2024 NUR 2063 PATHOPHYSIOLOGY RASMUSSEN COLLEGE FINAL EXAM WITH CORRECT ANSWERS, Exams of Advanced Education

Download 2024 NUR 2063 PATHOPHYSIOLOGY RASMUSSEN COLLEGE FINAL EXAM WITH CORRECT ANSWERS and more Exams Advanced Education in PDF only on Docsity! 2024 NUR 2063 PATHOPHYSIOLOGY RASMUSSEN COLLEGE FINAL EXAM WITH CORRECT ANSWERS What are the complications of anemia? - CORRECT-ANSWERSrenal failure, fatigue, dyspnea, hypoxima, pale, cold, low metabolic activity How do we treat anemia? - CORRECT-ANSWERSfrom the causes! can give o2, blood transfusion if needed What is polycythemia? - CORRECT-ANSWERSabnormal excess of RBCs leading to thicken blood that clots easily What is polycythemia vera? - CORRECT-ANSWERSbone marrow cancer that causes high RBC count What is a secondary cause of polycythemia? - CORRECT-ANSWERSdue to low o2 available, affects those at high altitudes How do we treat polycythemia? - CORRECT-ANSWERSblood dilution where blood is removed and replaced with saline Explain primary prevention - CORRECT-ANSWERSPreventing"; altering susceptibility or reducing exposure of disease for people Explain secondary prevention - CORRECT-ANSWERS"Screening"; early detection, screening, and management of disease to catch disease early before it spreads Explain tertiary prevention - CORRECT-ANSWERS"Treating" and preventing further complications from a disorder or disease after the person has the condition What are examples of primary prevention? - CORRECT- ANSWERSVaccinations and Handwashing What is a thrombus? - CORRECT-ANSWERSblood clot that is stasis and has platelets, fibrin and dead cells What is a pulmonary embolism? - CORRECT-ANSWERSblood clot in the lungs What is an emboli? - CORRECT-ANSWERSIntravascular mass that travels and occludes downstream vessels What is a DVT? - CORRECT-ANSWERSBlood clot in an extremity (usually in calf) in the vein What is an arterial thrombus? - CORRECT-ANSWERSblockage of an artery What is a venous thrombus? - CORRECT-ANSWERSblockage of vein causes of anemia - CORRECT-ANSWERSreduced number of red blood cells from the result of blood loss, bone marrow failure, renal failure, nutritional deficiencies, and abnormal hemoglobin hemorrhagic anemia - CORRECT-ANSWERScaused by blood loss aplastic anemia - CORRECT-ANSWERSfailure of blood cell production in the bone marrow iron deficiency anemia - CORRECT-ANSWERSfrom lack of iron in the diet, resulting in insufficient hemoglobin What is PICA? - CORRECT-ANSWERScraving for nonfood substances such a dirt, clay, ice, Landry starch, cardboard or hair Problem with PICA - CORRECT-ANSWERSoften indigestible, toxic and can cause infection perncious anemia - CORRECT-ANSWERSfrom lack of vitamin b12 sickle cell anemia - CORRECT-ANSWERSfrom a mutated hemoglobin molecule that causes RBCs to be in a spiky or crescent shape. Cells are stiff, rupture easily, do not carry enough o2 and can clog small vessels. crises are painful Thalessemia - CORRECT-ANSWERSblood disorder causing reduced hemoglobin on the rbcs. Target shaped cells. S/S: fatigue, weakness, paleness, slow growth. What types of disorders are sickle cell and thalassemia? - CORRECT- ANSWERSgenetic bronchodilator , corticosteroids, to decrease inflammation. IgE therapy, epinephrine given during anaphylaxis through IV or through IM in epipens What are signs and symptoms of a type 1 hypersensitivity reaction? - CORRECT-ANSWERShives, runny nose, eczema, throat constriction, ,localized edema, wheezing, tachycardia, anaphylaxis. Explain Type 2 Hypersensitivity - CORRECT-ANSWERSThe cells attack healthy organs and blood, causing symptoms Mediating factor for type 2 hypersensitivity - CORRECT-ANSWERScytotoxic- IgM/ IgG Examples of type 2 hypersensitivity - CORRECT-ANSWERSBlood transfusions when wrong blood given, hemolytic disease of newborn, grans disease, myasthenia gravis What is type 3 hypersensitivity? - CORRECT-ANSWERSThe igG antibodies are stuck beneath the membranes of cells. Can activate immune responses that can damage tissues. Immune complex Mediating factor type 3 hypersensitivity - CORRECT-ANSWERSimmune complexes