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NURSING PATHO > TEST 2 > Flashcards

TEST 2 Flashcards

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1
Q

blood vessels containing blood flowing to the heart

A

veins

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2
Q

blood vessels containing blood flowing from the heart

A

arteries

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3
Q

from the right ventricle, deoxygenated blood is pumped through WHAT and then WHAT

A

pulmonary valve then pul artery

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4
Q

primary function of the respiratory system

A

gas exchange

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5
Q

right side

A

into the lungs

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6
Q

left side

A

system

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7
Q

main pump of the heart

A

left ventricle

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8
Q

lowest volume system; responsible for the gas exchange

A

capillaries

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9
Q

govern the flow of blood in the vascular system.

A

principles of blood flow- look over this in book

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10
Q

Pressure Difference/Resistance

A

flow

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11
Q

between two ends of a vessel

A

pressure difference

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12
Q

causes of resistance of blood flow

A

sickle cell anemia, peripheral artery disease, mi

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13
Q

Distance measurement speed at which blood flows through the vessel

A

velocity

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14
Q

heart rate should be

A

60-100

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15
Q

the smaller the lumen

A

the higher the flow

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16
Q

velocity, cross-sec, and flow

A

velocity=flow rate over cross sectional

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17
Q

The relationship between the wall tension of a vessel, its intraluminal pressure, and its radius

A

law of laplace

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18
Q

Ability of a blood vessel to be stretched and accommodate an increased volume of blood

A

distensibility

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19
Q

depolarization of atria

A

P

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20
Q

depolarization of ventricles

A

QRS

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21
Q

repolarization of ventricles

A

ST

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22
Q

QT interval

A

de and repolarization of ventricles

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23
Q

baseline is also the

A

isoelectric line

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24
Q

PR segment

A

Impulse travel through AVN

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25
Q

PR interval

A

Atrial depolarization and travel time

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26
Q

Slow repolarization of the Purkrnje fibers

A

U wave

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27
Q

QT interval

A

Total ventricular activity

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28
Q

occurs when the heart contracts to pump blood out

A

systole

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29
Q

occurs when the heart relaxes after contraction

A

diastole

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30
Q

Endothelial relaxing factors

A

nitric oxide

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31
Q

What is the of nitric oxide role and what pharmacological agent produces the effect of nitric oxide.

A

it is a vasodilator. helping blood vessels to relax and expand when necessary ; nitro glycerin

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32
Q

ACE I end in

A

pril

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33
Q

ARBS end in

A

sartan

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34
Q

humoral controls of blood flow

A 
Norepinephrine
Epinephrine
Angiotensin II
Histamine
Serotonin
Bradykinin
Prostaglandins
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35
Q

causes vasoconstriction of blood vessels

A

norepi

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36
Q

causes more increase in heart rate and cardiac output through contractibility

A

epi

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37
Q

hormones made by the adrenal glands

A

Catecholamines

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38
Q

angiotension ii is a what

A

vasoconstriction

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39
Q

histamine is a what

A

vasodilator

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40
Q

plays major role in control of bleeding

A

serotonin

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41
Q

serotonin is a what

A

vasoconstrictor

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42
Q

bradykinin is a what

A

vasodilator

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43
Q

bradykinin causes

A

constriction of venules
dilation of arterioles
increased capillary permeability

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44
Q

Prostaglandin E group

A

vasodilators

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45
Q

Prostaglandin F group

A

vasoconstrictors

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46
Q

refers to increased levels of cholesterol in the blood.

A

Hypercholesterolemia

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47
Q

a genetic disorder that affects the body’s connective tissue.

A

marfan syndrome

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48
Q

marfan syndrome clinical manifestations

A 
Long arms, legs and fingers
Tall and thin body type
Curved spine
Chest sinks in or sticks out
Flexible joints
Flat feet
Crowded teeth
Stretch marks on the skin that are not related to weight gain or loss
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49
Q

is a recurring progressive, nonatherosclerotic inflammation and thrombosis of small and medium-sized arteries and veins, usually the plantar and digital vessels in the foot and lower leg.

