Test 3 Flashcards
Do patients with asthma and emphysema often have respiratory acidosis or alkalosis?
Respiratory alkalosis often occurs with asthma and emphysema.
What are four diseases or conditions that can cause lung tissue restriction?
Pneumonia, TB, pulmonary edema, and lung cancer.
What is RHF caused by pulmonary vascular resistance known as?
Cor pulmonale.
What is an adjective used to describe the effects of different factors on cardiac contractility?
Inotropic.
What is a malignant neoplastic condition of the prostate gland common in males over age 50, diagnosed with an elevated PSA and rectal examination of the prostate?
Prostate cancer.
What condition has symptoms like the swelling of bronchial lining and constriction of bronchial musculature in response to an allergen, and wheezing on exhalation and use of accessory muscles?
Asthma.
What are signs and symptoms of the dangerous DVT sequela known as a pulmonary embolism?
Chest pain, SOB, hemoptysis, shock, and massive release of inflammatory mediators.
What are abnormal clumps of proteins and cells that flow with the urine or adhere to the luminal wall?
Casts.
What is one possible etiology that causes hypoventilation (aka bradypnea)?
Increased pressure on respiratory center from an intracranial bleed.
What two treatments are used in cardiogenic shock?
Positive inotropes to increase contractility, and peripheral vasodilators to decrease afterload.
What is the presence of air in the pleural space (for example, from trauma) which can cause a lung to collapse?
A pneumothorax.
What is another name for croup?
Laryngotracheobronchitis.
What two conditions are an indicator of renal ischemia or tubule death and with the possibility of casts being present in the urine?
Acute tubular necrosis or an intra-renal acute kidney injury.
What are several signs and symptoms associated with a pleural effusion?
Chills, pyrexia, pleurisy (pleuritic pain) upon deep breaths, and hypopnea.
What is preload?
What comes to the ventricles before contraction (from venous return).
Which muscles used during inhalation is normal, but is abnormal during exhalation?
The diaphragm and intercostal muscles.
What does BUN stand for?
Blood urea nitrogen.
What are inflammatory/infectious debris accumulate in alveoli and surrounding tissue called?
Infiltrates.
In which obstructive lung disease does chronic hypercapnia most often occur?
In chronic bronchitis.
What is the normal V/Q amount?
4 liters of ventilation over 5 liters of perfusion, equaling 0.8.
Is the “barrel chest” symptom one that occurs in emphysema or chronic bronchitis?
It occurs in emphysema.
If a patient is experiencing hyperphosphatemia due to CKD, how would this be treated?
With oral antacids so they can bind to phosphates and prevent their absorption.
Where do most venous disorders occur?
In the legs.
What is the hallmark sign of croup?
Stridor.
If a patient has depressed or absent gag, swallowing, and/or cough reflexes, which type of pneumonia are they at risk for?
Aspiration pneumonia.
What is a clot that develops on the wall of a vein, most of the time in deep veins (not usually surface veins) of thighs and calves called?
A deep vein thrombosis (DVT).
What are several signs and symptoms associated with pulmonary edema?
Cough, SOB, inspiratory rales, frothy-pink sputum, and hypoxemia.
What is a localized dilatation or outpouching of arterial vessel wall?
An aneurysm.
What is the presence of abnormal amounts of nitrogen and nitrogen-based compounds in the blood called?
Azotemia.
What is the most often cause of a hypercoagulable state?
Dehydration.
What is subjective sensation of not being able to get enough air?
Dyspnea.
What condition exists when a patient may be in chronic metabolic acidosis, anemic, and experience pruritus from high levels of urea in the blood?
Chronic kidney disease.
What are six signs and symptoms associated with emphysema?
Alveolar hyperinflation without elastic recoil, chronic hyperventilation, pursed-lip breathing, anorexia, and a barrel chest.
What are two ways to increase one’s level of HDLs?
Exercise and sometimes niacin.
Having CAD increases which two serum chemicals?
CRP and homocysteine (linked to worsening atherosclerosis).
What are two conditions that restrict the pleura?
Pleural effusion and pneumothorax.
What is the amount of blood ejected during every systole called?
Stroke volume.
What is another name for a closed pneumothorax?
