NUR 2063 Pathophysiology Exam 2 NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2 R, Exams of Nursing

Download NUR 2063 Pathophysiology Exam 2 NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2 R and more Exams Nursing in PDF only on Docsity! NUR 2063 Pathophysiology Exam 2 NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2 Review Study Guide Latest Update 2024 What is gastritis? - Correct AnswerInflammation of the stomach lining. The lining will be red and inflamed and irritated What are the causes of gastritis? - Correct AnswerIngestion of irritating substances such a alcohol, aspirin, NSAIDS, viruses and bacteria What is GERD? - Correct Answerthe back flow of gastric contents into the esophagus through the lower esophageal sphincter. The inflammation occurs from the reflex of highly acidic stomach acid that comes up. What are the causes of GERD? - Correct Answer Any condition or agent that alters closure of the lower esophageal sphincter or increases in abdominal pressure, fatty food, caffeine, large amounts of alcohol, smoking, pregnancy and anatomical features like hiatal hernia What are complications of GERD? - Correct AnswerBarrett's esophagus where columnar tissue replaces normal squamous tissue in the distal esophagus that carries a high risk for cancer. Progression can lead to ulcers and scarring. Esophageal strictures, pulmonary symptoms such as cough, asthma and laryngitis from reflux in breathing passages. What are the signs and symptoms of peptic ulcer disease? - Correct Answerepigastric 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 the role of H.pylori in peptic ulcer disease? - Correct Answerpromotes 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 pseudomembranous colitis?(C.diff) - Correct Answeracute inflammation and necrosis of large intestine. The intestinal lining cannot absorb well. What is the cause of pseudomembranous colitis? - Correct Answerclostridium difficile, exposure to long term antibiotics that off set the e.coli and c.diff balance in intestine What are the manifestations of pseudomembranous colitis? - Correct Answerfoul smelling/bloody stool, abdominal pain, fever, leukocytosis, sepsis, colonic perforation. How do we treat pseudomembranous colitis? - Correct Answerstop current antibiotics, treat ischemia and contributing conditions, give oral antibiotics like metronidazole or vancomycin, fecal transplant or colectomy if severe How do we prevent the spread of pseudomembranous colitis? - Correct Answerwearing appropriate PPE and washing hands with soap and water only What are the signs and symptoms of appendicitis? - Correct AnswerPeriumbilical pain, RLQ pain, presence of a positive McBurneys point with pain, nausea, vomiting, fever, diarrhea, RLQ tenderness, systemic signs of infection How do we assess for appendicitis? - Correct AnswerMcBurney's point technique when pressing on the belly button and RLQ hip region and removing the pressure causes intense pain, indicates positive appendicitis What are the causes of bowel obstructions? - Correct Answerprevious surgery of the intestines with adhesions, congenital abnormalities of the bowel, metastatic cancer of the intestinal tract or female reproductive organs, accumulation of fluid, gas, water and electrolytes in the bowel. What is a functional bowel obstruction? - Correct Answera problem 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 Answerdue to adhesions, hernia, tumors, impacted feces, volvus or twisting of the intestines, intussusception What are the signs and symptoms of liver disease? - Correct Answerhepatocellular 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,) Explain what jaundice is? - Correct Answergreen- yellow staining of tissues from increased level of bilirubin as the liver cannot metabolize extra bilirubin Where can you find jaundice on assessment? - Correct Answereyes, skin, and mouth Explain what ascites is? - Correct Answerpathological 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 can we do the prevent pyelonephritis? - Correct Answerremove catheters are early as possible to prevent UTIs and possible spread What are the signs and symptoms of post infectious acute glomerulonephritis? - Correct AnswerSmoky or coffee colored urine, proteinuria, edema as they cannot urinate, decreased output What is the cause of post infectious acute glomerulonephritis? - Correct Answertype b hemolytic strep; follows impetigo and strep throat What age group is most affected by post infectious acute glomerulonephritis? - Correct Answerchildren in developing countries What are the signs and symptoms of acute kidney injury? - Correct AnswerSudden reduction in kidney function, decreased urine output, although occasionally urine output remains normal Fluid retention, causing swelling in your legs, ankles or feet Shortness of breath Fatigue Confusion Nausea Weakness Irregular heartbeat Chest pain or pressure Seizures or coma in severe cases What are the 3 stages of causes of acute kidney injury - Correct Answerpre renal, intrarenal or intrinsic, post renal What are the pre renal causes