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NR 283 / NR283: Pathophysiology Exam 2 Study Guide (Latest 2021 / 2022) Chamberlain, Study Guides, Projects, Research of Nursing

NR 283 / NR283: Pathophysiology Exam 2 Study Guide (Latest 2021 / 2022) Chamberlain College of Nursing

Typology: Study Guides, Projects, Research

2020/2021

Available from 12/16/2021

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NR I 283 IPathophysiology IExam I 2 IStudy IGuide

Chapter I8: ISkin IDisorders

  1. Viral Iinfections a. Take Iantiviral Ito Ireduce Iviral Ishedding I(can’t Iproliferate)
  2. Autoimmune Iskin Idisorders a. Shingles b. P emphi gus I Ibli st ers i. 2 Iforms I= Ivulgaris I& Ifoliaceus ii. Antibodies Idisrupt Ithe Icohesion Ibetween Ithe Iepidermal Icells Icausing Iblisters Ito Iform iii. Treatment I= Isystemic Iglucocorticoids Isuch Ias Iprednisone I& Iother Iimmunosuppressants
  3. Psoriasis a. A Ichronic Iinflammatory Iskin Idisorder Icaused Iby Iabnormal IT Icell Iactivation b. Cells Iare Ishedding Iepithelium Ia Ilot Ifaster Ithan Ithey Ishould I(increased Imitosis) I= Iflakiness c. lesions Ifound Ion Iface, Iscalp, Ielbows I& Iknees d. Treatment I= Iglucocorticoids, Itar Ipreparations I& Iantimetabolites
  4. HSV II Iand IHSV III I(Herpes ISimplex IVirus II I& III) a. Type II I= Icold Isores I& Ifever Iblister b. Type III I= Igenital c. Spread Iby Idirect Icontact
  5. HPV I(Human IPapilloma IVirus) a. Types I1-4 I= Iplantar Iwarts b. Types I 6 I& I 11 I= Igenital Iwarts c. P redi sposi ng I fact or: I Cancer I I Cervi cal
  6. Fungal Iinfections I(mycoses) a. Most Iare Isuperficial b. Diagnosed Iby Iskin Iscrapings c. Treatment I= Itopical Iantifungal d. Athletes Ifoot I= ITinea Ipedis I& ITinea Icapitis I= Icradle Icap
  7. Scabies a. Invasion Iby Imite Ibite I(female Iburrows, Imale Ifertilizes Ithe Ifemale I& Idies, Ifemale Ilays Ieggs I& Idies,Irepeat) b. highly Icommunicable Iin Iany Isetting Iand Idoes Inot Irespect Isocial Istatus i. put Ipatient Iin Ia Iprivate Iroom ii. nurse Ishould Iwear Igloves I& Igown c. Itchy; IBurrows Iappear Ion Ithe Iskin Ias Itiny, Ibrown Ilines d. Common Isites I= Ibetween Ithe Ifingers, Iwrists, Iinner Isurface Iof Ielbow I& Iwaistline e. Treatment I= Ilindane I(gamma-hexachlorocyclohexane)
  8. Contact Idermatitis a. Exposure Ito Ian Iallergen I= IPruritic Irash I(wool, Iitchy) b. No Iimmune Iresponse c. Treatment I= Itopical Iglucocorticoid 9. Atopic Idermatitis I(eczema) a. A Icommon Iproblem Iin Iinfancy I& Imay Ipersist Iin Iadulthood b. A Ifamilial Itype II Ihypersensitivity Ioften Iassociated Iwith Ihay Ifever I& Iasthma c. Atopic I= Irefers Ito Ian Iinherited Itendency Itoward Iallergic Iconditions d. Etiology I= Ichronic Iinflammation Iresults Ifrom Ithe Iresponse Ito Iallergens; Ieosinophilia I(high Ilevel IofIWBCs Iin Ithe Iblood) I& Iincreased Iserum IIgE Ilevels Iindicate Ithe Iallergic Ibasis e. S&S I= Ipruritic Ilesions, Iskin Iappears Idry I& Iscaly f. Treatment I= Iavoid Iaggravating Iagents I& Itopical Iglucocorticoids
  9. Hansen’s Idisease I(Leprosy) a. Myobacterium Ileprae b. Infects Ithe Iskin, Imucous Imembrane I& Iperipheral Inerves c. Determined Iby Ia Iskin Ibiopsy d. Treatment I= Iantibiotics
  10. Impetigo

a. Very Icontagious b. Common Iin Iinfants Iand Ichildren c. Cause Iby I S. Iaureus I (antibiotic Iresistant Istrains Iare Iincreasing) d. Transmitted Iby Iclose Iphysical Icontact Ior Ifomites e. Pruritis Iis Icommon Iwhich Ileads Ito Iscratching I& Ifurther Ispread Iof Iinfection f. Lesions Iusually Ion Iface g. Treatment I= Itopical Iantibiotic Ifor Iearly Istages I& Isystematic Iadministration Ifor Iextensive Ilesions