A tension pneumothorax.
What is an autosomal recessive disease that causes abnormality in the chloride channel present on the surface of many types epithelial cells—airways, sweat ducts, pancreas?
Cystic fibrosis.
What are five factors that can lead to decreased contractility from RV weakness, leading to RHF?
Ischemia, MI, electrolyte disturbances, and/or HR/rhythm problems.
What happens to cardiac output with PADs?
Cardiac output is decreased with PAD.
Which blood pressure is the pressure in the arteries that is exerted when the heart is contracting and ejecting blood out to the arteries?
Systolic pressure.
What is the microbe that causes syphilis?
The spirochete Treponema pallidum.
What is another name for peripheral arterial disease?
Peripheral arterial insufficiency.
What disease has the signs and symptoms of inflammation of the larynx and bronchi with fever, increased RR, barking cough, stridor usually occurs in infants and children younger than 1 year old?
Croup.
What is almost always the cause of arterial insufficiency?
Atherosclerosis.
What is a disorder in which the coronary arteries are narrowed and/or occluded?
Coronary artery disease.
What condition consists of large, stiff, hyperinflated alveoli that have no elastic recoil, chronic hyperventilation, pursed-lip breathing, thin with no appetite, and a barrel chest?
Emphysema.
What are seven signs and symptoms specific to LHF?
Fatigue, asthenia, decreased LOC, hypotension, SOB, prolonged capillary refill, and oliguria.
What is the pressure issue that occurs in someone with pneumothorax?
The normal negative pressure of the lungs is disrupted, becoming the same of that of the atmosphere as air comes in.
What are two factors that contribute to venous congestion?
Gravity “winning”, and valve incompetence.
What are seven signs and symptoms associated with PADs?
Intermittent claudication, diminished/absent pulses, delayed capillary refill, delayed wound healing, pallor, no hair on legs, and oliguria.
The “lub” sound signifies what when listening to the heart?
The closure of the AV valves.
If a patient has an abnormally elevated serum BNP level, what diagnosis can be confirmed?
Heart failure.
What BP would be considered hypotension?
<90/<60.
Why does pruritus occur in patients with CKD?
Because the of urea deposition in the skin when the kidneys can get rid of it normally.
What are the four most common obstructive lung diseases?
Asthma, emphysema, chronic bronchitis, and cystic fibrosis.
What changes would you see in the specific gravity of a patient with CKD?
A low specific gravity.
What are five treatments used in the treatment of venous problems?
Mobility, hydration, leg elevation, checks for skin breaks, and sometimes blood thinners.
What does a peak flow test measure?
How well a patient can force air out of their lungs.
What is the treatment for croup?
Cool mist and sometimes steroids.
What are six signs and symptoms of an asthma exacerbation?
Expiratory wheezing, accessory muscle use for exhaling, prolonged expirations, hyperventilation, respiratory alkalosis, and lower-than-normal PF.
What are two ways that ischemia to the cardiac cells affect cardiac function?
It causes negative inotropic influences and decreased cardiac output.
What are seven known factors that contribute to the development of CVI?
Aging, heredity, obesity, job-related issues, immobility, lack of muscular assistance, and sometimes pregnancy.
If epinephrine is consistently over-released, what effect does that have on the heart?
It increases HR and contractility considerably.
Who are those that are most likely to fall in Virchow’s triad?
Sedentary lifestyles, casts or other immobilizing devices, bed-ridden, wheelchair-bound, pregnant, obese, diuretics, certain hormone therapies (like BCPs), and pre-existing circulation issues.
Which seven signs and symptoms are associated with decreased cardiac output?
Fatigue, asthenia, mental status changes, hypotension, dyspnea, prolonged capillary refill, and oliguria.
What do blood tests look for to see if a patient is suffering from an acute myocardial infarction?
CK and troponin.
How is cardiac output calculated?
By multiplying the heart rate and the stroke volume.
What is the normal time for capillary refill (or nail blanching)?
A time equal to or less than two seconds.
What is endometriosis?
The presence of functioning endometrium outside the uterus.
What are sequelae of HTN and hypervolemia caused by RAAS over-activity?
Hypertrophy and hyperplasia of arterial smooth muscles, and intima damage of the arteries and arterioles.