Examples type 3 hypersensitivity - CORRECT-ANSWERSRA, lupus What is type 4 hypersensitivity? - CORRECT-ANSWERSthere is a delayed cell reaction caused by the T cells. Antigens are phagocytized and are sensitized to receptors on the t cell. Reexposure causes the memory cells to release destructive cytokines. Mediating factor type 4 hypersensitivity - CORRECT-ANSWERSdelayed cell mediated Examples type 4 hypersensitivity - CORRECT-ANSWERSTB test, contact dermatitis Characteristics of benign tumors - CORRECT-ANSWERSLocalized growth that is curable. They more closely resemble the original tissue type, they grow slowly, have little vascularity, rarely necrotic, and usually have similar function to the original cells. Can be fatal depending on the location (brain, heart,etc), usually grows at the original areas of the body. Encapsulated Characteristics of malignant tumors - CORRECT-ANSWERSusually cancerous. They ignore growth controlling signals and replicate despite signals from the environment. They can escape signals and can die. they can also display different functions poorly or not at all related to the tissue. Greater degree of differentiation means that it is more aggressive. Can move around with a poor prognosis. Anaplasia, metastasis S/S of peptic ulcer disease - CORRECT-ANSWERSepigastric burning pain that is usually relieved by food or antacids (gastric ulcers present on empty stomach but can be after food, duodenal ulcers present 2-3 hours after food and is relieved by food). Can also be life threatening as GI bleeding can occur without warning and cause a drop in H/H and dark tarry stools and hematemesis What is H.pylori? - CORRECT-ANSWERShas a key role in promoting both gastric and duodenal ulcer formation and thrives in acidic areas. It slows down ulcer healing and can reoccur frequently, and taking it away can help ulcers heal What is a functional bowel obstruction? - CORRECT-ANSWERSproblem with the act of the bowel actually moving, such as things that inhibit movement from surgery, medications, opioids, low fiber diets that can slow motility or shut off the GI system from the SNS stimulation What is a mechanical bowel obstruction? - CORRECT-ANSWERSblockage of the bowel inhibiting movement. adhesions, hernia, tumors, impacted feces, volvus or twisting of the intestines, intussusception adhesions - CORRECT-ANSWERSbands of scar tissue joining two surfaces that are normally separated in the bowel hernia - CORRECT-ANSWERSProtrusion of bowel through the wall of the cavity that normally contains it volvus - CORRECT-ANSWERStwisting of the bowel Intusseption - CORRECT-ANSWERStelescoping of the intestines S/S of appendicitis - CORRECT-ANSWERSPeriumbilical pain, RLQ pain, presence of a positive McBurneys point and rebound tenderness when one presses on the belly button and hip region and when the pressure is removed, the client has pain, nausea, vomiting, fever, diarrhea, RLQ tenderness, systemic signs of infection. how to assess appendicitis - CORRECT-ANSWERSMcBurney's point technique when pressing on the belly button and RLQ hip region and removing the pressure causes intense pain, indicates positive appendicitis. Rebound tenderness= positive rebound tenderness - CORRECT-ANSWERSpain that increases when pressure (as from a hand) is removed-in appendicitis S/S of liver disease - CORRECT-ANSWERShepatocellular failure (jaundice, decreased clotting, hypoalbuminemia, decreased vitamin D and K) and portal hypertension (GI congestion due to blockage of blood, more esophageal or gastric varies, hemorrhoids, enlarged spleen,) what is jaundice? - CORRECT-ANSWERSgreen yellow staining of tissues from increased level of bilirubin as the liver cannot metabolize extra bilirubin. Found on eyes, skin, and mouth. present with liver disease What is ascites? - CORRECT-ANSWERSpathological accumulation of fluid in the peritoneal cavity due to the loss of albumin in the liver, causing fluid to be free amongst the cells. It can cause a lot of pain in the abdomen, and it must be drained with a parenthesis What is hepatic encephalopathy? - CORRECT-ANSWERSneuropsychiatric