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NURS 402 > Test #4 > Flashcards

Test #4 Flashcards

1
Q

Which lung has more lobes?

A

The right

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2
Q

Where does gas exchange take place?

A

Alveolar capillary membrane

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3
Q

What is ventilation?

A

The movement of air in and out of the respiratory system

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4
Q

What causes air to enter into the lungs?

A

Decreased intrathoracic pressure as the diaphragm increases the space in the lungs

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5
Q

What is respiration?

A

The process of gas exchange at the alveolar level and the diffusion of gases in the blood

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6
Q

What is the V/Q ratio?

A

Ventilation perfusion ratio

(Air flow to blood flow)

Normal is 4:5

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7
Q

What causes a low V/Q ratio?

A

Shunting where perfusion exceeds ventilation

The oxygen and carbon dioxide are there but they cannot be exchanged

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8
Q

What is perfusion?

A

Flow of blood to the capillaries

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9
Q

What is tidal volume?

A

The volume of air taken in and out with each breath

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10
Q

What is inspiratory reserve volume?

A

Additional air which can be inhaled after a normal inhalation

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11
Q

What is expiratory reserve volume?

A

The maximum volume of air that can be exhaled

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12
Q

What is vital capacity?

A

The maximum volume of air exhaled from a maximal inspiration

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13
Q

What is forced expiratory volume?

A

Volume exhaled forcefully over time in seconds

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14
Q

What is peak flow rate?

A

Maximal expiratory flow

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15
Q

What is a normal pH?

A

7.35-7.45

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16
Q

What is a normal PaCO2?

A

35-45

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17
Q

What is a normal HCO3?

A

22-26

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18
Q

What is a normal PaO2?

A

80-100

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19
Q

How fast can the respiratory system effect change for the pH?

A

15-30 minutes

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20
Q

How fast can the renal system effect change for the pH?

A

Hours to days

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21
Q

What are the signs of respiratory acidosis?

A
  • Hypoventilation
  • Hypoxia (results from hypoventilation)
  • Decreased BP
  • Dyspnea
  • Headache
  • Hyperkalemia
  • Dysrhythmias due to increased K
  • Drowsiness, dizziness, disorientation (neurological changes)
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22
Q

What are the signs of metabolic acidosis?

A
  • Kussmaul’s to compensate (hyperventilation)
  • Headache
  • Decreased BP
  • Hyperkalemia (watch for cardiac changes)
  • Warm, flushed skin from vasodilation
  • Nausea, vomiting, and diarrhea
  • Changes in LOC
  • Potential for seizures
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23
Q

What are some causes of alkalosis?

A

Hyperventilation from:

  • Anxiety
  • Pulmonary embolism
  • High altitude
  • Pregnancy
  • Overuse of antacids
  • Loss of gastric juices
  • Potassium wasting diuretics
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24
Q

What are the signs of respiratory alkalosis?

A
  • Seizures
  • Rapid, deep breathing
  • Hyperventilation
  • Tachycardia
  • Hypokalemia
  • Numbness or tingling of extremities
  • Lethargy and confusion
  • Nausea, vomiting
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25
Q

What are the signs of metabolic alkalosis?

A
  • Restlessness followed by lethargy
  • Tachycardia
  • Compensatory hypoventilation (bradypnea)
  • Decreased LOC
  • Tremors, muscle cramps, tingling, tetany
  • Hypokalemia (watch for EKG changes)
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26
Q

Use of birth control pills increases change of what?

A

Blood clots and pulmonary embolisms

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27
Q

In alkalosis, the body dumps what to compensate for lack of hydrogen?

A

Body dumps potassium

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28
Q

What four processes result in metabolic acidosis?

A
  • Overproduction of hydrogen ions (lactic acidosis, DKA)
  • Under elimination of hydrogen ions (Kidney failure)
  • Under production of bicarbonate (Kidney failure, impaired liver or pancreas)
  • Over elimination/loss of bicarbonate (Vomiting and diarrhea)
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29
Q

What is the one underlying cause of respiratory acidosis?

What are some examples of causes (depress)?

A

Retention of CO2

D: Drugs, diseases of the neuromuscular system

E: Edema in the lungs

P: Pneumonia and excessive mucus production

R: Respiratory center of the brain is damaged

E: Emboli (can block branches of the lungs which means CO2 cannot get out and air cannot get in)

S: Spasm of bronchial tubes (asthma)

S: Sac elasticity (reduced in COPD)

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30
Q

What are the causes of respiratory alkalosis?