of AKI? - Correct Answerdisruption in renal perfusion and blood flow. It can cause low blood pressure, low blood volume, heart failure, renal artery obstruction, fever, vomiting, diarrhea, burns that lead to dehydration, Drugs such as ACE inhibitors or angiotensin 2 blockers, NSAIDs that can drop the blood pressure or cause bleeding What are the intrarenal/intrinsic causes of AKI? - Correct Answerdamage or disruptions within the kidney blood vessels, tubules, or glomeruli. It can cause reduced blood supply within the kidneys, toxic injury with medications, chemo, and contrast medias, renal inflammation, or prolonged prostate/ stones/ in the post renal stage What are the post renal causes of AKI? - Correct Answercaused by an obstruction in the urinary collecting system, urethra, bladder, or ureters due to stone, tumor, or enlarged prostate that results in elevated pressure in the Bowman's capsule that impedes glomerular filtration. Prolonged injury can lead to intrinsic injury and irreversible damage What are the 3 stages of AKI presentation? - Correct Answerprodromal, oliguric, postoliguric Explain what happens during prodromal presentation of AKI - Correct Answernormal or declining urine output, The BUN and creatinine levels rise, showing there is a problem. Duration of this phase depends on cause of injury, amount of toxin, duration of hypotension Explain what happens during oliguric presentation of AKI - Correct Answerlasts up to 8 weeks with usual urine output being 50ml-400 mls, when normal output is 30 ml per hour. Characterized by oliguria, lower GFR, and hypovolemia. S/S of fluid excess, hyperkalemia, uremic syndrome. Dialysis may be needed. Explain what happens during postoliguric presentation of AKI - Correct AnswerUrine volume increases, leaving patient at risk for dehydration and electrolyte imbalances they are ridding themselves of too much fluids. Higher GFR, and can last 1 week-1 year. Full recovery when BUN and creatinine levels are normal, but renal insufficiency may occur. (early recovery of the condition, but not all recover) What happens if AKI does not resolve? - Correct Answerchronic kidney disease What are the causes of chronic kidney disease? - Correct Answeroutcome of progressive and irrevocable loss of the nephrons, associated with hypertension, diabetes, recurrent pyelonephritis, glomerulonephritis, polycystic kidney disease, history, toxins, age. Leading from AKI What are the complications one may have from chronic kidney disease? - Correct Answercardiovascular disease, hypertension, uremic syndrome, metabolic acidosis, electrolyte imbalance, malnutrition, anemia, pain, depression Explain the the complication of hypertension/cardiovascular disease from CKD - Correct Answercauses excess fluid in the blood, increase of plaque in the vessels, hypervolemia, the heart must work harder Explain the the complication of uremic syndrome from CKD - Correct Answermetabolic waste can't leave, it can precipitate on the skin as frost Explain the the complication of metabolic acidosis from CKD - Correct Answerthere is retention of acidic wastes that can cause hyperkalemia and arrhythmias Explain the the complication of electrolyte imbalances from CKD - Correct Answerthere will be more potassium, phosphorus and magnesium retained Explain the the complication of bone and mineral disorders from CKD - Correct Answerelevated phosphorus and PTH causes altered bone or mineral metabolism as the kidneys cannot reabsorb calcium Explain the the complication of malnutrition from CKD - Correct Answerdecreased food intake, depression, dietary limitations with what they can eat Explain the the complication of anemia from CKD - Correct Answerlack of erythropoietin that the kidney produces to make new RBC's. Uremia shortens RBC lifespan Explain the the complication of pain from CKD - Correct Answer: from disease, treatment, comorbidities Explain the the complication of depression from CKD - Correct Answerfrom the disease, disruption of social interactions and relationships due to long hours and days at dialysis What happens when CKD is not treated? - Correct Answerend stage renal disease What are some of the types of urinary incontinence? - Correct Answerurge, stress, overflow, reflex Explain what urge incontinence is - Correct Answerthe sudden need to void with an involuntary leakage of urine. sometimes this occurs at night. overactive bladder What is nocturia? - Correct Answerfrequent urination at night Explain what stress incontinence is - Correct Answersmall amounts of urine are voided involuntarily when there is an increase in intraabdominal pressure.Can happen when one sneezes, laughs, picks up heavy objects, etc What population are we most likely to see stress incontinence with? - Correct Answerpregnant women Explain what overflow incontinence is - Correct Answeroccurs when the bladder becomes full and overflows. Often see when one has an obstruction in the urethra such as an enlarged prostate, prolapsed uterus, or urethral stricture. Dribbling of the urine occurs What populations are we most likely to see