syndrome from too much ammonia in the blood as the liver cannot break it down. Dementia=ammonia and psychotic symptoms common along with jerking What is portal hypertension? - CORRECT-ANSWERSIncreased pressure in the portal venous system from a build-up of portal vein pressure due to progressive hepatic fibrosis which increases hepatic resistance What is esophageal varices? - CORRECT-ANSWERSa complication of portal hypertension resulting from alcoholism or hepatitis. Causes the vessels in the esophagus to become dilated and bleed, and the rupturing can be forceful enough for one to bleed out How do we treat esophageal varices? - CORRECT-ANSWERSreduce the hypertension, banding the varices to prevent rupturing and bleeding by cutting of the flow with a band What role does albumin play in the blood? - CORRECT-ANSWERSAlbumin helps keep fluid in the blood stream and in cells so it does not leak into other tissues. It can also carry other substances in the body What happens to albumin during liver failure? - CORRECT-ANSWERSleads to low albumin levels, causing edema in the extremities and buildup of fluid in abdomen called ascites from fluid leaking through the cells and vessels into the tissues Three functions of the kidneys - CORRECT-ANSWERSelimination, excretion, regulation What is compartment syndrome? - CORRECT-ANSWERSDamage to nerves and vasculature of an extremity due to compression. if untreated it can cause edema, increased pressure, reduced capillary flow, ischemia and necrosis What must be done in compartment syndrome? - CORRECT- ANSWERSfasciotomy to reduce pressure in the area What are the 5 P's for compartment syndrome? - CORRECT-ANSWERSPain paralysis paresthesia pallor pulselessness What are pressure ulcers? - CORRECT-ANSWERSlocalized area of cellular necrosis resulting from pressure between any boney prominence and with an external object Which populations are most likely to have a pressure ulcer? - CORRECT- ANSWERSelderly, bedridden patients, incontinent patients, those who are malnourished, bad hygiene, those with paralysis Risk factors for pressure ulcers - CORRECT-ANSWERSpoor nutrition, aging, immobility, sensory loss, bowel and bladder incontinence Most common places to find pressure ulcers - CORRECT-ANSWERSbuttocks, coccyx, heels, elbows, back of head, shoulders stage 1 pressure ulcer - CORRECT-ANSWERSIntact skin with non blanching redness stage 2 pressure ulcer - CORRECT-ANSWERSpartial thickness skin loss involving the epidermis or dermis or both stage 3 pressure ulcer - CORRECT-ANSWERSfull thickness tissue loss with visible fat stage 4 pressure ulcer - CORRECT-ANSWERSfull thickness tissue loss with exposed bone, muscle or tendon How can we prevent pressure ulcers - CORRECT-ANSWERSturning patients every 2 hours who are bedridden. Appropriate nutrition and hydration. float heels off bed, clean linens, doing incontinence care, movement of patients What are electrolyte reservoirs? - CORRECT-ANSWERSwhere electrolytes are found at an abundance, usually in the bones Which electrolytes are stored in the bones? - CORRECT-ANSWERScalcium, phosphate, magnesium What is osteomyelitis? - CORRECT-ANSWERSsevere pyogenic infection of bone and local tissues. the organism reaches the blood adjacent to soft tissue or directly into it. if not managed, necrotic bone can separate the bone into dead segments Causes of osteomyelitis - CORRECT-ANSWERSburns, sinus disease, trauma, tumors, periodontal infection and pressure ulcers, open fractures, penetration of wounds, surgical contamination or use of metal screws What is osteoporosis? - CORRECT-ANSWERSoccurs when the rate of bone resorption is greater than bone formation. The bones end up becoming fragile and light Who is most likely to get osteoporosis? - CORRECT-ANSWERSwomen age 60- 80 that are caucasian What are the causes of osteoporosis? - CORRECT-ANSWERSestrogen deficiency, poor calcium intake and disuse of supplements S/S of osteoporosis - CORRECT-ANSWERSshort stature, muscle wasting, back spasms and difficulty bending. bones will be porous and have holes in them, more