A

T: Temperature increase in body

A: Aspirin toxicity (causes body to hyperventilate)

C: Controlled mechanical ventilation

H: Hyperventilation

Y: Hysteria/anxiety

P: Pain, pregnancy

N: Neurological injury

E: Emboli

A: Asthma due to hyperventilation

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31
Q

What is the pathophysiology of respiratory alkalosis?

A
  • Expelling too much CO2 due to tachypnea (hyperventilation)
  • Kidneys excrete excess bicarbonate
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32
Q

What are the signs of respiratory alkalosis?

A
  • Fast respiratory rate
  • Neurological changes, tired
  • Increased heart rate from working so hard
  • Tetany, EKG changes, muscle cramps, positive chvostek’s sign
  • Hypokalemia
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33
Q

What are the causes of metabolic acidosis (acidotic)?

A

A: Aspirin toxicity

C: Carbohydrates not metabolized

I: Insufficiency of kidneys

D: Diarrhea (body fluids are rich in bicarb), DKA

O: Ostomy drainage

T: Fistula

I: Intake of too much fat

C: Carbonic anhydrase inhibitors

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34
Q

What is the pathophysiology of metabolic alkalosis?

A
  • Body has lost an excessive amount of hydrogen ions or body has increased bicarb production
  • Lungs start trying to compensate and cause hypoventilation
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35
Q

What are the causes of metabolic alkalosis?

A

A: Excessive aldosterone (causes body to keep sodium which offloads hydrogen and potassium)

L: Loop diuretics (hydrochlorothiazide), causes you to pee of hydrogen ions

K: Alkali ingestion (baking soda, antacids, milk)

A: Anticoagulant (citrate), if you get a massive transfusion

L: Loss of fluids (severe vomiting, NG suction)

I: Increased bicarb administration

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36
Q

What is the pathophysiology of anemia?

A

Decreased red blood cell production (or increased destruction) leads to decreased oxygen delivery to the tissues

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37
Q

Which two things can cause decreased red blood cell production?

A

1) Bone marrow deficiency (aplastic anemia, cancer)
2) Nutritional deficiency: iron, folate, B12, copper, chronic blood loss

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38
Q

What are the symptoms of decreased red blood cell production?

A

Pallor, tachycardia, headache, fatigue, shortness of breath, weakness, murmur

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39
Q

What are the symptoms of anemia from blood loss?

A

Pallor, fatigue, headache, weakness, cool skin, tachycardia, decreased peripheral pulses, low blood pressure

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40
Q

What are the symptoms of anemia from increased red blood cell destruction?

A

Yellow sclera, pallor, fatigue, headache, dark urine, splenomegaly, hepatomegaly

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41
Q

What is the most common type of anemia in children and how is it usually treated?

A

Iron-deficiency

Usually from excessive intake of cow’s milk and low iron

Vitamin C needed to absorb iron

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42
Q

What are the clinical features of sickle-cell anemia?

A
  • Obstruction caused by sickled red blood cells (causes local hypoxia)
  • Vascular inflammation
  • Increased red blood cell destruction
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43
Q

What medication can we give for sickle cell anemia?

A

Hydroxyurea: causes red blood cells to be bigger and rounder

L-glutamate therapy increases the amount of free glutamate to reduce oxidative stress

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44
Q

What are some nursing considerations for patients with sickle cell anemia?

A
  • Preventative antibiotics
  • Avoid contact sports
  • Give pain medications
  • Promote rest
  • Do not use ice
  • Avoid aspirin
  • Avoid skin puncture
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45
Q

What is the pertinent family education for patients with sickle cell anemia?

A
  • Seek early intervention
  • Recognize signs of stroke!

These children are prone to clotting

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46
Q

What is the first organ affected in a vaso-occlusive crisis?

A

Spleen

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47
Q

What will labs look like in iron deficiency anemia?

A

Low red blood cells, hematocrit, and hemoglobin

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48
Q

What is the physical presentation of sickle cell anemia?

A

Pain, shortness of breath, fatigue, pallor, jaundice (due to RBC breakdown)

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49
Q

What will labs look like in sickle cell anemia?

