors
The respiratory center characteristics
- located in the brain stem.
- affecting the respiratory muscles’ ability to contract and relax
- transmitting impulses that bring about the physical act of breathing.
- influenced by emotions and pain.
most commonly caused by radioactive exposure, rheumatoid arthritis, or uremia
Chronic pericarditis
Define Emphysema
- abnormal permanent enlargement of gas-exchange airways (acini) accompanied by destruction of alveolar walls without obvious fibrosis.
Which pathology most commonly results in pulmonary edema?
Increasing pressure in the left chambers of the heart
often called the cardioexcitation center
Sympathetic Stimulation
Cigarette smoking produces:
- an increased LDL level
- thrombotic/inflammatory state
- decreased HDL
Cyanosis definition
- bluish discoloration of the skin & mucous membranes,
- caused by increasing amounts of desaturated or reduced hemglobin in the blood.
When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for
Shock & Death
a nurse recalls respiratory distress and hypoxemia in laryngotracheobronchitis are caused by
mucosal edema
This reflex causes the heart rate to increase after intravenous infusions of blood or fluid
Bainbridge Reflex
Complications of hypertension
- ventricular hypertrophy
- angina pectoris
- congestive heart failure
- coronary artery disease
- myocardial infarction
- sudden death
Pneumonia is caused by
viral or bacterial infections
characteristic of idiopathic pulmonary arterial hypertension (IPAH)
- fatigue
- dyspnea
- Jugular Vein Distention
this is the collapse of lung tissue which tend to develop post op
Atelectasis
HDL
- associated with phospholipids and protein
- good
Oxygen consumption for newborn
doubles
Define Tension Pneumothorax?
- pleural rupture acts as a one way valve
- air ents on inspiration but preventing its escape by closing during expiration.
- air pressure exceeds barometric pressure
- life threatening
A 20 year old male presents to his primary health care provider, difficulty breathing when lying down. What term should the nurse use to document this condition?
orthopnea
Which of the following would shift the oxyhemoglobin dissociation curve to the left?
Hypocapnia
A 60 year old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. a diagnosis of pleural effusion is made, and a watery fluid is drained. when giving report, the nurse will refer to this fluid as
transudative
A 30 year old male prison inmate contracted tuberculosis during an outbreak. while planning interactions, the nurse realizes the patient can transmit this disease through
airborne droplets
A patient with PND is most likely to have
left ventricular failure
Clinical Manifestation of Pulmonary Edema
- dyspnea
- crackless
- dullness of percuss at lung bases
- pink frothy sputum
- hypercapnia
Symptoms of acute myocardial infarction (AMI)
- Fever
- Diaphoresis
- Substernal Pain
- Cool, Clammy Skin
Functions of the Precardium
- prevents displacement of the heart during gravitational acceleration/deceleration
- physical barrier, protects the heart against infection
- contains pain receptors/mechanoreceptors that affect blood pressure.
- brings about the force required to normalize blood pressure
A 60 year old female with emphysema is having difficulty expiring a given volume of air. when giving report, the nurse will relay that the patient is most likely experiencing ___ pulmonary disease
Obstructive Pulmonary Disease
A 20 year old male is in acute pain. ABG reveals decreased CO2. What is most likely the cause
hyperventilation
Expected assessment findings for someone with a pulmonary embolism
- chest pain
- tachycardia
- tachypnea
- fever
- hemoptysis
Reduced oxygenation of arterial blood
Hypoxemia
dietary fat package
Chylomicrons
A young woman presents with pallor, numbness, and a sensation of cold temperature of her digits. Which condition is the most likely cause for these symptoms?
Raynauds Phenomenon
A 20 year old male is in acute pain. ABG reveals decreased CO2. What is most likely the cause
hyperventilation
LDL
- associated with cholesterol and protein
- Bad
refers to actual blood flow and oxygen delivery
circulation
lipid-laden cells that contribute to fatty streaks.
Foam cells
This represents the measure of time from the onset of atrial activation to the onset of ventricular activation?
PR interval
Asthma affects ____% of children between 5-17 years old
10%
a disease of the myocardium.
Cardiomyopathy
A nurse remembers bronchiolitis mainly occurs in children under the age of ______
One
A patient experiences an elevated systolic pressure accompanied by normal diastolic pressure (below 90 mmHg). Which is the correct term for this condition?
Isolated systolic hypertension
A patient experiences spinal cord damage following a motorcycle accident. What type of shock would most likely result?
Vasogenic
Define Alveolar Dead Space
- a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion
Which are steps in the process of gas exchange?
- Ventilation
- Diffusion
- Perfusion
occlusion of the coronary arteries without pain
Silent ischemia
mean pulmonary artery pressure reading will indicate to the nurse that pulmonary hypertension is occurring? Pulmonary artery pressure above _________ mmHg
Above 25
This interval represents the sum of all ventricular muscle cell depolarizations.
QRS complex
Define Croup
- an acute laryngotracheobronchitis
- occurs in children between 6 months and 5 years of age, with a peak incidence at 2 years of age
- Almost always caused by a virus
Which enzymes are released by damaged myocardial muscle tissue
- Creatnin Kinase
- LDH
- Troponin
a 50 year old male is diagnosed with pulmonary embolism (PE). what symptoms most likely occurred before treatment
chest pain and shortness of breath
is an accumulation of fluid in the pericardium
Pericardial effusion
often associated with ectopic hormone production, especially antidiuretic hormone
Small Cell Carcinoma
Reduced oxygenation of arterial blood
Hypoxemia
Define Open Pneumothorax
- air pressure in the pleural space equals barometric pressure
- b/c air that is drawn into the pleural space during inspiration is forced back out during expiration
A 60 year old male with a 40 year history of smoking presents with chest pain, cough, sputum production, and pneumonia. tests reveal widespread metastatic cancer, and the primary care provider plans radiation therapy. which of the following is the most likely type of cancer to be documented on the chart
Non Small Cell Carcinoma
a hypersensitivity usually due to penicillin, latex, and food allergies
Anaphalactic Shock
A patient has a loud pansystolic murmur that radiates to the back and axilla. Which valvular abnormality is this describing?
Mitral regurgitation
Which conditions are associated with dyslipidemia?
Very low-density lipoproteins (VLDL) - triglycerides and proteins
Asthma related to Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by
mucus secretion, bronchoconstriction, and airway edema
SIDS peaks between ____ and ____ months of age
3, 4
a result of atherosclerosis
peripheral vascular disease
A 20 year old male presents to his primary health care provider, difficulty breathing when lying down. What term should the nurse use to document this condition?
orthopnea
the persistent abnormal dilation of the bronchi
Bronchiectasis