  1. Scleroderma a. Tight, Ithin, Ishiny, Ihard, Iimmovable Iskin b. increased Icollagen Ideposit Iin Iarterioles I& Icapillaries Ireduces Iblood Iflow c. Can Ibe Isystemic d. Raynaud I disease I I col d I fi nger It i ps e. Treatment I= Ianti-inflammatory Idrugs Isuch Ias INSAIDs Ior Icorticosteroids I& IimmunosuppressantItherapies 13. Kaposi ISarcoma a. Usually Iin Ipatients Iwith IHIV/AIDS I(immunocompromised) b. May Iaffect Ithe Iviscera Ias Iwell Ias Ithe Iskin c. Etiology I= IHerpesvirus I 8 I(KSHV); Imalignant Icells Iarise Ifrom Ithe Iendothelium Iin Ismall Iblood Ivessels d. S&S I= IMultiple Iskin Ilesions I(large, Iirregular Ishaped, Imay Ibe Idarker Iin Icolor Iaka Ipurple/brownish) IoftenIon Ithe Iface, Iscalp, Ioral Imucosa, Ior Ilower Iextremities e. Treatment I= Icombination Iof Iradiation, Ichemotherapy, Isurgery I& Ibiologic Itherapy f. Put Ipatient Iin Iprotective Iisolation I(protect Ithem Ifrom Iour Igerms)
  2. Malignant IMelanoma a. Melanocytes Ieffected; Iusually Idetected Ilate I= Ia Ibad Iprognosis b. Itchy, Igrows Irapidly, Imetastasizes, Iirregular Iborders c. Development Idepends Ion Igenetics, Iexposure Ito IUV Iradiation I(sunbathing), Ihormones, I&Iimmunosuppressed d. Treatment I= Isurgery, Iradiation I& Ichemotherapy
  3. Basal ICell ICarcinoma a. Pearly Iwhite Iborders
  4. Cancer a. Radiation I= Ishrinks’ Itissue b. Chemotherapy I= Ieradicates Icells c. Complete IBlood ICount I(CBC) d. Monitor Iwhite Iblood Icount 17. Pediculosis I= Ilice