A

Decreased hemoglobin, increased white blood cells, elevated bilirubin

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50
Q

What are the characteristics of beta thalassemia?

A

Inherited genetic disorder which causes defective synthesis of hemoglobin, structural impairment of red blood cells, shorted red blood cell lifespan

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51
Q

What are the symptoms of beta thalassemia?

A

Pallor, fatigue, heart failure, cardiomegaly, hepatomegaly

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52
Q

How is beta thalassemia treated?

A

Blood transfusion

Stem cell transplant

Bone marrow transplant

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53
Q

What is aplastic anemia?

A

When all components of the bone marrow are suppressed (RBC, WBC, platelets)

Can be primary or accquired

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54
Q

How is primary aplastic anemia treated?

A

Bone marrow suppression, transplantation

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55
Q

What are the symptoms of aplastic anemia?

A

Infection, fatigue, fever, tachycardia, petechiae, purpura, bloody stools, weakness, neutropenia can lead to infection

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56
Q

What neutrophil count qualifies for neutropenia?

A

Less than 1500

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57
Q

What is hemophelia?

A

An X linked inherited bleeding disorder that impairs clotting

Hemophilia A: Factor 8 (VIII)

Hemophilia B: Factor 9 (IX)

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58
Q

Female carriers have what chance of passing hemophilia to son’s?

A

50%

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59
Q

What percentage of cases are caused by a new mutation?

A

30%

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60
Q

What are the clinical manifestations of hemophilia?

A

Hemarthrosis, bleeding

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61
Q

What are the treatments for hemophilia?

A
  • Replace missing clotting factor
  • Control bleeding
  • Desmopressin shown to increase factor 8 (A)
  • Gene therapy
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62
Q

What are the nursing considerations for patients with hemophelia?

A
  • Limit invasive procedures
  • Limit joint involvement
  • Avoid aspirin
  • Avoid IM injections, rectal temps, contact sports
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63
Q

What medication prevents transmission of HIV from mother to child?

A

HAART

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64
Q

How is severe combined immunodeficiency treated?

A
  • Prevent infection
  • Donor bone marrow, IVIG, prophylaxis
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65
Q

What are the chracteristics of Wiskott-Aldrich syndrome?

A
  • Thrombocytopenia (platelets less than 150,000)
  • Eczema
  • Immunodeficiency of B and T cells
  • X linked recessive inheritance
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66
Q

What labs are consistent with hemophilia?

APTT, PT, Platelets

A
  • APTT levels prolonged (normal: 30-40 seconds)
  • PT normal (11-13 seconds)
  • Platelets normal (150,000-450,000)
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67
Q

What are the characteristics of COPD?

A

A progressive condition which blocks air getting into the lungs and CO2 getting out

Either chronic bronchitis or emphysema

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68
Q

What are the characteristics of chronic bronchitis?

A

Chronic infection which is accompanied by mucus buildup impairs gas exchange

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69
Q

What is emphysema?

A

Lung damage caused by weakening or breaking of the alveoli

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70
Q

What is COPD usually caused by?

A

Long term exposure to irritants

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71
Q

What are the symptoms of COPD?

A
  • Easily fatigued
  • Frequent respiratory infections
  • Use of accessory muscles
  • Orthopnea
  • Cord pulmonale (right sided heart failure)
  • Wheezing
  • Pursed lip breathing
  • Chronic cough
  • Barrel chest
  • Prolonged expiratory time
  • Digital clubbing
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72
Q

How is COPD treated?

A
  • Smoking cessation
  • Short-acting bronchodilators (albuterol)
  • Long-acting bronchodilators (salmeterol)
  • Inhaled steroids (budesonide, fluticasone)
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73
Q

What percentage of COPD exacerbations are viral and what percentage are bacterial?

A

50% viral, 50% bacterial

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74
Q

What are some non-infectious causes of a COPD exacerbation?

A

Allergies, smoking, pollution, stress, nonadherance

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75
Q

What is pneumonia?

A

Infection in the alveoli which causes inflammation and leakage of fluid into the air sacs

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76
Q

What does the fluid inside the air sacs do?

A

Blocks gas exchange

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77
Q

What are the symptoms of pneumonia?

A

Dyspnea, wet cough, fever, chest pain secondary to inflammation, clammy or blue skin, low BP, nausea, vomiting, hemoptysis

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78
Q

What is a pulmonary embolism?

