Test 4 Flashcards
What are three complications of diverticulitis?
Abscess formation, rupture, and peritonitis.
What are seven clinical manifestations seen in people with Alzheimer’s?
Dementia, absentmindedness, emotional upset and behavioral changes if posterior frontal lobe is involved, rigidity, and changes to posture and gait.
If you are experiencing an lower GI bleed, what are the three sites that could be producing that bleeding?
The jejunum, ileum, or colon.
What does the basilar artery supply blood to?
It supplies blood to the brain stem and cerebellum.
Which tract carries sensations of pain, temperature, crude and light touch from the body to the brain for processing?
The spinothalamic tracts.
What treatment and/or prevention is used in regards to hepatitis A virus?
Vaccines for prevention and immunoglobulin shots for acute exposures.
What is the most common cause of Addison’s disease?
Autoantibodies that cause adrenal atrophy and hypofunction.
What is the most common cause of hyperthyroidism?
Graves’ disease.
What are five things considered when observing a person’s level of consciousness (LOC)?
- Being alert or easily arousable to alertness if asleep.
- Being oriented x4: self, time, place, events
- Following commands appropriately
- Having normal speech
- Conversing appropriately
What are six signs and symptoms associated with the hepatitis A/B/C virus?
Fairly acute fever, malaise, jaundice, NandV, and diarrhea that is usually mild with full recovery; (HBV and HCV can be asymptomatic for years).
When is Immitrex supposed to be used in relation to a CNS disorder?
At the first sign of the prodromal stage of a migraine.
What is a severe, life-threatening disorder associated with the escape of pancreatic enzymes into the pancreas and surrounding tissues, causing autodigestion and hemorrhage?
Acute pancreatitis.
What is status epilepticus?
A seizure that is unremitting and not-responsive to medications.
Following an illness, a patient becomes hypocalcemic. Which of the following negative-feedback, endocrine compensatory mechanisms will increase the calcium in her blood?
The parathyroid will increase its secretion of PTH.
*What are six signs and symptoms associated with acute pancreatitis?
Epigastric pain, abrupt onset post-prandial or post-ETOH ingestion, pain radiation to the back, possible jaundice due to biliary obstruction/inflammation.
What are six possible causes of cirrhosis?
Excessive ETOH intake, toxic reactions to drugs and chemicals, viral hepatitis, bile duct disease, and genetic disorders.
What would the lab results look like in acute pancreatitis?
High amylase and lipase which may occur with leukocytosis too.
What is Graves’ disease?
An autoimmune disorder where autoantibodies attack/stimulate TSH receptors on the thyroid, resulting in oversecretion of T3 and T4.
What is another name for a thyrotoxic crisis?
A thyroid storm.
What are several expected lab results in a person who has cirrhosis?
High indirect and low direct bilirubin, and elevated AST, ALT, and ALP.
What does myelin do?
It gives white matter its color and increases the speed of nerve impulse transmission.
Where does a microbe that causes meningitis most commonly enter the body?
Through the highly vascular nasopharyngeal area where it can be taken to the choroid plexus.
What are several symptoms associated with hypercalcemia?
Asthenia, lethargy, renal calculi, osteoporosis, and hyperpolarization.
Upon assessing his patient, a nurse notes hemiparesis of the right arm & leg and dysphasia which the patient states began 2 days ago. What does the nurse most likely think caused this?
A stroke involving the left hemisphere of the brain.
Which organs are located in the LUQ?
Stomach, spleen, and transverse colon.
What is the hypophysis?
The pituitary gland.
What is a patient’s status like in the post-ictal stage?
They are often dazed, confused, and sometimes combative because the brain’s “circuits” are still not back to normal.
How does dysarthria differ from dysphasia?
Both are difficulty speaking, but dysarthria is due to an issue with the jaws, while dysphasia is due to a neurological problem.
A patient with Type I diabetes has a pH of 7.32. This is most likely caused from the byproducts of increased what?
Gluconeogenesis.
What are four signs and symptoms seen with abnormal protein catabolism like in Cushing’s disease?
Myasthenia and muscle atrophy, short stature in children, and weakened collagen fibers which leads to purple striae.
What two conditions are known to cause stones in the gallbladder and the gallbladder duct?
Hypercholesterolemia and dehydration.
What substance(s) or chemical(s) is/are refluxed in GERD?
Hydrochloric acid and pepsin.
What happens because of the decreased dopamine levels present in people suffering from Parkinson’s disease?
There is an increased cholinergic effect which causes a variety of symptoms.
What are known causes of GERD?
Relaxation of the lower esophageal sphincter and/or delayed emptying of the stomach.
What part of the brain is most likely being affected when there are changes in heart rate and blood pressure?
The medulla.
What is the issue(s) in Cushing’s syndrome (NOT Cushing’s disease)?
Hypercortisolism due to receiving chronic steroid treatment.
What two types of medications are given in treatment of Parkinson’s disease?
Anticholinergics and ones that contain dopamine.
What level of serum glucose would be considered hypoglycemic?
A blood glucose <70.