fragile How do we diagnoses osteoporosis? - CORRECT-ANSWERSbone mineral density scan with levels being -1.0 to -2.5 How do we treat osteoporosis? - CORRECT-ANSWERScalcium and vitamin D supplements, exercise, human parathyroid hormone, supplemental estrogen What is rickets? - CORRECT-ANSWERSdefective mineralization of both bone and growth plate cartilage in children What causes rickets? - CORRECT-ANSWERSVitamin D deficiency Which population is affected by rickets? - CORRECT-ANSWERSchildren S/S of Rickets - CORRECT-ANSWERSbowleg, knock kneed, beading of ribs, improper formation of teeth, long ends of the bones, pelvis deformities What is osteomalacia? - CORRECT-ANSWERSa rare condition of the adult bone associated with vitamin D deficiency, resulting in decalcification and softening of bone. Which population is affected with osteomalacia? - CORRECT-ANSWERSadults What causes osteomalacia? - CORRECT-ANSWERSLow vitamin D in adults What is osteoarthritis? - CORRECT-ANSWERSlocal degenerative disorder associated with aging and wear and tear from repetitive stress. Characterized by loss of articular cartilage, calcification, wear of bone and bone spurs. Non inflammatory, and the weight bearing joints are affected What causes osteoarthritis? - CORRECT-ANSWERSlong-term or excessive wear and tear on joints, aging, genetics s/s of osteoarthritis - CORRECT-ANSWERSpain, stiffness, enlargement, tenderness, limited range of motion and deformity, crepitus What are Heberden's and Bouchard's nodes? - CORRECT-ANSWERSboney bumps on fingers and joints caused by joint inflammation in osteoarthritis and RA What is rheumatoid arthritis? - CORRECT-ANSWERSa chronic progressive inflammatory disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles. What causes rheumatoid arthritis? - CORRECT-ANSWERSautoimmune disorder s/s of rheumatoid arthritis - CORRECT-ANSWERSs/s similar to osteoarthritis, malaise and fatigue. What is psoriatic arthritis? - CORRECT-ANSWERSinflammation of the joint cavities associated with psoriasis What is psoriatic arthritis associated with? - CORRECT-ANSWERSpsoriasis What causes psoriatic arthritis? - CORRECT-ANSWERSautomimmune disorder where cells attack the joints if not corrected earlier s/s of psoriatic arthritis - CORRECT-ANSWERSsimilar to RA, but secondary to psoriasis. oligoarthritis, combined soft tissue and peripheral joint disease What is gout? - CORRECT-ANSWERSdisorder in which the disturbance of uric acid metabolism leads to deposition of uric acid crystals in the joints What is associated with gout? - CORRECT-ANSWERSuric acid and uric acid crystals from autoimmune conditions or removal of the adrenals, secondary to removal of corticosteroid therapy S/S of Addison's disease - CORRECT-ANSWERSweight loss, salt wasting of fluids, weakness, malaise, hyperpigmentation or bronzing of skin, hypoglycemia, and hyperkalemia. Reduced cardiac output, inadequate blood volume, low blood pressure Hypothyroidism causes - CORRECT-ANSWERScaused by cells attacking the thyroid gland or surgical removal of tissues, iodine deficiency. Leads to a lack of T3/T4 and too much of TSH. The TSH recognizes the lack of the T3/T4 so more is pushed into it yet the thyroid cannot produce it. Lab values for hypothyroidism - CORRECT-ANSWERSelevated TSH, low T3/T4 S/S hypothyroidism - CORRECT-ANSWERSlow metabolism, weakness, lethargy, cold intolerance, low appetite, bradycardia, weight gain, dry skin, constipation, depression, difficulty concentrating, menstrual problems Hyperthyroidism causes - CORRECT-ANSWERSexcessive iodine, Graves' disease, nonmalignant thyroid tumors, thyroid inflammation, and taking large amounts of thyroid hormone replacement Lab values for hyperthyroidism - CORRECT-ANSWERSHigh T3/T4 levels, low TSH S/S of hyperthyroidism - CORRECT-ANSWERSexophthalmos or eye budging, lid lag, vision changes, light sensitivity, high metabolism, rapid weight loss, insomnia, restlessness, cannot concentrate, tremors and irritability, palpitations, heat intolerance, diaphoresis, diarrhea, amenorrhea type 1 diabetes mellitus patho - CORRECT-ANSWERSthe inability