A

Thromboangitis Obliterans (Buerger)

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50
Q

fingers become white due to lack of blood flow; turn blue to keep blood vessels dilate; turn red as blood returns

A

raynauds

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51
Q

what is the predominant symptom of Thromboangitis Obliterans

A

pain

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52
Q

dyspnea, stridor, or a brassy cough caused by pressure on the trachea.
Hoarseness may result from pressure on the recurrent laryngeal nerve, and there may be difficulty swallowing because of pressure on the esophagus

A

aneurysms of thoracic

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53
Q

abdominal aneuryms

A

Saccular aneurysm-sac on the vessel

Fusiform aneurysm- takes up whole blood vessel

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54
Q

slide 106

A

go over

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55
Q

“strangling of the chest”
temporary imbalance
Ischemia limited in duration

A

Angina pectoris

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56
Q

Moderate to prolonged exertion
Frequency, duration, and intensity
Activity tolerance
Treatment: Goal

A

stable angina

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57
Q

Umbrella term for conditions that cause chest pain due to insufficient blood supply to the heart muscle (acute myocardial ischemia).

A

acute coronary syndrome

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58
Q

risk factors for ACS non modifiable

A

Age

Gender

Family history

Ethnic background

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59
Q

risk factors for ACS modifiable

A

Cholesterol levels

Smoking

Physical inactivity

Hypertension

Serum homocysteine

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60
Q

Pain assessment for ACS?

A

History

Pain assessment

Cardiovascular assessment

Psychosocial assessment

Laboratory assessment

Radiographic assessment

Diagnostic assessments

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61
Q

Psychological assessment for ACS

A

(major defense mechanism) DENIAL

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62
Q

MONABATH

A

Morphine
Oxygen
Nitroglycerin
ASA

Beta-blockers
ACE-I
Thrombolytics
Heparin

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63
Q

Contraindications to thrombolytics….absolute

A 
Active internal bleeding
Known allergey to streptokinase products
Recent head trauma
Known bleeding discorders
Suspected aortic dissection
Increased BP 200/120 mm Hg
Pregnancy or recent delivery
CVA within past 2 months
Recent spinal or cerebral surgery, cranial neoplasm
Prolonged Cardiopulmonary resuscitation
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64
Q

Contraindications to thrombolytics….relative

A

Endocarditis or pericarditis

Hemostatic defects

Severe uncontrolled hypertension

Trauma within 10 days

Current use of oral anticoagulants

Active peptic ulcer disease

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65
Q

signs of infective endocarditis

A

osler node

janeway lesion

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66
Q

infection of the heart valves in the endocardium

A

infective endocarditis

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67
Q

involving pink rings on the torso and inner surfaces of the limbs which come and go for as long as several months. It is found primarily on extensor surfaces

A

Erythema Marginatum

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68
Q

sac surrounding the heart

A

pericardium

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69
Q

Acute Pericarditis: Clinical Manifestations

A

chest pain, friction rub, ecg changes

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70
Q

first-line therapy for acute perdicard

A

aspirin or NSAIDS

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71
Q

the accumulation of fluid in the pericardial cavity, usually as a result of an inflammatory or infectious process that includes pericarditis.

A

Pericardial Effusion

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72
Q

Cardiac Tamponade: Becks Triad

A

JUGULAR VENOUS DISTENSION, muffled heart sounds, low bp

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73
Q

right side heart failure clinical manifestations

A

congestion of peripheral tissue, liver congestion, gi tract congestion

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74
Q

left side heart failure clinical manifestations

A

decreased cardiac output, pulmonary congestion, impaired gas exchange, pulmonary edema

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75
Q

treating congestive heart failure

A 
Upright position 
Nitrates
Lasix- urinate less pressure in body 
Oxygen
Ace i
Digoxin
Fluids - decrease
Afterload- decrease 
Sodium restriction
Test - Digoxin levels, ABGs, potassium levels
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76
Q

whats the main test for congestive hf

A

ABGs- blood test

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77
Q

compensatory mech for hf

A

slide 191

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78
Q

Loss of whole blood

Loss of plasma

Loss of extracellular fluid

A

hypovolemic shock

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79
Q

inability of the heart to maintain cardiac output necessary to meet body needs. extra strain on the heart causes decrease tissue perfusion

A

cardiogenic shock

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80
Q

respiratory airways

A

gas exchange takes place in alveoli

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81
Q

is used each day to humidify the air we breathe.