If you suspect a patient is having a stroke, which four vital signs should you check?
BP, HR, RR, and temperature.
A patient who just came out of general anesthesia has lab work done. The serum osmo is 165. The nurse taking care of this patient suspects that his _____ is due to _________.
hypoosmolality; syndrome of inappropriate ADH (SIADH)
What happens if you don’t eat after your body has told you to eat and after it has released epinephrine and cortisol?
GH and glucagon are then secreted to begin glycogenolysis first, then gluconeogenesis if the former isn’t enough.
Which cranial nerve would be affected in the brain/brain stem to cause problems with the heart rate?
CN X, the vagus nerve.
What are seven signs and symptoms associated with ulcerative colitis?
Dehydration, bloody diarrhea, abdominal cramps, obstruction, fistula, confluent inflammation, and a mild risk for malnutrition.
What is the hallmark sign of posthepatic jaundice?
Gray-colored or clay-colored stool.
What are several, eleven, signs and symptoms seen in patients with hyperthyroidism?
Tachycardia, increased afterload, exophthalmus, goiter, increased body temperature, heat intolerance, diaphoresis, thin hair, alopecia, and overall increases to CNS and GI systems.
If a patient is having issues with their BP, HR, RR, or temperature, in addition to there being a suspected stroke, which part of the brain is most likely affected by the CVA?
The brain stem.
What treatment(s) is indicated for age-related macular degeneration?
There is no effective treatment.
A patient with cirrhosis and all its associated problems has an RBC count of 2 million, thrombocytopenia, and ascites. In reviewing the patient’s lab work, the nurse understands that one likely cause of the ascites is what?
A serum osmolality <280 due to decreased serum proteins.
What are three acute conditions that can precipitate a seizure?
Head injury, stroke, and cerebral edema.
What is the hallmark of myasthenia gravis?
Myasthenia that increases during periods of activity and improves after periods of rest.
What are the three main problems that result from portal hypertension?
Ascites, splenomegaly, and varices (hemorrhoidal, umbilical, or esophageal).
What are five etiologies indicated in diabetes insipidus?
Sick kidneys with decreased response to ADH, pituitary tumor, acute head injury, cerebral edema, or increased ICP.
What is Barrett’s esophagus?
An uncommon disorder with dysplastic changes in esophageal tissue due to GERD.
What are nine signs and symptoms associated with hypocortisolism?
Hypoglycemia which can cause asthenia, fatigue, apathy, psychosis, anorexia, NandV, and diarrhea.
How does meningitis usually spread?
Via sneezing, tussis, and sharing eating utensils.
What are nine signs and symptoms seen in Cushing’s syndrome/disease?
Increased glycogenolysis and gluconeogenesis, abnormal lipolysis, abnormal protein catabolism, increased osteoclastic activity, prostaglandin suppression, hypokalemia, hirsutism, and hypervolemia.
What are three stressors that have been known to elicit a thyroid storm?
Infection, trauma, and surgery.
How is prehepatic jaundice treated when it has a physiologic etiology in neonates?
With UV light therapy to help immature glucuronyl transferase convert unconjugated bilirubin to conjugated.
A jaundiced patient has a higher than normal direct bilirubin. The mechanism most likely responsible for this is ________, and a likely responsible disease process is ____________.
posthepatic obstruction; cholelithiasis
What makes up intracranial pressure?
Arterial and venous pressures, CSF pressure, and brain tissue–the totalities of pressures in the brain.
What are several, ten, signs and symptoms associated with a thyrotoxic crisis?
Extreme restlessness and agitation, delirium, seizures, coma, tachycardia, HF, shock, hyperhidrosis, and hyperthermia.
A patient with myasthenia gravis is on a drug to block an enzyme called cholinesterase. This drug’s action will help the patient by decreasing what?
The breakdown of acetylcholine in neuromuscular junctions.
What are three signs and/or symptoms seen in GERD?
Pyrosis, epigastric pain, and coughing within one hour of eating.
What are some signs and symptoms of a hiatal hernia?
GERD, epigastric pain, and dysphagia, or asymptomatic.
What happens to steroids in a body suffering from cirrhosis?
They cannot be broken down normally, so people can experience Cushing’s disease, gynecomastia, and hirsutism.
What are several risk factors associated with cholecystitis?
Obesity, excessive estrogen, starvation, genetic component, and European heritage.
What is another name for the ascending sensory tracts used for observing neurologic function below the shoulders?
The spinothalamic tracts.
What are the three main functions of calcium in our bodies?
Building and maintenance of appropriate bone density, cell electrical activity, and clotting.
What is edema and inflammation of the optic nerve where it enters the retina that cannot be detected without an ophthalmoscope?
Papilledema.
What are four things known to exacerbate the signs and symptoms of GERD?
Lying down, alcohol, coffee, and smoking.
What causes ascites to occur in cirrhosis?
Increased pressure in the portal veins which causes increased venous hydrostatic pressure, forcing fluid into the abdominal cavity.
What are two treatments used with IBD?