The “dub” sound signifies what when listening to the heart?
The closure of the pulmonary and aortic valves.
What are six signs and symptoms seen in patients with lung cancer?
Pleural effusion, cough, hemoptysis, SOB, chest wall pain, and anorexia.
What are the two subcategories of someone with acute coronary syndrome?
Unstable angina and myocardial infarction.
In which form of COPD are you likely to destruction of the alveoli and the capillaries?
In emphysema.
What is the most common cause of atrial fibrillation?
When the myocardium has to endure long-term hypoxic strain or a chronic problem such as HF.
What condition exists when a patient will chronically have hyperphosphatemia, hyperkalemia, hypocalcemia, possibly hypernatremia, and high serum levels of BUN and creatinine?
Chronic kidney disease.
What are three pathological causes of primary hypertension?
Atherosclerosis, overactivity of the SNS, and overactivity of the RAAS.
What is the organism that causes TB?
The Gram-neutral Mycobacterium tuberculosis.
What are two commonalities of arterial disease in all parts of body?
Alteration in vasomotor tone (loss of flexibility and responsiveness), and non-patent lumen.
In which form of COPD are you more likely to see cor pulmonale?
In chronic bronchitis.
In which form of COPD are you likely to see an overall pink appearance?
In emphysema.
What is hypopnea?
Shallow breathing.
What is atelectasis?
Lung tissue collapse with the loss of volume.
What is hypoventilation?
A respiratory rate under 12 breaths per minute.
What are four treatments used to address stable angina?
Ones that maximize coronary patency, ones that decrease cardiac workload, NTG, and ASA.
Which type of COPD has chronic hyperventilation, emphysema or chronic bronchitis?
Emphysema.
What conditions exists when a valve orifice is constricted and narrowed so blood cannot easily flow forward through it, causing turbulence that can be heard as a murmur?
Stenosis.
What is systemic vascular resistance?
The afterload of the left ventricle.
What is characterized by excruciating or colicky flank or groin pain, a decrease in urinary output, hematuria, and may create hydronephrosis if not treated quickly?
Renal lithiasis.
What are thin-walled vessels that take deoxygenated blood from tissue beds all over the body back to the right side of the heart?
Veins.
What is excess water in the alveoli from a cardiac problem, such as LHF known as?
Cardiogenic pulmonary edema.
What is the normal respiratory rate for adults?
12-20 breaths per minute.
In which form of COPD is there a bronchial component?
In chronic bronchitis, but not emphysema.
Which organs are considered to be a part of the central circulatory system?
The heart, lungs, brain, and kidneys.
What most commonly causes nosocomial pneumonia?
The Gram-negative microbes of Pseudomonas.
What are the four primary reasons for low V/Q disorders?
Chest wall restrictions, airway restrictions, pleural restrictions, and lung tissue restrictions.
If a patient has oliguria and the specific gravity is low, what should a nurse do?
Look for a renal problem.
Is asthma a restrictive or obstructive lung disease?
It’s an obstructive lung disease.
What is the compensatory response to stable angina with its subtle ischemia?
Arteriogenesis (aka collateral circulation).
What group of lung diseases refers to processes related to difficult with inhalation?
Restrictive lung diseases.
What are the eight signs and symptoms associated with pneumonia?
Pyrexia, chills, malaise, pleurisy, cough, SOB, rales, and diminished breath sounds.
With RHF, you would generally see signs and symptoms of poor cardiac output and fluid back up to where?
To the periphery like JVD, ascites, and peripheral edema in the legs and feet.
What is the genus of the species that causes gonorrhea.
Neisseria.
What are three signs and symptoms associated with prostate cancer?
Age over 50, elevated PSA, and palpable changes during digital rectal exam.
What does venous stasis do to pressures inside the body?
It causes an increase in hydrostatic pressure inside the affected veins.
What are two common pathological causes of aneurysms?
Atherosclerosis and HTN.
What is the volume of blood returning to the right side of the heart from the veins of the body?
Preload.
True or false, cold feet with diminished pulses is a sign of atherosclerosis?
True.
What are three causes of tachycardia?
Neurohormonal influences, electrolyte changes that cause hypopolarization, and SA/AV node “glitches”.