A

A blood clot in the lungs

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79
Q

How is a PE diagnosed?

A

Elevated d-dimer, chest x ray, VQ scan

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80
Q

How do we treat a PE?

A

Anticoagulants and thrombolytics (streptokinase, alteplase)

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81
Q

What is the standard course of heparin therapy for a PE?

A

5-10 days

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82
Q

Where do you want the PTT for a patient on heparin?

A

1.5 - 2.5 x the patients control

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83
Q

What is the antidote for heparin?

A

Protamine sulfate

84
Q

What is the standard course of coumadin for a PE?

A

3-6 months

85
Q

What is the goal INR for a coumadin patient after a PE?

A

2.0-3.0

86
Q

What is the antidote for coumadin?

A

Vitamin K

87
Q

Which foods are high in vitamin K?

A

Leafy greens

88
Q

Which foods are high in vitamin K?

A

Leafy greens

89
Q

What is a pneumothorax?

A

The collapsing of a lung due to air accumulating in the pleural space

90
Q

What are the causes of a pneumothorax?

A

Spontaneous, trauma to the chest, mechanical ventilation with PEEP

91
Q

How is a pneumothorax diagnosed?

A

X-ray or CT scan

92
Q

What is a closed penumothorax?

A

Air leaks into the pleural space without a chest wound

Fractured rib, spontaneous

93
Q

What is an open pneumothorax and how do you treat it?

A

An open wound allows air to pass in and out of the lungs and bypass the trachea

Sucking chest wound

Place a sterile occlusive dressing taped on three sides

94
Q

What is a tension pneumothorax and why is it a medical emergency?

A

An opening creates a one way valve, which means air collects and cannot get out

A medical emergency due to mediastinal shift

95
Q

Why is a tension pneumothorax a medical emergency?

A

Pressure is placed on the health lung and heart, and mediastinal shift will compress the vena cava which decreases venous return

96
Q

What are the symptoms of a tension penumothorax?

A

Hypoxia, tachypnea, tachycardia, low blood pressure, reduced cardiac output, jugular venous distension, tracheal deviation, mediastinal shift

Patient is going into shock

97
Q

What is acute respiratory failure?

A

A condition that occurs as a result of an underlying process

There is either insufficient O2 transferred to the blood or inadequate CO2 removed from the lungs

98
Q

What are the two ways acute respiratory failure manifests?

A

Hypoxemia: low oxygen

Hypercapnia: high CO2

99
Q

What are some examples of hypoxic respiratory failure?

A

ARDS, pneumonia, inhalation, PE

100
Q

What are some examples of hypercapnic respiratory failure?

A

Asthma, COPD, cystic fibrosis, muscular dystrophy

101
Q

What are some causes of acute respiratory failure?

A

Airway obstruction, respiratory diseases (COPD, asthma), neurological cause, chest wall injury, alveolar disorders (pneumonia, COPD)

102
Q

What is the most common cause of acute respiratory failure?

A

COPD

103
Q

What percentage of PE patients have no symptoms?

A

50%

104
Q

What are some risk factors for PE?

A

Birth control use, history of DVT, sedentary lifestyle, obesity

105
Q

What are early signs of ARF?

A

Dyspnea, tachycardia, cyanosis, restlessness, confusion, increased BP, decreased O2, rise in CO2

106
Q

What does hypercapnia cause and what are the symptoms?

A

Depressed central nervous system function and vasodilation

  • Dyspnea
  • Headache
  • Peripheral vasodilation
  • Decreased level of consciousness
  • Slow respiration
  • Respiratory acidosis
  • Increasing CO2 no long stimulates breathing center
107
Q

Why don’t we want to give COPD patients too much oxygen?

A

They are desensitized to CO2 and rely on low oxygen to trigger their breathing, so if we give then too much oxygen they will stop breathing

108
Q

How do we diagnose ARF?

A

ABG, chest x-ray, pulse ox, CBC, electrolytes, ECG, VQ scan

109
Q

What is the usual oxygen flow for a COPD patient and what do you want to watch for?

A

1-2 L/minute and watch for changes in mental status

110
Q

What is acute respiratory distress syndrome?

A

A severe, sudden form of acute respiratory failure

111
Q

What happens during ARDS?

A

The alveolar capillary membrane is damaged and permeable to intravascular fluid

The alveoli fill with fluid which results in severe dyspnea and hypoxemia, refractory to O2 therapy

112
Q

What is the main characteristic of ARDS?