A

1 pint

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82
Q

why is it important to drink water when you have a fever

A

water vapors increase so you lose water in the resp tract; resp secretions thicken and this prevents the cilia from movement;impairing the protective function of the mucociliary defense system

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83
Q

what type of alveolar cells provide surface area for gas exchange

A

i

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84
Q

what type of alveolar cells provide surface tension; helps with destruction of pathogens; surfactant secreting

A

ii

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85
Q

slow down

A

parasym

86
Q

flight or fight

A

sym

87
Q

innervation of lungs airway constriction; increases respiratory secretions

A

parasym

88
Q

How easily lungs can be inflated

A

compliance

89
Q

Impedance to flow that the air encounters as it moves through the airways

A

airway resistance

90
Q

what does gas exchange require

A

matching of ventilation and perfusion ; equal amounts of air and blood enter the respiratory portion of lung

91
Q

the volume of air which is inhaled that does not take part in the gas exchange,

A

dead space

92
Q

blood that moves from the left to the right side of the circulation without being oxygenated

A

shunt

93
Q

ABG (partial blood gases)

A

ph 7.35-7.45
PCO2-35-45

HCO3- 22-26

PaO2- >80

94
Q

pco2 is what

A

carbon dioxide

95
Q

hco3

A

bicarbonate

96
Q

Hemoglobin’s ability to bind oxygen

A

affinity

97
Q

Hemoglobin binds oxygen more readily when its affinity is WHAT and releases it more readily when its affinity is WHAT

A

increased

decreased

98
Q

Affinity is also influenced by

A

pH
Carbon dioxide concentration
Body temperature

99
Q

a right shift in graph means

A

decreased oxygen affinityof hemoglobin allowing more oxygen to be available to the tissues.

100
Q

a left shift in graph means

A

increased oxygenaffinity of hemoglobin allowing less oxygen to be available to the tissues

101
Q

what nerve stimulates the diaphragm

A

phrenic nerve

102
Q

3 upper respiratory viruses in adults

A

common cold
influenza
rhinosinusitis

103
Q

Occur in early fall and late spring in persons between ages 5 and 40

A

rhinovirus

104
Q

Occur in children younger than 3

A

parainfluenza

105
Q

occur in winter and spring in children younger than 3

A

Respiratory syncytial virus

106
Q

Occur in winter and spring

A

Coronaviruses and adenoviruses

107
Q

facial pain, headache, purulent nasal discharge, decreased sense of smell, fever

A

acute rhino sinusitis

108
Q

nasal obstruction, fullness in the ears, postnasal drip, hoarseness, chronic cough, loss of taste and smell, unpleasant breath, headache

A

chronic rhinosinusitis

109
Q

influenza has 3 divisions what are they

A

URI- rhinotracheitis
viral pneumonia
respiratory viral infection followed by bacterial

110
Q

how to differentiate between influenza and common cold

A

influenza is profound malaise

111
Q

Transmission is by aerosol (three or more particles) or direct contact.

A

influenza

112
Q

URI is a division of influenza (rhinotracheitis) a clinical manifestation

A

PROFOUND MALAISE

113
Q

clinical manifestation of this division of influenza;

fever, tachypnea, tachycardia, cyanosis, hypotension

A

viral pneumonia

114
Q

survivors of viral pneumonia might have what

A

stiffening of the lungs..not good

115
Q

causative organisms of a Respiratory viral infection followed by a bacterial infection.

A

S. pneumoniae
S. aureus
H. influenza
M. catarrhalis

116
Q

children with reyes syndrome should not be given what? and why

A

aspirin

kids being treated from a viral infection and fever and are given aspirin could result in reyes syndrome

117
Q

Pneumococcal Pneumonia is caused by

A

s. pneumoniae

118
Q

legionnaires disease is caused by

A

gram-negative rod, Legionella pneumophila.

119
Q

characterized by patchy involvement of the lung alveolar septum and pulmonary interstitium

A

primary atypical pnemoniae

120
Q

most causative organism of primary atypical pneumoniae

A

m. pneumoniae

121
Q

community acquired pneumonia

A

infection that begins outside the hospital or is diagnosed within 48 hours after admission to the hospital in a person who has not resided in a long-term care facility for 14 days or more before admission.