Chapter I13: IRespiratory IDisorders

  1. Primary Icontrol Icenters Ifor Ibreathing Iare Ilocated Iin Ithe Imedulla Iand Ipons
  2. Pulmonary IVolumes a. Tidal IVolu me I(TV) I= Iamount Iof Iair Ientering Ilungs Iwith Ieach Inormal Ibreath I(500mL) b. Residual IVolume I(RV) I= Iamount Iof Iair Iremaining Iin Ithe Ilungs Iafter Iforced Iexpiration I(1200mL) c. Inspiratory IReserve I(IRV) I= Imaximal Iamount Iof Iair Ithat Ican Ibe Iinhaled Iin Iexcess Iof Inormal IquietIinspiration I(3000mL) d. Expiratory IReserve I(ERV) I= Imaximal Ivolume Iof Iair Iexpired Ifollowing Ia Ipassive Iexpiration I(1100mL) e. Vital ICapacity I(VC) I= I maximal Iamount Iof Iair Iexpired Ifollowing Ia Imaximal Iinspiration I(4600mL) i. Incentive Ispirometer Iused Ito Imeasure Ithis f. Total ILung ICapacity I(TLC) I= Itotal Ivolume Iof Iair Iin Ithe Ilungs Iafter Imaximal Iinspiration I(5800mL)
  3. Dyspnea I= Ia Isubjective Ifeeling Iof Idiscomfort Ithat Ioccurs Iwhen Ia Iperson Ifeels Iunable Ito Iinhale Ienough Iair
  4. Cyanosis I= Ithe Ibluish Icoloring Iof Ithe Iskin Iand Imucus Imembranes Ithat Iresults Ifrom Ilarge Iamounts IofIunoxygenated Ihemoglobin Iin Ithe Iblood 5. Gas Iexchange a. Oxygen Idiffuses Iinto Ithe Iblood Ithrough Ithe Ialveoli b. Flow Iof Igases Ibetween Ithe Ialveolar Iair I& Iblood c. Depends Ion Ithe3 Irelative Iconcentrations I(partial Ipressures) Iof Ithe Igases I(PO2 I& IPCO2) d. Dalton’s Ilaw I= Ieach Igas Imoves Ialong Iits Ipartial Ipressure Igradient, Iindependent Iof Iother Igases
  5. Oxyhemoglobin IDissociation ICurve a. Relationship Ibetween Ipercentage Isaturation Iof Ihemoglobin I& IPO
  1. Arterial Iblood Igas Ilevels a. Know Ithe Ivalues: i. Oxygen I= ii. Carbone Idioxide I= Inormal Iis I35- iii. Bicarbonate I= Inormal Iis I 24 iv. Serum IpH I= Iacidosis Iis Iless Ithan I7.35, Inormal Iis I7.36-7.44, I& Ialkalosis Iis Igreater Ithan I7. b. Hypoxemia I= Iinadequate Ioxygen Iin Iblood; Idecrease Ifrom I~105 Ito I 60 Imm IHg; Ichemoreceptors Irespond c. Hypoxia I= Iinadequate Isupply Iof Ioxygen Ito Ithe Icells d. Hypercapnia I= I increased Icarbon Idioxide Iin Ithe Iblood; ICO2 Ieasily Idiffuses Iinto ICerebrospinal Ifluid I(CSF); Icauses Irespiratory Iacidosis e. Hypocapnia I= Ilow Icarbon Idioxide Iconcentration I(low Ipartial Ipressure Iof ICO2) Iin Iblood; Imay Ibe Icaused by Ihyperventilation; Icauses Irespiratory Ialkalosis
  2. Boyle’s Ilaw: I“As Ithe Isize Iof Ithe Ithoracic Icavity Idecreases, Ithe Ipressure Iinside Ithe Icavity Idecreases”
  3. Respiratory Imucosa I(where Iis Iit Ilocated) a. Consists Iof Ipseudostratified Iciliated Icolumnar Iepithelial Icells, Iwhich Iincludes Imucous-secreting Igoblet Icells. IMucous Iblanket Itraps I& Icilia Isweeps Iforeign Iparticles Iout Iof Ithe Irespiratory Itract ➢ Starts Iin Inares Iand Iends Iin Ithe Ialveoli ➢ Respiratory Imucosa Iis I CONTINUOUS
  4. Chemoreceptors a. Central I= Imedulla b. Peripheral I= Icarotid Ibodies c. Purpose I= Idetects Ichanges Iin Icarbon Idioxide, Ihydrogen Iion, Iand Ioxygen Ilevels Iin Ithe Iblood IorIcerebrospinal Ifluid I(CSF)
  5. Characteristics Iof Isputum Iand Iwhat Ivariations Irepresent a. General Imanifestation Iof Irespiratory Idisease b. Yellow/greenish, Icloudy, Ithick Imucus I= Iusually Ibacterial Iinfection c. Rusty/dark Icolored I= Iusually Ipneumococcal Ipneumonia d. Large Iamounts Iof Ipurulent Iwith Ifoul Iodor I= Imay Ibe Iassociated Iwith Ibronchiectasis e. Thick, Itenacious, Imucus I= Iasthma Ior Icystic Ifibrosis i. blood-tinged Isputum—may Iresult Ifrom Ichronic Icough; Imay Ialso Ibe Isign Iof Itumor IorItuberculosis f. Hemoptysis I= IBlood-tinged I(bright Ired) Ifrothy Isputum, Iusually Iassociated Iwith Ipulmonary Iedema
  6. Laryngotracheobronchitis a. Common Iin Ichildren I(3 Imonths I- I 3 Iyears) b. Gradual Ionset; Iinflammation Iof Ilarynx I& Itrachea; Ican Iobstruct Ithe Iairway c. CROUP I I what I causes I i t? I = I parai nfl uenz a I vi ruses I & I adenovi ruses
  7. Tuberculosis a. Protect Iourselves Ifrom Ithese Ipatients I(airborne I= Ineed Ito Iwear Imasks) b. Caused Iby Imycobacterium Ituberculosis c. Spread Iby Ioral Idroplets I(can Istay Ilive Ifor Iabout I 3 Iweeks Iwhen Idried) d. Common Iin Icrowded Iliving Iconditions I(poor) I& Ithe Iimmunocompromised e. It Iis Inot Ilimited Ito Ithe Ilungs f. S&S I= Iweight Iloss, Ifailure Ito Ithrive, Iinfection I(measles), Icavitation Iin Ithe Ilungs, Icough, IpositiveIsputum, Iradiograph, Iskin Itest g. Treatment I= Ia Icombination Iof Idrugs Ifor I6-12 Imonths h. Types i. Primary Iinfection I= Iwhen Imicroorganism Ifirst Iinfects Ilungs; Iengulfed Iby Imacrophages I– IlocalIinfection ii. Secondary I= Iactive Iinfection; Ioften Iyears Iafter Iprimary Iinfection; Ibrought Iback Ibecause Iof cell-mediated Iimmunity Iis Iimpaired I(stress, Iage, Iinfection) iii. Miliary/Extrapulmonary I= Imore Icommon Iin Ikids; Irapidly Iprogressive Iform
  8. Cystic IFibrosis a. Inherited Igenetic Idisorder Ilocated Ion Ichromosome I 7 b. Tenacious Imucus; Iaffects Ilungs I& Ipancreas c. Mucus Iblocks Iairflow Iin Ibronchioles I& Ismall Ibronchi d. Infections I(Pseudo. IAureus I& IStaph. IAureus)
  9. Atelectasis I= I the Inon-aeration Ior Icollapse Iof Ia Ilung Ior Ipart Iof Ia Ilung Ileading Ito Ia Idecreased Igas Iexchange I&Ihypoxia