for one to produce insulin needed to transport glucose into cells. They are insulin dependent. The beta cells in the pancreas are destroyed or not present. No insulin to stimulate production of glucagon, causing glucose levels to rise. What must type 1 diabetes do with their condition? - CORRECT- ANSWERStake lifelong insulin type 2 diabetes mellitus - CORRECT-ANSWERScaused by the cells of the pancreas becoming resistant ot insulin, and decrease of receptors on the target cells. They lose the ability to respond to cells. Results in decreased insulin production. What must type 2 diabetics do with their condition? - CORRECT- ANSWERStake insulin or oral diabetic agents. can have a low sodium diet and exercise regularly to keep stress levels low, keep their blood pressure low and weight gain at a minimum Normal blood sugar range - CORRECT-ANSWERS60-120 Hypoglycemia blood sugar levels - CORRECT-ANSWERSlower than 60 Hyperglycemia blood sugar levels - CORRECT-ANSWERSabove 120 How do we diagnose diabetes? - CORRECT-ANSWERSrandom sampling of blood glucose over 200 mg, fasting blood glucose level of 126, or and Hgba1C over 6.5 Normal A1C level - CORRECT-ANSWERS4-6 Diabetic A1c level - CORRECT-ANSWERSabove 6.5 Where should any diabetic aim their A1C level to be at? - CORRECT- ANSWERSless than 7 S/S of hyperglycemia - CORRECT-ANSWERSDry mouth, increased thirst, blurry vision, weakness, headache, frequent urination "sugar high" S/S of hypoglycemia - CORRECT-ANSWERScold, pale, sweating, sleepy, lack of coordination, irritability, hunger Which takes priority: hyperglycemia or hypoglycemia? - CORRECT- ANSWERShypoglycemia What do we need to do to treat hypoglycemia? - CORRECT-ANSWERSby giving 15g of carbs or D50 over time and rechecking the sugar every 15 minutes What are the 3 P's of diabetes? - CORRECT-ANSWERSpolyuria, polydipsia, polyphagia Explain polyuria - CORRECT-ANSWERSincreased urination Explain polydipsia - CORRECT-ANSWERSincreased thirst Explain polyphagia - CORRECT-ANSWERSincreased hunger Primary Brain Injury - CORRECT-ANSWERSoccurs as a direct result of the initial insult to the brain Examples primary brain injury - CORRECT-ANSWERSstroke, concussion, trauma Secondary Brain injury - CORRECT-ANSWERSoccurs as the response to the initial impact or trauma. Can be progressive damage resulting from the body's response to the initial insult Examples of secondary brain injury - CORRECT-ANSWERSbrain swelling secondary to stroke or trauma What is intracranial pressure? - CORRECT-ANSWERSthe volume of the craniums brain tissue, CSF, and blood, overall pressure in the skull and spinal cord What is increased ICP? - CORRECT-ANSWERSoccurs when there is a rise in pressure from trauma, stroke, swelling, tumor, obstruction, etc. There is often compression occurring from the skull that does not allow the brain to expand, adding to the pressure becoming high Result of increased ICP - CORRECT-ANSWERScutting off of the blood supply, tissue damage, ischemia, hypoxia and eventually necrosis. brain cannot expand Normal ICP range - CORRECT-ANSWERS0-15 mmHg Increased ICP range - CORRECT-ANSWERSabove 15 mmHg S/S of increased ICP - CORRECT-ANSWERSLOC changes, headache, vomiting, drowsiness, impaired speech, low arousal, blurry vision, impaired pupil responsiveness to light reflex, unequal pupil size, fixed and dilated pupils, altered respiratory pattern, lack of movement Explain the Glasgow Coma Scale - CORRECT-ANSWERSA scale that measures the degree or level of consciousness (LOC is always number #1 with neurological assessment) What 3 categories is the Glasgow coma scale based on? - CORRECT- ANSWERSeye opening, verbal utterances, and motor reactions Mild Range Glascow coma scores - CORRECT-ANSWERSAbove 12 Moderate Range Glascow coma scores - CORRECT-ANSWERS9-12 Severe Range Glascow coma scores - CORRECT-ANSWERSless than 8 What should you do during a seizure? - CORRECT-ANSWERSmaintain an airway, remove clothes that could constrict, lay person on left side, have suction and o2 at bedside, prevent aspiration, protect injury, document start and stop time of