Steroids to control inflammation and sometimes surgery for a colectomy.
What are several signs and symptoms of myxedema coma?
Sudden impaired LOC, hypotension, and hypoventilation.
What are three known causes of prehepatic jaundice?
Hemolytic anemia, erythroblastosis fetalis, and simple physiologic immaturity in newborns
What immediate interventions are carried out in a medical setting once a patient has been diagnosed with a CVA?
O2, BP management, HOB elevated at least 30 degrees, diuretics, and sometimes an ICP monitor.
What is homonymous hemianopia and what typically causes it?
A visual deficit in one side of both eyes due to cerebral focal edema around the right CN II.
What is the normal fasting serum glucose range?
70-99.
Which tends to be milder, viral or bacterial meningitis?
Viral meningitis.
Besides oral steroids, what else is recommended that patients with Addison’s disease do as a treatment?
To take in lots of fluids and to eat a high-sodium diet.
What are the two general types of Alzheimer’s disease seen in people?
Familial which makes up 30% of cases, and non-hereditary (sporadic) Alzheimer’s which makes up 70% of cases.
Why are NSAIDs and steroids considered to worsen GI issues with the stomach?
Because they decrease synthesis of prostaglandins which normally have a protective effect on the stomach lining.
What does the treatment of migraines usually consist of?
Trigger-avoidance, NSAIDs, and “abortive” drugs like Immitrex.
If both pupils respond equally to light and constrict to the same size, which cranial nerves are intact according to this assessment?
CN II and III.
What does the treatment of diverticulitis consist of?
Increased dietary fiber, avoidance of seeds and nuts, and sometimes antibiotics and surgery.
Regardless if a CVA’s origin is ischemic or hemorrhagic, what are ultimately the actual two causes of the negative effects seen in these conditions?
Cerebral edema and increased ICP.
What are some symptoms present in people with age-related macular degeneration?
Good peripheral vision, but central vision is affected which feels like having a black spot in the middle of one’s vision.
What is mydriasis?
Pupillary dilation normally due to NE stimulating alpha-1 adrenergic receptors.
What is a mostly age-related disease process where there is an elevation of intraocular pressure that results in a loss of visual fields and can eventually lead to blindness?
Glaucoma.
What is the normal range of bicarbonate (HCO3) in our bodies?
22-26.
Where do diverticula most commonly occur?
In the sigmoid colon.
What are the two types of inflammatory bowel disease?
Crohn’s disease and ulcerative colitis.
*What are five symptoms that are unique to a hemorrhagic stroke?
Intense headache (10/10), cervicalgia, photophobia, and N&V.
Which two lab results are expected to be seen in a patient with hypothyroidism?
High TSH and low T4.
What are some characteristics of conjugated bilirubin?
It is made in the liver to be water soluble so that is can more easily be incorporated into bile to emulsify fats.
What is the chronic inflammatory condition of the stomach and proximal duodenum where disturbance of their mucosal lining allows acid to ulcerate the underlying tissues?
Peptic ulcer disease (PUD).
Which two forces is the maintenance of effective cerebral blood flow dependent on?
Cerebral perfusion pressure (CPP) and intracranial pressure (ICP).
What is the main culprit in causing increased ICP, causing a loss of balance between the ICP and CPP?
Cerebral edema.
In which type(s) of diabetes mellitus is micro- and macroangiopathy seen?
Type I and II.
What are two lab results expected to be seen in patients suffering from cholecystitis?
Leukocytosis and high direct bilirubin.
Which type of stroke has a higher mortality rate, ischemic or hemorrhagic?
Hemorrhagic strokes have a higher mortality rate.
What kind of stroke occurs when fragments break from an arterial thrombus and travel downstream until they get stuck in a smaller artery of the brain?
An embolic stroke.
What is an Addisonian crisis?
Severe hypotension due to fluid losses.
What are five signs and/or symptoms associated with Schwartz-Bartter syndrome?
Oliguria, hyponatremia, peripheral and pulmonary edema, and low serum osmolality.
What two lab results are expected to be seen in someone suffering from hyperthyroidism?
High T4 and low TSH.
If a patient has a focal lesion of the brain, would you expect their signs and symptoms to be unilateral or bilateral?
Unilateral.
What are some of the most common causes of an UGI bleed?
Acute hemorrhagic gastritis, esophageal varices, & peptic ulcers.
Which arteries form the right and left middle cerebral arteries (MCA) that supply blood to the right and left cerebral cortices?
The right and left internal carotid arteries.
How would you differentiate a partial seizure from a general seizure?
They are normally local (not diffuse) and the patient has some varied level of consciousness.
What is the most common cause of esophageal varices?
Liver disease.
What are eight signs and symptoms associated with Crohn’s disease?
Bloody diarrhea, abdominal cramps, transmural patchy inflammation, malabsorption, obstruction, fistula, malnutrition, & weight loss.
How is HAV normally transmitted?
Via enterally (fecal/oral) like with tainted oysters.
What risk factors are associated with the development of AMD?
HTN, smoking, Caucasian race, and diabetes.