a. A Icollapsed Ilung; Imarked Iby Iairway Iobstruction I(also Imay Ibe Ia Icause) b. Sound Iof Ilung Iis Idecreased Ion Ithat Iside I& Ithe Ichest Idoesn’t Irise Ion Ithat Iside c. S&S I= Ismall Iareas Iare Iasymptomatic; Ilarge Iareas Icause Idyspnea, Iincreased Iheart I& Irespiratory Irates, I&Ichest Ipain d. Treatment I= Itreat Ithe Icause I& Ire-expand Ithe Icollapsed Ilung; Ideep Ibreathing Iexercises, Ichanging Ibody positions, Iforced Icoughing; Iremoval Iof Ifluid, Itissue Ior Itumor; Ichest Iclapping Ior Ipercussion, IposturalIdrainage, I& Imedications Ito Iopen Iairways I& Iloosen Imucus

  1. Pneumothorax a. Patients Iwith Icancer I(branchiogenic Icarcinoma) b. Happens Ibecause Iof Itumor, Iblood Iin Ilungs, Ipleural Ieffusion i. Eats Ithrough Ilungs I= Iair Ican Iget Ithrough ii. Air Iin Ilungs c. Hemothorax I= Iblood Iin Ithoracic Ispace
  2. Pleural IEffusion I= Ithe Ipresence Iof Iexcessive Ifluid Iin Ithe Ipleural Icavity

Chapter I10: IBlood IDisorders

  1. Vitamin IK I= Ipurpose Iof Iit Iin Ithe Iliver Iis Ibecause Iit Iis Ia Iclotting Ifactor a. Platelets Iand Iprothrombin Ihelp Iwith Iclotting Iin Iblood
  2. ABO ➢ Know Iblood Itypes I– Ibased Ion Iantigens Iin Ithe Iplasma I& Imembrane Iof Ithe Ierythrocytes o O I= Ino Irbc Iantigen, Ianti-A I& Ianti-B Iantibodies Iin Iplasma, Ican Ionly Ireceive IO o A I= IA Irbc Iantigen, Ianti-B Iantibodies Iin Iplasma, Ican Ireceive IA Ior IO o B I= IB Irbc Iantigen, Ianti-A Iantibodies Iin Iplasma, Ican Ireceive IB Ior IO o AB I= IA I& IB Iantigen, Ino Iantibodies Iin Iplasma, Ican Ireceive IA, IB, IO, Ior IAB ➢ What Iantibodies Iare Ipresent I(A=A, IB=B, IO=NONE) ➢ Rh I(+ Ior I-) o I + I= Iantigen ID Iin Iplasma Imembrane o - I= Iabsence Iof Iantigen ID ➢ O- I= Iuniversal Idonor ➢ AB I= Iuniversal Irecipient
  3. Hyperchromic IErythrocytes I= I RBCs Ithat Ilack Icolor a. indicative Iof Iiron Ideficiency Ianemia
  4. Anemias I= Ireduce Ioxygen Itransport Iin Iblood Idue Ito Ia Idecrease Iin Ihemoglobin Icontent a. Iron Ideficiency Ianemia i. Insufficient Iiron Iimpairs Ihemoglobin Isynthesis I= Ireducing Ithe Iamount Iof Ioxygen ItransportedIin Iblood ii. Microcytic I(small), Ihypochromic I(pale) IRBCs I= Inot Icarrying Ithe Ioxygen Ithey Ineed iii. Hemoglobin Ilevels Iare Ilow I(hypochromic); Idecreased Iproduction iv. Frequently Ia Isign Iof Ian Iunderlying Iproblem I(cancer) v. Etiology I= Idecreased Idietary Iintake, Imalabsorption, Ichronic Iblood Iloss, Isevere Iliver Idisease vi. S&S I= Ipallor Iof Iskin, Ifatigue, Ilethargy, Iirritability, Itachycardia, Idelayed Ihealing, ImenstrualIirregularities vii. Treatment I= Igive Iiron Ito Itake Iwith Iorange Ijuice Ibecause Ivitamin IC Iabsorbs Iiron I(must Iuse Ia straw Ito Iavoid Idiscoloration Iof Iteeth) b. Sickle Icell Ianemia i. Abnormal Ihemoglobin I(HbS) I= Iunstable I& Ichanges Ishape Iin Ihypoxemia; IRBC Ielongates I&Ihardens Iin Ia Isickle Ishape Iwhen Ioxygen Ilevels Iare Ilow I– Ihave Ia Ishort Ilife Ispan ii. Occurs Iwhenever Ioxygen Ilevels Iare Ilowered iii. Cells Iare Itoo Ilarge Ito Ipass I& Iobstruction Ileads Ito Imultiple Iinfarctions I& Iareas Iof Inecrosis iv. Etiology I= Irecessive Iinheritance; Iappears Iat I 12 Imonths ➢ Cause I= Iautosomal Irecessive I(genetic Idisorder) ➢ Occurs Iin Ihomozygous Irecessive ➢ Common Iin IAfrican IAmericans I& IMiddle IEast ➢ S&S I= Ipallor, Iweakness, Itachycardia, Idyspnea, Ihyperbilirubinemia, Isplenomegaly, Igrowth I&Idevelopment Iare Idelayed ➢ Additional Ieffect I= Ipainful Icrisis Iwith Imultiple Iinfarctions; Iorgan Ifailure