122
Q

most common cause of community acquired pneumonia

A

bacterial or viral

s. pneumonia

123
Q

key components of VAP (ventilator associated pneumonia)

A

Elevation of the head of the bed
Daily “sedation vacations” and assessment of readiness to extubate
Peptic ulcer disease prophylaxis
Deep venous thrombosis prophylaxis

124
Q

causative organism of tuberculosis

A

Mycobacterium tuberculosis hominis

125
Q

type of necrosis tuberculosis will cause

A

caseous necrosis

126
Q

clinical manifestations of pulmonary tb

A

night sweats, coughing up blood (hemoptysis)

127
Q

what test is done for pulmonary tb

A

a culture OR The Mantoux tuberculin skin test (TST) or the TB blood test

128
Q

how to know if tb is positive

A

read 48-72 hours after; looking for induration-how big is it, feel raised area, hard

129
Q

histoplasmosis comes from

A

poop from birds; fungi H. capsulatum

130
Q

what is the lung cancer called

A

Bronchogenic carcinoma; arises from epithelial cells of the lining

131
Q

manifestations of lung cancer

A

coughing up blood, chest pain worse with deep breathing, hoarseness,

132
Q

blueness

A

cyanosis

133
Q

decrease in blood oxygen levels so not oxygenating tissues

A

hypoxemia

134
Q

manifestations of hypoxemia

A

hypotension, bradycardia, retinal hemorrhage

135
Q

PO2 less than than 60 mm Hg

A

hypoxemia

136
Q

increase in carbon dioxide levels of the atrial blood; respiratory acidosis

A

hypercapnia

137
Q

manifestations of hypercapnia

A

respiratory acidosis; sleepy; decrease muscle contraction (vasodilation)

138
Q

PCO2 greater than 50 mm Hg

A

hypercapnia

139
Q

lines the thoracic wall and superior aspect of the diaphragm.

A

parietal pleura

140
Q

covers the lungs

A

visceral pleura

141
Q

space between the two layers contains a thin layer of serous fluid.

A

pleural cavity

142
Q

fluid in the pleural cavity

A

pleural effusion

143
Q

serous fluid in the pleural cavity

A

hydrothorax

144
Q

pus in the pleural cavity

A

empyema ; yogurt

145
Q

what can happen in the body when pneumothorax occurs

A

medial stenum shift

146
Q

Air enters the pleural cavity.

Air takes up space, restricting lung expansion.

A

pneumothorax

147
Q

Incomplete expansion of the lung

A

Atelectasis

148
Q

tachypnea, tachycardia, dyspnea, cyanosis, signs of hypoxemia, diminished chest expansion, absence of breath sounds, and intercostal retractions.

A

manifestations of atelectasis

149
Q

treatment of atelectasis

A

chest tube to expand the lung

150
Q

inflamed airways in lungs; makes them swollen and sensitive

A

asthma

151
Q

when does cough occur for asthma

A

at night, sometimes in the early am

152
Q

external environment causes it; mast cells release histamine as an inflammatory mediator

A

extrinsic atopic asthma

153
Q

internal environment; Respiratory infections

Epithelial damage, IgE production

A

intrinsic nonatopic asthma

154
Q

what can cause intrinsic asthma

A

smoking, medications, sulfites, viral cold

155
Q

COPD types

A

emphysema
Chronic obstructive bronchitis
Bronchiectasis

156
Q

affects the air spaces and destruction of lung tissue; destruction to alveoli

A

emphysema

157
Q

increase muscus product; obstruction of airways

A

Chronic obstructive bronchitis

158
Q

path of emphysema

A

α1-antitrypsin inactivates the trypsin before it can damage the alveoli.
A genetic defect in α1-antitrypsin synthesis leads to alveolar damage.

159
Q

emphysema is aka

A

pink puffer

160
Q

characteristics of pink puffer

A

increase co2, can get in, purse lip breathing, barrel chest,

161
Q

chronic irritation of the airways; mucus hyper secretion; productive cough

A

chronic bronchitis

162
Q

chronic bronchitis is aka

A

blue bloaters

163
Q

Increase respiration to maintain oxygen levels
Dyspnea; increased ventilatory effort
Use accessory muscles; pursed-lip breathing

A

pink puffers; emphysema- prob w alveoli

164
Q

Cannot increase respiration enough to maintain oxygen levels
Cyanosis and polycythemia
Cor pulmonale

A

blue bloaters ; bronchitis- mucus

165
Q

right sided heart failure, is an enlargement of the right ventricle due to high blood pressure in the arteries of the lungs usually caused by chronic lung disease

A

cor pulmonae

166
Q

MAIN lab test that indicates severity of heart failure and normal value

A

BNP test. brain natriuretic peptide

167
Q

affects the cells that produce mucus, sweat, and digestive juices. It causes these fluids to become thick and sticky.