A

Despite 100% oxygen, P/F ratio is less than 200 (normal is greater than 400)

113
Q

What is FiO2?

A

The percent of O2 inspired or breathed

114
Q

What is PaO2

A

Partial pressure of oxygen, does not reflect if it is being used by the hemoglobin

Normal is 80-100

115
Q

What is an O2 sat?

A

Percent of hemoglobin bound to oxygen

116
Q

What is the P/F ratio?

A

PaO2 to FiO2

A clinical indicator of hypoxemia

117
Q

What are the specific characteristics of ARDS that separate it from ARF?

A
  • Chest white out (bilateral and diffuse infiltrates)
  • Lack of evidence for left ventricular dysfunction
  • Rapid onset
  • P/F ratio less than 200
118
Q

What are some causes of ARDS?

A

Not a primary process but may result from the following:

  • Infection
  • Shock (hemorrhagic, septic)
  • Inhalation injuries
  • Drug overdose
  • Trauma
119
Q

What is the most common cause of ARDS?

A

Sepsis

120
Q

What are the symptoms of ARDS?

A
  • Rapid onset
  • Tachypnea
  • Anxiety
  • Progressive respiratory distress with rising respiratory rate
  • Intercostal retractions and accessory muscle use
  • Cyanosis
  • Initially clear breath sounds which worsen
  • Agitation, confusion, lethargy
  • Nasal flaring
121
Q

What is CPAP?

A

Continuous positive airway pressure

122
Q

What is PEEP?

A

Positive end expiratory pressure

123
Q

What percentage of cancer deaths are related to lung cancer

A

28%

124
Q

What is the five year survival rate for lung cancer?

A

15%

125
Q

Which gender is more likely to develop lung cancer?

A

Women

126
Q

What percentage of lung cancers are non-small cell lung cancers?

A

80%

127
Q

What percentage of lung cancer patients have no symptoms?

A

25%

128
Q

What are the symptoms of lung cancer?

A

Shortness of breath

Chest pain

Hemoptysis

Shoulder pain

Paralysis of vocal cords

Hoarseness

Dysphagia

Pneumonia

129
Q

What are the subtypes of non-small cell lung cancer?

A

Adenocarcinoma

Squamous cell

Large cell

130
Q

What are the characteristics of adenocarcinoma?

A
  • Not related to smoking
  • Most common
  • Usually no signs until metastasis
  • Does not respond well to chemotherapy
131
Q

What are the characteristics of squamous cell?

A
  • Almost always related to smoking or environmental carcinogens
  • Earlier diagnosis because of constricted bronchioles
132
Q

What are the characteristics of large cell?

A
  • High correlation with smoking and exposure to carcinogens
  • Least common form of NSCLC
  • Surgery usually not successful due to high rate of metastasis
133
Q

What are the characteristics of small cell lung cancer?

A
  • Associated with smoking and environmental exposure
  • Most malignant form of lung cancer
  • Associated with endocrine disturbance
  • Causes bronchial constriction
  • Average survival is 16 months
134
Q

What are the characteristics of syndrome of inappropriate ADH?

A
  • Edema
  • Hyponatremia
  • Coagulation abnormalities
135
Q

What are some risk factors for TB?

A
  • Exposure
  • Immigration from high incidence country
  • Injectable illegal drug use
  • High risk settings
136
Q

What are the symptoms of tuberculosis?

A
  • Night sweats
  • Hemoptysis
  • Progressive fatigue
  • Malaise
  • Weight loss
  • Chronic, productive cough
  • Chest pain
  • Low grade fever in the late afternoon
137
Q

How does TB spread?

A

Airborne

138
Q

What is the patient teaching for TB discharge?

A
  • Dispose of secretions properly
  • Take full regimen of medications (full six months)
139
Q

A patient with TB is considered contagious until which criteria are met?

A
  • 3 negative sputum cultures
  • Improving symptoms
  • On medication for 2+ weeks
140
Q

What are the first line drugs for TB?

A

Isoniazid, Rifampin, Purazinamide

141
Q

What are second line drugs for TB?

A

Streptomycin, cycloserine, p-aminsalicylic acid

142
Q

How do you measure an oral pharygeal airway and which way do you put it in?