c. Pernicious IAnemia I= Ivitamin IB12 Ideficiency i. Lack Iof Iabsorption Ibecause Iof Ilack Iof Iintrinsic Ifactor I(owing Ito Iimmune Ireaction) ii. RBCs I= Imegaloblasts I(immature Inucleated Icells); Ishort Ilife Ispan iii. Very Ilarge, Iimmature, Inucleated Ierythrocytes iv. Vitamin IB12 Iis Ineeded Ifor Ithe Ifunction I& Imaintenance Iof Ineurons v. Tongue Iis Itypically Ienlarged, Ired, Isore, I& Ishiny I(big I& Ibeefy) vi. Etiology I= Ideficit Iof Iintrinsic Ifactor Iowing Ito Iimmune Ireaction vii. Gastric Ibypass Ipatients viii. Additional Ieffects I= Ineurologic Idamage I& Iachlorhydria d. Aplastic IAnemia I= Iimpairment IorIfailure Iof Ibone Imarrow i. RBCs I= Ioften Inormal Icells; Ipancytopenia ii. May Ibe Itemporary Ior Ipermanent iii. Often Iidiopathic iv. Blood Icounts Iindicate Ipancytopenia I(all/whole; Idecrease) v. Identification Iof Icause I& Iprompt Itreatment Ineeded Ifor Ibone Imarrow Irecovery ➢ Etiology I= Ibone Imarrow Idamage Ior Ifailure ➢ Additional IEffects I= Iexcessive Ibleeding I& Imultiple Iinfections ➢ Cancer Iof Ithe Iblood; IHIV Iare Iprone

  1. Leukemias I= Igroup Iof Ineoplastic Idisorders Iinvolving IWBC I(uncontrolled Iproduction Iin Ibone Ior Ilymph Inodes) a. WBCs I& IRBCs Iare Ilow; Idepresses Ithe Iimmune Isystem I= Iprone Ito Iinfections Iso Iput Ipatients Iin IisolationIrooms I& Ilimit Ivisitors; Iwear Igowns, Igloves I& Imasks Ito Iprotect Ithem Ifrom Iyou; Ino Ifresh Ifruits Ior Iflowers b. Acute Ileukemias i. High Iproportion Iof Iimmature Inonfunctional Icells Iin Ibone Imarrow I& Iperipheral Icirculation ii. Onset Iis Iusually Iabrupt; Icomplications; Iusually Iin Ichildren I& Iyoung Iadults iii. Acute Ilymphocytic Ileukemia I(ALL) I= IB-lymphocytes I& Iyoung Ichildren
  2. Multiple Iopportunistic Iinfections Ioccur Ibecause Icells Iare Iimmature I& IhaveIweakened Ifunction
  3. The Imost Icommon Ichildhood Icancer
  4. Cause I= Iunknown; Iassociation Iwith Ichromosomal Iabnormalities I(translocation) iv. Acute Imyelogenous I(or Imyelocytic) Ileukemia I(AML) I= Igranulocytic Istem Icells I& Iadults
  5. Cause I= Iexposure Ito Iradiation, Ichemicals, I& Icertain Iviruses v. Acute Imonocytic Ileukemia I= Imonocytes I& Iadults c. Chronic Ileukemias i. Higher Iproportion Iof Imature Icells ii. Insidious Ionset Iwith Imild Isigns I& Ibetter Iprognosis; Icommon Iin Iolder Iadults iii. Chronic Ilymphocytic Ileukemia I(CLL) I= IB-ly mphocytes I& Iadults Igreater Ithan I 50 Iyears iv. Chronic Imyelogenous Ileukemia I(CML) I= Igranulocyte Istem Icells I& Iadults I30- ➢ Predisposing Ifactors 6. Polycythemia a. Primary I= IVera i. Increased Iproduction Iof Ierythrocytes I& Iother Icells Iin Ithe Ibone Imarrow I= Ithick Iblood I= Ihard ItoIget Ithrough Iarteries I& Ivessels ii. Cells Ihave Ihypertrophy Ibecause Iof Iincreased Iwork iii. Blood Ivolume Iis Iincreased I(hematocrit Iincreased) iv. Causes Iincrease Iin IBP v. Phlebotomy Idone Ito Iremove I 500 Icc Iblood I& I 500 Icc Iof IIV Ito Idilute Iblood vi. Neoplastic Idisorder b. Secondary I= Ierythrocytosis i. Increase Iin IRBCs Iin Iresponse Ito Iprolonged Ihypoxia ii. Increased Ierythropoietin Isecretion iii. Compensation Imechanism Ito Iprovide Iincreased Ioxygen Itransport
  6. Warning Isigns Iof Iexcessive Ibleeding I& Ipossible Iblood-clotting Idisorders a. Persistent Ibleeding Ifrom Igums I& Inosebleeds b. Petechiae I= Ipinpoint Iflat Ired Ispots Ion Iskin Ior Imucous Imembranes I(like Ia Irash) c. Frequent Ipurpura I& Iecchymoses I(large, Ipurplish Ired Ior Igreenish Ibruises) d. Hematemesis I= Ibleeding Iinto Ia Ijoint I(swollen, Ired I& Ipainful) e. Hemoptysis I= Ibright Ired Iflecks Iin Isputum I(coughing Iup Iblood)