seizures, do not put anything in the mouth, dim room and quiet, give time to rest after the seizure as it deprives the brain of oxygen and energy What is cerebral palsy? - CORRECT-ANSWERSA permanent impairment affecting automatic postural control and movement as a result of a non- progressive brain disorder What is cerebral palsy caused by? - CORRECT-ANSWERSby prenatal infections or mechanical trauma to the head before, during or after birth or exposure to nerve damaging poisons or reduced oxygen supply to the brain Is cerebral palsy reversible? - CORRECT-ANSWERSNo but ti can be managed with surgery, casts, braces, rehab What causes Parkinson's disease? - CORRECT-ANSWERSthe loss of dopamine producing neurons over time that are in the brain, dopamine deficiencies associated with motor impairment S/S of Parkinson's disease - CORRECT-ANSWERSdifficulty initiating and controlling movements, slow movements, tremors that occur at rest, loss of facial expression, shuffling gait, absent arm swing What are spinal injuries caused by? - CORRECT-ANSWERStrauma, MVA, fall, GSW, injury resulting in the spinal cord being compressed, transected or bruised. Secondary to bleeding, swelling, ischemia or inflammation Types of spinal cord injuries - CORRECT-ANSWERShyperflexion, hyperextension or compression What is spinal shock? - CORRECT-ANSWERSoccurs right away and is a loss of reflexes below the injury. The muscles are flaccid and at the end the flaccidity is replaced with spasms What is neurogenic shock? - CORRECT-ANSWERSthere is peripheral vasodilation resulting in hypotension, bradycardia, and circulatory collapse due to no pressure to move the blood in the body. Can potentially affect the respiratory system. What is autonomic dysreflexia? - CORRECT-ANSWERSreflexive response due to sympathetic activation below the injury level such as visceral stimulation, hypertension, headache. Leads to flushing above the level of injury and clammy skin below it. How do we treat spinal cord injuries? - CORRECT-ANSWERSdo not move head or spine. stabilize with a brace to maximize recovery What happens to co2 and o2 levels during hypoventilation? - CORRECT- ANSWERScauses o2 to not be able to get into the lungs and for co2 to be retained and not expelled from the lungs What happens to co2 and o2 levels during hyperventilation? - CORRECT- ANSWERScauses too much co2 to be eliminated and too much o2 to be let into the lungs too fast Normal pH - CORRECT-ANSWERS7.35-7.45 Normal CO2 range - CORRECT-ANSWERS35-45 Normal HCO3 - CORRECT-ANSWERS22-26 Acidosis pH - CORRECT-ANSWERSless than 7.35 Alkalosis pH - CORRECT-ANSWERSgreater than 7.45 Acidosis CO2 - CORRECT-ANSWERSgreater than 45 Alkalosis CO2 - CORRECT-ANSWERSless than 35 Acidosis HCO3 - CORRECT-ANSWERSless than 22 Alkalosis HCO3 - CORRECT-ANSWERSgreater than 26 What happens during respiratory acidosis? - CORRECT-ANSWERSpH is low and CO2 is high; leads to more CO2 retained and not enough O2 Examples of respiratory acidosis? - CORRECT-ANSWERShypoventilation, opioid overdose, impaired airway, respiratory depression, COPD What happens during respiratory alkalosis? - CORRECT-ANSWERSpH is high and CO2 is low; leads to not enough CO2 retained and too much oxygen held on Examples of respiratory alkalosis? - CORRECT-ANSWERShyperventilation, fever, anxiety, sepsis, brain trauma, ventilation What happens during metabolic acidosis? - CORRECT-ANSWERSpH is low and HCO3 is low Examples of metabolic acidosis? - CORRECT-ANSWERSaspirin toxicity, excessive alcohol use, lactic acid buildup. DKA, starvation, persistent diarrhea, kidney failure What happens during metabolic alkalosis? - CORRECT-ANSWERSpH is high and HCO3 is high Examples of metabolic alkalosis? - CORRECT-ANSWERSexcessive vomiting or NG suctioning What is asthma? - CORRECT-ANSWERSchronic inflammatory disorder of the airways from stimuli What is extrinsic asthma? - CORRECT-ANSWERScaused by external factor such as pet dander, pollen dust from an IgE response What is intrinsic asthma? - CORRECT-ANSWERSfrom internal factors such as inflammation, upper respiratory infections, air