A

From the midpoint of the incisors to the angle of the mandible

Put it in upside down and turn

143
Q

How do you measure a nasal pharyngeal airway?

A

From the lateral edge of the nostril to the tragus of the ear

144
Q

What is peak airway pressure?

A

How much pressure is occuring in the lungs

145
Q

Why are all the pressures in the lungs positive during mechanical ventilation?

A

Because all the air is pushed instead of pulled

146
Q

What are the characteristics of asthma?

A
  • Characterized by hyper-reactive and inflamed airways
  • Excessive fluid, tightening of muscles, and overproduction of mucus
147
Q

What is restrictive lung disease and what are some examples?

A

Lungs are not able to expand on inspiration, lungs become stiff, often arises from structural problems with the lungs

Scarring, muscle disease in chest wall, protein deposits in lungs

148
Q

What is obstructive lung disease and what are some examples?

A

Lungs are not able to collapse back to normal size (problems with expiration), lungs stay expanded and CO2 cannot get out

Mucus plug, collapsed airway, COPD

149
Q

What disease represent problems with exchange?

A

Fluid in alveoli, pneumonia, secretions, edema in lungs

150
Q

What is one nursing consideration for ARDS?

A

Do not give steroids

151
Q

True or false - ARDS always requires ventilation?

A

True

152
Q

Where do lung cancers most commonly start?

A

The bronchi

153
Q

What percent of TB infections are latent and why?

A

90% - granulomas form around bacteria

154
Q

What does a peak flow meter do and how do you use it? What is normal value?

A

Measures lung capacity

Stand up straight, breath in, hold breath, position device, blow hard

Peak flow depends on height but should be above 400 for women and above 600 for men

155
Q

What IQ number qualifies for intellectual disability?

A

Below 70

156
Q

What are the characteristics of intellectual disabilities?

A
  • IQ less than 70
  • Limitations in communication skills, self care, home living, social skills, self-direction, academic work
157
Q

What are some of the hereditary causes of intellectual disability?

A

Tay sachs, fragile x

158
Q

What are the characteristics of autism spectrum disorder?

A

Pervasive, usually severe impairment of reciprocal social interaction skills, communication, and restricted stereotypical behavioral patterns

159
Q

What are some autism spectrum disorders?

A
  • Classic autism
  • Rett’s disorder
  • Childhood disintegrative disorder
  • Asperger’s disorder
160
Q

When does autism usually present?

A

18 months to 3 years

161
Q

What are some of the characteristics of autistic behavior patterns?

A

Little eye contact, few facial expressions, limited communication, limited ability to relate to peers, inability to engage

162
Q

What are the characteristics of tic disorder?

A

Rapid, sudden, recurrent, nonrhythmic motor movement or vocalization

163
Q

How are tic disorders typically treated?

A

Atypical antipsychotics (olanzapine or risperidone)

164
Q

What are the characteristics of Tourette’s disorder?

A

Multiple motor tics, one or more vocal tics

165
Q

What are the characteristics of learning disorders?

A

Achievement in reading, mathematics, and written expression is below the expected level for child’s age

166
Q

What is developmental coordination disorder and what does it often coexist with?

A

Marked impairment of coordination which interferes with ADLs or academic achievement

Often concurrent with a communication disorder

167
Q

What are the characteristics of stereotypic movement disorder?

A
  • Rhythmic, repetitive behavior
  • Self inflicted injuries common, pain not a deterrent
168
Q

What are the characteristics of communication disorders?

A

Communication deficit severe enough to hinder engagement, achievement, or ADLs

169
Q

What are the types of communication disorders?

A
  • Expressive
  • Mixed
  • Receptive
  • Phonologic: inability to correctly form the sounds of words
  • Stuttering
170
Q

What is encopresis?

A

Defecating in inappropriate places

Child must be at least four, can be intentional or involuntary

171
Q

What is enuresis?

A

Repeated urination during the day or night in clothes or bed

Child must be at least 5, usually involuntary, intentional often associated with behavior disorder

172
Q

What are the characteristics of ADHD?

A
  • Inattentiveness, overactivity, impulsiveness
  • Often diagnosed when starting school
  • Inability to follow directions, fidgeting, noisy, disruptive
173
Q

What are some common medications for ADHD?

A

Stimulants: Ritaliin, Adderall

Antidepressants

Non-stimulants: atomoxetine

Antihypertensives: Clonidine, guanfacine

174
Q

What are the characteristics of disruptive behavior disorders?