f. Hematemesis I= Ivomiting Iblood I(often Ibrown Ilike Icoffee Igrinds; Imay Ibe Ired) g. Blood Iin Ifeces h. Feeling Ifaint I& Ianxious, Ilow IBP, Irapid Ipulse

  1. Hemophilia IA I(classic Ihemophilia ) I= Ia Ideficit Ior Iabnormality Iof Iclotting Ifactor IVIII a. Most Icommon Iinherited Iclotting Idisorder; IX-linked Irecessive Itrait b. S&S I= Iprolonged Ior Isevere Ihemorrhage Iafter Iminor Itrauma, Ipersistent Ioozing Iof Iblood Iafter Iminor Iinjuries, Ihematomas Iis Icommon, Ihemarthrosis I(spontaneous Ibleeding Iinto Ijoints), Ihematuria I(blood Iin Iurine Ior Ifeces) Imay Ioccur c. Precautions I= Iavoid IASA Ior IASA-containing Idrugs, Ibe Iprepared Iwith Isupplies Iin Icase Iof Iemergency, Ilab tests Ito Icheck Ifor Icurrent Iblood-clotting Istatus; Iavoid Icontact Isports I& Isharp Iobjects, Iuse Ielectric Irazors I& Iavoid Ienemas d. Treatment I= Idesmopressin I(DDAVP), Ireplacement Itherapy
  2. Disseminated IIntravascularICoagulation I(DIC) I= Iexcessive I bleeding I& Iclotting Iat Ithe Isame Itime a. An Ioften-life-threatening Icondition Ithat Iinvolves Iboth Iexcessive Ibleeding I& Iexcessive Iclotting b. Consumption Iof Iclotting Ifactors Iand Ifibrinolysis Ileads Ito Ihemorrhage I& Ieventually Ihypertension I&Ishock c. Etiology I= Ia Ivariety Iof Idisorders Ican Iinitiate Iit Isuch Ias Iobstetric Icomplications I(abruptio Iplacenta I= Irips off Iuterine Iwall), Icarcinomas I& Itrauma d. S&S I= Ilow Iplasma Ifibrinogen Ilevel, Ithrombocytopenia Ioccurs, Iprolonged Ibleeding I(hemorrhage) Iaccompanied Iwith Ilow IBP I& Ishock, Irespiratory Iimpairment, Iseizures I& Iacute Irenal Ifailure Iwith Ioliguria e. Treatment I= Idifficult I& Idepends Iif Ihemorrhages Ior Ithromboses Iare Idominant; Imust Itreat Iunderlying cause Isuccessfully; Iprognosis Idepends Ion Ithe Iseverity Iof Ithe Iproblem