What is chronic venous insufficiency (CVI) most often caused by?
Leg vein valves wearing out and becoming “floppy”; so, they don’t close tightly during diastole, allowing backflow into distal veins of legs and feet.
What is a normal BNP level?
50 pg/mL.
What is one common etiology associated with noncardiogenic pulmonary edema?
Inhalation of smoke leading to capillary endothelium injury, causing increased capillary permeability and disrupting surfactant production.
What are four conditions that would lead to systemic vascular resistance?
HTN, increased peripheral arterial vasoconstriction, and narrowed/blocked systemic arteries.
What is a normal heart rate?
60-100 bpm.
If HTN is caused by over-activity of the RAAS, what can you expect to see in relation to vasculature?
High blood volume and pressure.
What is the presence of functioning endometrium outside the uterus, accompanied by signs and symptoms of dyspareunia, dysmenorrhea, pelvic pain, and infertility?
Endometriosis.
What is the average stroke volume in someone healthy?
Around 70 mL/heartbeat.
In which form of COPD are you likely to see weight loss?
Emphysema.
In which form of COPD are you likely to see weight gain?
Chronic bronchitis.
When is tuberculosis referred to as miliar TB?
When it invades tissues other than lung tissue.
What is afterload?
Any form of resistance to the ejection of blood from a heart.
What is a normal BUN level?
7-25 mg/dL.
What is cardiogenic shock?
Shock that is caused by a heart problem.
What are seven factors that cause damage to the arterial vessels?
HTN, smoking, diabetes, infection, hypercholesterolemia, free radicals, and aging.
What is an infection of the female reproductive tract, often caused by STIs with signs and symptoms like abnormal vaginal discharge and pelvic/abdominal pain?
Pelvic inflammatory disease (PID).
What are TWELVE signs and symptoms seen in people with acute coronary syndrome?
Diaphoresis, chest pain unrelieved by rest, abnormal HR, dysrhythmia, NandV, fatigue, asthenia, hypotension, SOB, prolonged capillary refill, and oliguria.
What does the P wave signify on an EKG?
Atrial depolarization.
What are several risk factors associated with the occurrence of renal calculi?
Male, gout, dehydration, dietary factors, and diseases that cause hypercalcemia (like multiple myeloma).
What is hyperpnea?
Increased depth (tidal volume) of respirations.
If HTN were due to altered hemodynamics associated with a disease process such as an adrenal tumor or renal problem, what would this be called?
Secondary HTN.
What is another name for community-acquired pneumonia?
“Walking” pneumonia.
What is arteriosclerosis?
A chronic disease of arterial system usually related to aging, in which artery walls become thick and hardened.
What does the QRS complex signify on an EKG?
Ventricular depolarization.
What are four conditions that cause pulmonary vascular resistance?
Increased pulmonary arterial vasoconstriction, chronic bronchitis, and narrowed/blocked pulmonary arteries.
Which blood pressure is the pressure existing in the arteries when the heart is between systoles?
Diastolic pressure.
What are the 5 P’s of PAD?
Pain, paresthesia, pallor, pulselessness, and poikilothermia.
What are seven common signs and symptoms associated with lung cancer?
Pleural effusion, cough, hemoptysis, chest wall pain, SOB, anorexia, and weight loss.
What are six signs and symptoms seen in somone with cardiogenic shock?
Hypotension, tachycardia, SOB, oliguria, pallor, and decreased LOC.
What does ST signify on an EKG?
The time interval between end of ventricular depolarization (S) & repolarization (T).
What is the hypersecretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years known as?
Chronic bronchitis.
If an AKI was caused by BPH, what type of AKI would it be?
A postrenal AKI due to BPH.
If either the left or right ventricle is overwhelmed by fluid overload, what is that condition called and what does it lead to?
Increased preload while leading to decreased cardiac output.
What are eight signs and symptoms associated with TB?
Cough, fatigue, weight loss, anorexia, low-grade pyrexia, nocturnal diaphoresis, purulent sputum, and hemoptysis.
In which form of COPD are you likely to see an overall blue appearance?
In chronic bronchitis.
What results from an increased HR and contractility?
Increased cardiac output and ejection pressure, which in itself leads to a higher volume.