pollution, emotional stress, smoke What is exercised induced asthma? - CORRECT-ANSWERSoccurs 10-15 minutes after the end of exercise as a compensatory mechanism to warm airways What are s/s of ALL asthma types? - CORRECT-ANSWERSwheezing, tight chest, dyspnea, cough, increased sputum production, hyper inflated chest, decreased breath sounds Which organism causes TB? - CORRECT-ANSWERSmycobacterium tuberculosis How does TB enter the body? - CORRECT-ANSWERSinhalation of small droplets containing the bacteria that are expelled with cough, sneeze or talking. It enters into the lungs and the macrophages ingest the microorganism. Seen on the chest x ray as chon complexes for the small clusters How is TB classified? - CORRECT-ANSWERSprimary is asymptomatic but when reactivated can impair the immune system S/S TB - CORRECT-ANSWERSlow grade fever, chronic cough with bloody sputum, night sweats, fatigue, weight loss How do we diagnose TB? - CORRECT-ANSWERSsputum culture, PPD test but does not work when one is exposed, CXR What results from thrombocytopenia? - CORRECT-ANSWERSlonger bleeding time, petechial, purpura, bleeding gums, hematuria What do we educate clients with thrombocytopenia? - CORRECT-ANSWERSno contact sports, physical trauma, use electric razors, soft tooth brush, put pressure on wounds. What is DIC? - CORRECT-ANSWERSlife threatening condition in which there is widespread coagulation followed by massive bleeding due to depletion of clotting factors, causing one to bleed out DIC causes - CORRECT-ANSWERStrauma, malignancy, burns, sepsis, shock and abuptio placente. There is widespread clot formation in small vessels. S/S DIC - CORRECT-ANSWERSbleeding from multiple sites of the body, clots, bruising and petechiae, hypotension due to low blood volume, shortness of breath, confusion, LOC changes, fevers. Bleed at some time as clotting How do we treat DIC? - CORRECT-ANSWERSremoval or correction of the cause, support major organs, give fresh plasma or packed rbcs, platelets, etc, use heparin to minimize further consumption of clotting factors. Monitor aPTT with heparin use! What hormone plays a role in RBC production? - CORRECT- ANSWERSerythropoietin Where is erythropoietin produced? - CORRECT-ANSWERSkidneys What is a key feature of Hodgkins lymphoma? - CORRECT-ANSWERSHas Reed-Sternberg cells that look like owl eyes S/S of Hodgkin's Lymphoma - CORRECT-ANSWERS- Enlarged, painless mass, most often in the neck, but may be mediastinal [Growth of the mass is from cytokines and growth factors secreted by malignant cells) - Lymphadenopathy from local symptoms associated with pressure/obstruction What is a key feature of non Hodgkins lymphoma? - CORRECT-ANSWERSno reed sternberg cells How are lymphomas diagnosed? - CORRECT-ANSWERSoften asymptomatic, bone marrow biopsy, blood smear Modifiable risk factors for hypertension - CORRECT-ANSWERSdiet, sedentary lifestyle, obesity and weight gain, metabolic syndrome, elevated blood sugar levels, type 2 diabetes, elevated cholesterol, alcohol, smoking Non-modifiable risk factors for hypertension - CORRECT-ANSWERSfamily history, genetics, age, ethnicity primary hypertension - CORRECT-ANSWERScauses are idiopathic but risk factors increase change of having it. Client will often have no symptoms until damage is done to organs secondary hypertension - CORRECT-ANSWERSbased from another condition, common in children, from renal disease or coaction of aorta or obstructive sleep apnea or form medications Medications used with Hypertension - CORRECT-ANSWERSdiuretics to lower blood volume, antihypertensive like beta blockers, ACE inhibitors, A2RB, calcium channel blocker What are the complications of uncontrolled hypertension? - CORRECT- ANSWERSheart disease, kidney disease, PVD, stroke, heart failure, blindness, hemorrhage RAAS system steps - CORRECT-ANSWERSRenin from kidney is released and it triggers Angiotensin 1 that constricts the blood vessels. It is then converted to angiotensin 2 with ACE enzyme. Angiotensin 2 vasoconstricts and increases the BP by increasing peripheral resistance Which organ secretes renin - CORRECT-ANSWERSkidney What happens with aldosterone and ADH during RAAS system - CORRECT- ANSWERSaldosterone is retained so salt is retained and water will follow as well so ADH will be retained Purpose of RAAS system - CORRECT-ANSWERSincreased the blood pressure and blood volume by hormones and constriction of the vessels What is coronary artery disease? - CORRECT-ANSWERSNarrowing of the small blood vessels that supply blood and oxygen to the heart. from plaque build up What causes coronary artery disease? - CORRECT-ANSWERSCaused by plaque buildup in the arteries that impedes blood flow. Can also be damage from bacteria or viruses or an inflammatory response. S/S of coronary artery disease - CORRECT-ANSWERSchest pain, SOB, dysrhythmias, heart attack, heart failure or death What does coronary artery disease put someone at risk for? - CORRECT- ANSWERShypertension, stroke, and increased BP due to narrowing and blockage What is atherosclerosis? - CORRECT-ANSWERSplaque buildup from fatty material and causes the blood vessels to narrow. Usually from cholesterol, lipids, macrophage deposits that will also cause inflammation Initiating factor of atherosclerosis - CORRECT-ANSWERSdamage to the endothelium inner layer What is stable angina? - CORRECT-ANSWERSchest pain that occurs with activity or emotional stress. The pain is predictable and is elicited by the same stimuli. What is unstable angina? - CORRECT-ANSWERSchest pain that is unpredictable, increases over time, duration and severity Is stable angina relieved with rest and nitroglycerin? - CORRECT- ANSWERSyes Is unstable angina relieved with rest and nitroglycerin? - CORRECT- ANSWERSno How do we diagnose acute heart conditions? - CORRECT-ANSWERS12 lead EKG after load - CORRECT-ANSWERSthe pressure or force needed to eject blood from the heart pre load - CORRECT-ANSWERSthe amount of blood returning to each ventricle or that enters and fills at rest cardiac output - CORRECT-ANSWERSthe amount of blood pumped out by each ventricle in 1 minute what happens during heart failure? - CORRECT-ANSWERSthe heart cannot pump effectively, blood cannot move and can back up. CO is decreased as fluid cannot move Left sided heart failure - CORRECT-ANSWERSaffects the lungs and can often lead to right sided heart failure. low CO from the left ventricle causing back up into the lungs Explain clot dissolution - CORRECT-ANSWERSdissolving or breakdown of the clot What medications can affect the hemostasis? - CORRECT-ANSWERSheparin and lovenox can increase chance of bleeding What is hemophilia? - CORRECT-ANSWERSdifferent hereditary bleeding disorders caused by a deficiency of clotting factors S/S of hemophilia - CORRECT-ANSWERSprolonged bleeding with minor injury that can be life threatening, joint damage, bleeding in joint cavities. Hemophillia A - CORRECT-ANSWERSfactor 8 deficiency Hemophillia B - CORRECT-ANSWERSfactor 9 deficient Treatment hemophilia A - CORRECT-ANSWERSfactor 8 concentrate Treatment hemophilia B - CORRECT-ANSWERSplasma What type of disorder is hemophilia? - CORRECT-ANSWERSgenetic normal BP range - CORRECT-ANSWERS120/80 Normal HR range - CORRECT-ANSWERS60-100 bpm Normal respiratory rate - CORRECT-ANSWERS12-20 breaths per minute High BP - CORRECT-ANSWERS140/90 Low BP - CORRECT-ANSWERS90/60 bradypnea - CORRECT-ANSWERSless than 12 breaths per minute Tachypnea - CORRECT-ANSWERSmore than 20 breaths per minute Tachycardia - CORRECT-ANSWERSheart rate above 100 bpm Bradycardia - CORRECT-ANSWERSheart rate less than 60 bpm Normal temperature - CORRECT-ANSWERS98.6 fever temperature - CORRECT-ANSWERS100.4 What is a sign? - CORRECT-ANSWERSsomething you can observe examples of signs - CORRECT-ANSWERSBleeding, fever, swelling, rash What is a symptom? - CORRECT-ANSWERSsubjective sensation that the person feels from the disorder examples of symptoms - CORRECT-ANSWERSpain, dizziness, itching, nausea What is anaplasia? - CORRECT-ANSWERSLoss of cell differentiation and tissue organization. in malignant tumors What is metastasis? - CORRECT-ANSWERScancer cells leaving a tumor and invading other parts of the body