Chapter I12: ICardiac IDisorders

  1. Stroke Ivolume Iand Icompensative Imechanisms
  2. Systolic Ipressure I= Ithe Ipressure Iexerted Iby Ithe Iblood Iwhen Iejected Ifrom Ithe Ileft Iventricle
  3. Diastolic Ipressure I= Ithe Ipressure Ithat Iis Isustained Iwhen Ithe Iventricles Iare Irelaxed
  4. Preload I= I volume Iof Ivenous Ireturn Iback Ito Ithe Iheart; Irefers Ito Ithe Imechanical Istate Iof Ithe Iheart Iat Ithe Iend IofIdiastole Iwith Ithe Iventricles Iat Itheir Imaximum Ivolume
  5. Afterload I= I volume/pressure Iof Iblood Ithat Icauses Ithe Iejection Iof Ithe Iblood Ifrom Ithe Ileft Iventricle; Ithe Iforce required Ito Ieject Iblood Ifrom Ithe Iventricles I& Iis Idetermined Iby Ithe IPR Ito Ithe Iopening Iof Ithe Isemilunar Ivalves
  6. Peripheral Iresistance I(PR) I= Ithe Iforce Iopposing Iblood Iflow, Ior Ithe Iamount Iof Ifriction Iwith Ithe Ivessel Iwalls Iencountered Iby Ithe Iblood
  7. Cardiac Ioutput I=volume Iof Iblood Iejected Iby Ia Iventricle Iin Ione Iminute; Idepends Ion ISV I& IHR
  8. Stroke IVolume I= Ithe Ivolume Ipumped Ifrom Ione Iventricle Iin Ione Icontraction; Ivaries Iwith Isympathetic IstimulationI& Ivenous Ireturn 9. CO I (cardia c I output) I = I S V I(stroke I volume) I I HR I (heart I rate) a. CO Iis Ia Icombination Iof IHR I& ISV I Iblood Ivolume Ipumped Iper Iminute I(~4900-5000mL) b. Decrease Iin Ioutput Iand Istroke Ivolume I= Iincrease Iof IHR c. If IHR Iincreases, ICO Idecreases Ibecause ISV Idecreases I(doesn’t Ihave Ienough Itime Ito Irefill Isame IamountIof Iblood) **d. BP I(blood Ipressure) I= ICO I(cardiac Ioutput) Ix IPR I(peripheral Iresistance)
  9. Angina** a. Chest Ipain; Ioccurs Iwhen Ithere Iis Ia Ideficit Iof Ioxygen Ito Ithe Iheart Imuscle b. Precipitating Ifactors I= Irunning Iupstairs, Igetting Iangry, Irespiratory Iinfection Iwith Ifever, Iexposure ItoIweather Iextremes Ior Ipollution, Ior Ieating Ia Ilarge Imeal c. S&S I= Isubsternal Ichest Ipain Idescribed Ias Ia Itightness Ior Ipressure, Ipallor, Idiaphoresis I(excessive sweating), I& Inausea d. Treatment I= Icoronary Ivasodilators Isuch Ias Initroglycerin e. Stable i. when Ia Icertain Iactivity Icauses Ichest Ipain Iit Iis Istable; Iusually Itriggered Iby Iphysical IorIemotional Istress f. Unstable i. More Iserious Iform; Irefers Ito Iprolonged Ipain Iat Irest I& Iof Irecent Ionset; Imay Ibe Ithe Iresult Iof IaIbreak Iin Iatheroma; Imay Iprecede Ia IMI ii. Random Ichest Ipains Iwhether Ior Inot Iactivities/exertion Iare Iperformed
  10. Deep IVein IThrombosis I(DVT)

a. Patients Iwho Iare Ipost Iop Iare Iat Irisk I– Iput Isequential Icompression Idevices Ion Ithem Ior Ianti- embolicIstockings I(ted Istockings) b. Do Inot Imassage Itheir Ilegs Ibecause Iit Ican Imove Ithe Iclot c. Thrombophlebitis I= Irefers Ito Ithe Idevelopment Iof Ia Ithrombus Iin Ia Ivein Iin Iwhich Iinflammation Iis Ipresent d. Phlebothrombosis I= Ia Ithrombus Iforms Ispontaneously Iin Ia Ivein Iwithout Iprior IinflammationI(inflammation Imay Idevelop Isecondarily Iin Iresponse Ito Ithe Ithrombus) e. Critical Iproblem Iis Ithat Ivenous Ithrombosis Imay Ilead Ito Ipulmonary Iembolism f. S&S I= Iaching, Iburning, Ior Itenderness Iin Ithe Iaffected Ileg, Ileg Imay Ibe Iwarm Iand Ired, Imay Icause Iedema, IaIpositive IHomans Isign I(pain Iin Ithe Icalf Imuscle Iwhen Ithe Ifoot Iis Idorsiflexed), Isystemic Isigns Isuch Ias Ifever, Imalaise I& Ileukocytosis g. Treatment I= Icompression Ior Ielastic Istockings, Iexercise Ito Ireduce Istasis, Ianticoagulant Itherapy, fibrinolytic Itherapy, I& Ithrombectomy

12. Myocardium IInfarction I(MI) a. An IMI I(heart Iattack) Iinvolves Ithe Ideath Iof Imyocardial Itissue Idue Ito Iischemia I(deficiency Iof Iblood); Ioccurs Iwhen Ia Icoronary Iartery Iis Itotally Iobstructed, Ileading Ito Iprolonged Iischemia I& Iinfarction I(cellIdeath) Iof Ithe Iheart Iwall b. P at hophysi ol ogy I I TOT AL I OCCUL TIO N c. Warning Isigns: IChest Ipain I(feeling Iof Ipressure, Iheaviness, Ior Iburning Iespecially Iwith Iincreased Iactivity), Isudden Ishortness Iof Ibreath, Isweating, Ifatigue, Iweakness, Inausea, Iindigestion, Ianxiety I& Ifear d. Most Icommon Icause: IAtherosclerosis Iinvolving Ithrombosis e. S&S I= Ipallor, Idiaphoresis, Idizziness, Idyspnea, Ihypotension I& Ilow-grade Ifever f. Cardiac Ipatient Iwho Iis Isuspected Iof Ihaving Ian IMI Imust Icheck Ifor Ilevels Iof Itroponin I(protein IreleasedIwhen Icardiac Imuscle Ihas Ibeen Idamaged)/CPK Iwhich Iis Iindicative Iof Icardiac Imuscle Ideath g. Tot al I bl ockage I occurs I I part I of I myocardi um I isn’t I get ti ng I bl ood I It hat I part I of It he I heart I di es I Ishock occurs 13. Tetralogy Iof IFallout a. Disease Iof Iinfant Ithat Iis Iborn Icyanotic; Icaused Iby Ia Ihole Iin Ithe Iheart b. Surgery Iis Iusually Ilater Ion Ibecause Iit Imay Iheal Ion Iits Iown c. Most Icommon Icyanotic Icongenital Iheart Icondition d. Four Idefects Iare I= i. Pulmonary Ivalve Istenosis I= Irestricts Ioutflow Ifrom Ithe Iright Iventricle, Ileading Ito Iright IventricleIhypertrophy I& Ihigh Ipressure Iin Ithe Iright Iventricle ii. VSD I= iii. Dextroposition Iof Ithe Iaorta I(to Ithe Iright Iover Ithe IVSD) I= iv. Right Iventricle Ihypertrophy I= e. Blood Ifrom Iright Iatrium Ito Ileft Iventricle; Imixing Ideoxygenated Iblood Iwith Ioxygenated Iblood IandIsending Iout f. VS D I I bl ood I from I l eft It o I ri ght I I not I bl ue I because I bl ood I i s I oxygenat ed I t wi ce