What is a malignant neoplastic condition characterized by abdominal bloating, mild abdominal discomfort, and constipation that can be found early during yearly pelvic exams?
Ovarian cancer.
What is pulmonary vascular resistance?
The afterload of the right ventricle.
Where can syphilis present itself on the human body?
Anywhere where the microbe contacts the mucosa.
What are three lab results you would expect to see in a prerenal AKI?
High BUN, high specific gravity, and normal creatinine.
To which demographics is spontaneous pneumothorax most like to occur?
To those who are tall, thin, and smokers.
What can be caused by kidney stones, BPH, or uterine prolapse?
A post-renal acute kidney injury.
What are the two forms of symptomatic CAD?
Stable angina and acute coronary syndrome.
What does the T wave signify on an EKG?
Ventricular repolarization.
What are several known causes of pleural effusion?
Lung cancer, and heaving coughing (from bronchitis or pneumonia).
With LHF, you would generally see signs and symptoms of poor cardiac output and fluid back up to where?
To the lungs.
What are four conditions that lead to chest wall restrictions and therefore decreasing ventilation?
Kyphosis, obesity, polio, and myasthenia gravis.
What condition is present if RHF is caused by a pulmonary vascular resistance problem?
Cor pulmonale.
What is extra fluid in the pleural space from infection or cancer called?
Pleural effusion.
What is the normal range for partial pressure of oxygen in arterial blood (the PO2)?
80-100 mmHg.
What are seven signs and symptoms associated with low CO and low perfusion?
Fatigue, asthenia, LOC changes, hypotension, SOB, prolonged capillary refill, and oliguria.
What are the two major categories of heart valve problems?
Stenosis and incompetence.
What usually causes orthopnea?
When a person is lying down, causing an increase in venous return to the heart, but usually due to LHF the heart can’t handle the extra flow, causing dyspnea.
What are three medications used for asthma?
Bronchodilators, NSAIDs, and steroids.
Which disease is characterized by dysuria, frequency and urgency of urination, hematuria, pyuria, and can also include pyrexia or pain at the costo-vertebral angle?
A urinary tract infection.
Which two heart chambers are contracting during systole?
The right and left ventricle.
What are nine signs and symptoms associated with tuberculosis?
Cough, fatigue, weight loss, anorexia, low-grade pyrexia, nocturnal diaphoresis, purulent sputum, hemoptysis, and granulomatous lesions.
What are two sequelae of atrial fibrillation?
Decreased cardiac output, and blood pooling in atria.
What is a chaotic series of electrical impulses in the ventricles that cause them to quiver ineffectively instead of contracting smoothly?
Ventricular fibrillation.
What is the most common cause of PID in women?
Chlamydia.
What is a chronic disease of arterial system usually related to aging, in which artery walls become thick and hardened?
Arteriosclerosis.
What are four known causes of a pre-renal acute kidney injury?
Acute vasoconstriction or trauma to the aorta or renal arteries, hypotension/hypovolemia from hemorrhage, and inadequate cardiac output.
What is a proliferation of prostate glandular tissue which results in signs and symptoms that include urgency, delay in starting urine flow, decrease in flow of urine, urine retention?
Benign prostatic hyperplasia.
What is pneumothorax?
The presence of air in the pleural space which can cause a lung to collapse.
What begins systole?
An electrical signal generated by the SA node.
What is is a chronic inflammatory disorder of the airways due to bronchial hyperresponsiveness to stimuli such as allergens in environment known as?
Asthma.
What is any form of resistance to the ejection of blood from a heart?
The afterload.
What condition can be caused by nephrotoxic drugs; poisons & toxins; renal infections, or autoimmune situations?
An intra-renal acute kidney injury.
What lab results are expected to be seen in someone with an intrarenal AKI?
High serum creatinine and presence of casts in UA.
What are two responses to the tissue irritation caused by atherosclerosis?
Both inflammatory and coagulatory responses are triggered.
What is the goal of electrical and mechanical functions of heart?
To create effective cardiac output.
In males with unresolved cryptorchidism, what are they at greater risk for?
Testicular cancer.
What are the four organs primarily affects by hypertension?
The brains, eyes, heart, and kidneys.