A

cystic fibrosis

168
Q

high concentrations of sodium in sweat ; less sodium in resp mucus so it becomes thick

A

cystic fibrosis

169
Q

what is a hallmark of cystic fibrosis

A

salty skin. Normally, salt is carried to the skin by perspiration. Once the skin is cool, the salts are reabsorbed into the body.

170
Q

blood clot in the lung

A

pul emb

171
Q

shortness of breath, anxiety, chest pain

A

pul em

172
Q

most common form of WHAT DVT (deep venous thrombus)

A

pulmonary embolism

173
Q

prevention of deep vein thrombosis

A

early ambulation
anticoagulant
TED hose
Pneumatic compression stockings or boots

174
Q

what is considers pulmonary hypertension

A

elevated mean arterial is greater than 25 at rest

175
Q

if it precedes lung or breathing problems it is considered what

A

cor pulmonale

176
Q

Risk Factors Atherosclerosis non modifiable

A

male
Genetic disorders of lipid metabolism
Family history of premature coronary artery disease
increasing age

177
Q

Risk Factors Atherosclerosis modifiable

A 
Cigarette smoking 
Obesity 
Hypertension
Hyperlipidemia with elevated low-density lipoprotein and low high-density lipoprotein cholesterol 
Diabetes mellitus
178
Q

blackened of arteries, thickening of blood vessels

A

atherosclerosis

179
Q

when does atherosclerosis happen

A

can begin in the late teens; rapid progressive around 30s

180
Q

a peaked t wave is what

A

hyperkalemia (high potassium)

181
Q

inverted t wave is what

A

ischemia

182
Q

stretch on ventricle after diastole

A

preload

183
Q

pressure that ventricles eject blood

A

after load

184
Q

what is a side effect of pril

A

dry cough

185
Q

for hyperlipidemia, what is optimal for LDL

A

<100

186
Q

for hyperlipidemia, what total cholesterol is desirable

A

<200

187
Q

for hyperlipidemia, what is the low and high of HDL

A

<40 -LOW

>60- HIGH

188
Q

an irregular yellow patch or nodule on the skin, caused by deposition of lipids.

A

xanthoma

189
Q

a condition marked by a line of opacity close to the border of the cornea, from which it is separated by a narrow band of clear cornea

A

arcus lipoides

190
Q

t wave inversion

A

zone of ischemia

191
Q

st elevation

A

zone of injury

192
Q

abnormal q

A

zone of necrosis

193
Q

Atherosclerotic blockages found in the lower extremities.

A

peripheral artery disease

194
Q

manifestation of PAD

A

claudication

195
Q

why is claudication important

A

atherosclerosis leads to restriction of blood flow, coronary disease and strokes. leads to pain in calf, heart attacks that reduces life expectancy

196
Q

strongest risk factors of PAD

A

smoking and diabetes mellitus

197
Q

intrinsic rate for sa node

A

60-100

198
Q

intrinsic rate for av node

A

40-60

199
Q

why is av node aka gatekeeper

A

impulse comes from SA node it holds onto that impulse for 1/10 of a second allows the atrium to squeeze in systole

200
Q

intrinsic rate of perkingje fibers

A

20-40

201
Q

help to hold the heart structure

A

chordinae tendinae and papillary muscles

202
Q

STEMI

A

ST elevated MI

203
Q

full thickness MI; taken up all three of layers

A

STEMI

204
Q

not all three layers

A

NONSTEMI

205
Q

actin and myosin

A

tip of actin is troponin

206
Q

sacromere

A

unit of muscle cell

207
Q

inhibits sliding action of the muscle to contract

A

troponin

208
Q

electrolyte that helps move off the troponin so the two can contract

A

calcium

209
Q

troponin are very specific to what

A

myocardial injury

210
Q

if troponin are elevated what does this mean

A

sarcomere has been injured

211
Q

4 characteristics of cardiac cell

A

excitability
automaticity
contractility
conductivity

212
Q

2 things to have a heartbeat

A

mechanical and electrical activity

NURSING PATHO (16 decks)

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