A

Anger, hostility, and aggression directed towards people or property

Inability to manage own behavior according to social norms

175
Q

What are the types of disruptive behavior disorders?

A
  • Intermittent explosive disorder
  • Oppositional defiant disorder
  • Conduct disorder
  • Kleptomania
  • Pyromania
176
Q

What is kleptomania?

A

Impulsive, repetitive theft of items not needed by the person

177
Q

What is pyromania?

A

Repeated, intentional fire setting

178
Q

What is the typical age of onset for intermittent explosive disorder and what does it involve?

A

Adolescent to young adult, but only diagnosed after 18 years of age

Aggression towards people or property

179
Q

What is oppositional defiant disorder and when does it usually begin?

A

An enduring pattern of uncooperative, defiant, disobedient, and hostile behavior without antisocial violations

Usually directed at authority figures

Begins in adolescence

180
Q

What percentage of people with oppositional defiant disorder develop conduct disorder and what percent will be diagnosed with antisocial personality disorder?

A

25% diagnosed with conduct disorder

10% diagnosed with antisocial personality disorder

181
Q

What are the major characteristics of oppositional defiant disorder?

A

Frequent, intense behavior which leads to issues with academics, social and work life

Impaired problem solving, decreased attention and inflexible thinking

Low self esteem

Limited insight into consequences of behavior

182
Q

What is conduct disorder and what are the two subtypes?

A

Persistent antisocial behavior

Childhood - before age 10

Adolescent - after age 10

183
Q

What is cognition?

A

The processes by which we gain knowledge and comprehension

184
Q

What is a neurocognitive disorder?

A

A reduction or impairment of cognitive function in one of the following areas:

  • perception
  • defragmentation of concepts
  • memory
  • association and recall

Affects the person’s ability to care for self

185
Q

Neurocognitive disorders often occur after what?

A

Change in the brain resulting from things like neurological illness, mental illness, drug use, or brain injury

186
Q

What are some examples of neurocognitive disorders?

A

Delirium, dementia, amnesia

187
Q

What are the characteristics of delirium?

A

Acute, reversible, due to underlying cause

188
Q

What are the symptoms of delirium?

A
  • Alterations in level of consciousness
  • Abrupt onset
  • Disorganized thinking
  • Poor executive function
  • Disorientation
  • Agitation, anxiety
  • Poor memory
  • Hallucinations
189
Q

What is the most common pharmacological treatment for delirium and why?

A

Haldol

  • Few anticholinergic side effects
  • Smaller likelihood of causing hypotension or sedation
190
Q

What are the characteristics of dementia?

A
  • Stable level of consciousness
  • Steady attentiveness
  • Chronic
  • Slow onset
  • Undetermined cause
  • Irreversible
191
Q

What is the difference between major and minor dementia?

A

Major impacts ADLs, minor does not

192
Q

What are some causes of dementia?

A

Genetics, infection (parkinsons, amniotic disorders), vascular insufficiency

193
Q

What is the most common type of demetia?

A

Alzheimer’s

194
Q

What is the pathophysiology of alzheimer’s?

A
  • Plaques made of amyloid proteins accumulate in neurotransmitter synapses
  • Tau protein strands interfere with neuronal transport

Lead to death of neurons

195
Q

What is aphasia?

A

Disruption of ability to communicate

196
Q

What is apraxia?

A

Inability to perform tasks of movement

197
Q

What is agnosia?

A

Inability to process sensory information

198
Q

What is amnesia?

A

Loss of memory

199
Q

What is anomia?

A

Inability to recall names of everyday objects

200
Q

What is Karsakoff’s syndrome?

A

Disturbance in memory due to long term alcohol use

201
Q

What is confabulation?

A

The fabrication of imaginary memories to compensate for memory loss

202
Q

What is perseveration?

A

The repetition of a word, phrase, or behavior even though the original stimulus for the action has passed

203
Q

What is echolalia?

A

Meaningless repetition of another person’s words

204
Q

What is palilalia?

A

A speech disorder characterized by involuntary repetition of one’s own words or phrases

205
Q

Can you identify these lung volumes?

A-E

A

A: inspiratory reserve volume

B: tidal volume

C: expiratory reserve volume

D: residual volume

E: vital capacity

NURS 402 (1 decks)

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