What disease or condition presents in men ages 15 to 35 with a painless testicular mass?
Testicular cancer.
What is the average for cardiac output?
4-6 L/min.
Would a patient with CKD take or avoid drugs if they increased potassium reabsorption in DCT?
CKD patients avoid drugs that increase potassium reabsorption.
Why is there such variation in the radiation of pain from an MI or angina?
Because afferent sensory nerve fibers for the heart include C3 to T4.
What is given to help combat RAAS over-activity?
ACE inhibitors.
What is an acute infection of the lower respiratory tract caused by bacteria, viruses, fungi, or parasites characterized by atelectasis and consolidation?
Pneumonia.
What is cor pulmonale?
RHF due to a pulmonary vascular resistance problem.
What is contractility when talking about the heart?
The heart’s vigorousness of its contraction.
What are five signs and symptoms associated with fluid back-up into the peripheral veins?
JVD, liver congestion (leading to hepatomegaly), ascites, and peripheral edema.
What can be caused by acute vasoconstriction or trauma to aorta and/or renal arteries, hypotension/hypovolemia from hemorrhage, dehydration, and/or an inadequate CO?
A pre-renal AKI.
What group of lung diseases is due to difficulty with exhalation?
Obstructive lung diseases.
What is a normal serum creatinine level?
0.6-1.2 mg/dL.
What are of the most common causes of urethritis and prostatitis in men?
Chlamydia and gonorrhea.
What condition exists when the kidneys make a small amount of urine (or none at all) with a low specific gravity. Chronically high levels of serum wastes are present?
Chronic kidney disease.
What is cardiac output?
The average amount of blood the LV ejects (and is therefore in circulation) per minute.
If something has a “positive inotropic effect” what does it do?
It enhances contractility of the heart.
What are the two factors that contribute to good arterial perfusion of distal tissues?
A patent lumen and good vasomotor tone.
What are five signs and symptoms of chronic bronchitis?
Immobility, central cyanosis, digital clubbing, chronic hypercapnia, and excessive sputum production.
If a pulmonary embolus blocks one of the branches of the pulmonary arterial vasculature, what would you expect to happen to the V/Q?
It would lead to a high V/Q due to decreased perfusion.
What are six signs and symptoms of croup?
Laryngitis, bronchitis, pyrexia, tachypnea, stridor, and a “barking” cough.
What is the most common symptoms of CAD?
Angina.
What are the four sequelae of congestive heart failure?
Diminished CO, poor perfusion, hypervolemia, and backing-up of fluid.
When thinking about cardiac output, what three things happen in a patient with CHF?
Decreased (pumping) contractility, increased afterload, and increased preload.
What are four signs and symptoms of cystic fibrosis?
Sputum overproduction, frequent URIs, very salty sweat, and blocking of pancreatic enzymes.
What are four known acquired causes of chronic kidney disease?
AKI that is not “fixed quickly”, HTN, atherosclerosis, and DM.
What are the two greatest factors in maintaining normal flow of oxygenated blood in arteries?
Vasomotor tone and patent lumen.
What are three drugs used to treat heart failure?
Positive inotropic drugs, vasodilators, and diuretics.
What makes up Virchow’s triad and what does it signify?
Venous endothelium injury, blood flow stasis, and hypercoagulability states; having one of these puts you at high risk of DVT.
In which form of COPD can patients be seen standing in a tripod position?
In emphysema.
What is the normal specific gravity of the urine?
1.002 to 1.028.
Because of the increased venous hydrostatic pressure from venous stasis, what happens next?
Edema in the affected area which can lead to ulcers, and varicose veins.
What is a pleural effusion?
Extra fluid in the pleural space from an infection or cancer.
What are four forms of airway restrictions?
Croup, foreign bodies, and tumors of the trachea/bronchi.
Some venous blood tends to stay and settle out in the veins of the leg and foot tissues, what is this known as?
Venous congestion.
What is the process of delivery of oxygen and nutrients via arterial system to tissue beds all over body?
Perfusion.
What are several signs and symptoms associated with a DVT?
Inflammatory signs, usually unilateral, can be very painful or asymptomatic.
What is pulmonary consolidation?
The abnormal presence of liquid within lung tissue.