  1. Cardiac IDysrhythmias a. Bradycardia I= Islower Ithan I60/minute; IStroke IVolume Iincreased I& Ipossibly Ireduced ICardiac IOutput b. Tachycardia I= Ifast I100-160/ minute; Ipossibly Ireduced ICardiac IOutput c. Atrial Iflutter I= I160-350/ minute; Iless Ifiling Itime I& Ioften Ireduced ICardiac IOutput d. Fibrillation I= Iover I300/minute; Iuncoordinated Imuscle Icontractions; Ino Ifilling, Ino Ioutput, IcardiacIstandstill
  2. Congestive IHeart IFailure I(CHF)= Iinability Iof Ithe Iheart Ito Ipump Iblood Ito Imeet Ithe Idemand Iof Ithe Ibody a. Left-sided ICHF i. Causes I= Iinfarction Iof Ileft Iventricle, Iaortic Ivalve Istenosis, Ihypertension, Ihyperthyroidism ii. Basic Ieffects I= Idecreased Icardiac Ioutput, Ipulmonary Icongestion iii. Forward Ieffects I= Ifatigue, Iweakness, Idyspnea, Iexercise Iintolerance, Icold Iintolerance iv. Compensations I= Itachycardia I& Ipallor, Isecondary Ipolycythemia, Idaytime Ioliguria v. Backup Ieffects I= Iorthopnea, Icough Iproducing Iwhite Ior Ipink-tinged Iphlegm, Ishortness IofIbreath, Iparoxysmal Inocturnal Idyspnea, Ihemoptysis, Irales b. Right-sided ICHF i. Causes I= Iinfarction Iof Iright Iventricle, Ipulmonary Ivalve Istenosis, Ipulmonary Idisease I(corIpulmonale) ii. Basic Ieffects I= Idecreased Icardiac Ioutput, Isystemic Icongestion, I& Iedema Iof Ilegs I& Iabdomen iii. Forward Ieffects I= Ifatigue, Iweakness, Idyspnea, Iexercise Iintolerance, Icold Iintolerance iv. Compensation I= Itachycardia I& Ipallor, Isecondary Ipolycythemia, Idaytime Ioliguria

v. Backup Ieffects I= Idependent Iedema Iin Ifeet, Ihepatomegaly I& Isplenomegaly, Iascites, IdistendedIneck Iveins, Iheadache, Iflushed Iface

  1. Coronary IArtery IDisease I(CAD) a. Includes Iangina Ipectoris Iand Imyocardial Iinfarction b. Arteriosclerosis I= Igeneral Iterm Ifor Iall Itypes Iof Iarterial Ichanges; Iusually Idegenerative Ichanges Iin Ipeople Iover I 50 I& Idiabetes; Ielasticity Iis Ilost, Iwalls Ibecome Ithick I& Ihard, Ilumen Inarrows I& Imay Ibecome Iobstructed c. Risk Ifactors I= i. Nonmodifiable I= Iage, Igender, Igenetic Ifactors, ii. Modifiable I= Iobesity Ior Idiets Ihigh Iin Icholesterol I& Ianimal Ifat, Icigarette Ismoking, Isedentary Ilifestyle, Idiabetes Imellitus, Ipoorly Icontrolled Ihypertension, Icombination Iof Ioral IcontraceptivesI& Ismoking, Icombination Iof Ihigh Iblood Icholesterol I& Ihigh IBP d. Treatment I= Ilose Iweight, Iminimize Isodium Iintake, Icontrol Idiabetes I& Ihypertension, Istop Ismoking, exercise, I& Ipotentially Ioral Ianticoagulant I& Isurgical Iintervention
  2. Lipids a. LDLI= Ibad Iso Iyou Iwant Ithem Ito Ibe ILow b. What Iit Ipromotes Iif Iuntreated: IATHROMA c. HDL I= Igood Iso Iyou Iwant Ithem Ito Ibe IHigh