overflow incontinence with? - Correct Answerclients with diabetes, MS or spinal cord injury Explain what reflex incontinence is - Correct Answerfrom a disruption of the central nervous system communication that controls micturition.The person will have difficulty starting a stream. It will be painful and retention of urine is the result What are the stages of syphillis? - Correct Answerincubation, primary, secondary, latent, late Explain incubation stage of syphillis - Correct Answeroccurs for 10 to 90 days after first infected. No symptoms are noted Explain primary stage of syphillis - Correct Answera painless, single chancre ulcer is formed at the port of entry, usually on the genitals. May resolve in 3-6 weeks Explain secondary stage of syphillis - Correct Answera person will have a head to toe rash accompanied by hepatitis, meningitis and nephritis, fevers, malaise, sore throat, headache, and lymphadenopathy. Bacteria spreads Explain latent stage of syphillis - Correct Answerno symptoms present but the person still has the bacteria in their body, person still contagious and can last up to 40 years Explain late stage of syphillis - Correct Answermost destructive phase, causes major cardiovascular and central nervous system damage, blindness and paresis to bones. It is fatal What is pregnancy induced hypertension/ preeclampsia? - Correct Answeroccurs when there is a rapid rise in arterial blood pressure assoicated with loss of large amounts of protein in the urine What are the chacteristics with one who has pregnancy induced hypertension/preeclampsia? - Correct Answerproteinuria, weight gain, edema, arterial spasms in kidneys, brain and liver, decreased renal flow and GFR, kidneys retain salt and water. If severe: can cause convulsions, coma, renal failure, liver malfunction and hypertension What is hyperemesis gravidarum? - Correct Answerexcessive vomiting during pregnancy that is form response to large amounts of HCG What are the manifestations of hyperemesis gravidarium? - Correct Answerdehydration, electrolyte imbalances hepatic or renal damage or death What is the concern with chlamydial infections during labor and delivery? - Correct AnswerThe mom can pass it onto the baby through vaginal delivery, potentially causing optic issues in the newborn and blindness What do we do to prevent chlamydial infections in the infant? - Correct AnswerGive antibiotic eyedrops right after birth prophylactically What is the problem with the hormone involved in gigantism? - Correct Answertoo much growth hormone What is the pathophysiology behind gigantism? - Correct AnswerOccurs before skeletal plates fuse at the ends of bones. Leaves client with increased risk for cardiac problems. The client will also be very tall. What is the problem with the hormone involved in dwarfism? - Correct Answertoo little growth hormone What is the pathophysiology behind dwarfism? - Correct AnswerIt causes short stature, hypoglycemia, delayed dental eruption, thin hair, poor nail growth, greater fat mass, decreased muscle mass, and delayed bone formation and puberty. is congenital or idiopathic What is the problem with the hormone involved in acromegaly? - Correct Answertoo much growth hormone What is the pathophysiology behind acromegaly? - Correct AnswerOccurs when the cells grow width wise amongst the bones When does gigantism occur in the life span? - Correct Answerchildhood, before growth plates at ends of bones fuse When does acromegaly occur during the life span - Correct Answeradulthood, after fuseing of growth plates What is the problem with the hormone involved in diabetes insipidus? - Correct AnswerToo little ADH, causes the body to not retain enough water What is the pathophysiology behind diabetes insipidus? - Correct AnswerResults in the kidneys being unable to retain water in the body and a lot of urine output that is dilute. Extreme thirst. Lack of water leads to dehydration. Can be caused by trauma to the head What are signs and symptoms of diabetes insidious? - Correct Answerdizziness, disorientation, nausea, tachycardia, headaches, low blood pressure, hypovolemia, high electrolytes in the blood- sodium. High risk for hypovolemic shock, increased urine output, high electrolytes What is the problem with the hormone involved in SIADH? - Correct Answertoo much ADH. cause body to retain too much water What is the pathophysiology behind SIADH? - Correct AnswerCauses the body to retain too much water. Causes hypotonic hydration. There is low urine output, high osmolarity, electrolytes are at a lower concentration. Results in edema, weight gain, and hyponatremia due to excess water retention. What are the signs and symptoms of SIADH? - Correct Answercerebral edema due to low sodium, seizures, confusion, coma, death, swollen cells, low urine output, low electrolytes, edema What is ADH? - Correct Answerantidiuretic hormone What is ADH purpose in the body? - Correct Answerit helps the body keep water balance, and for more fluid retention. Prevents the body from being dehydrated, regulates thirst, and causes water to be reabsorbed What is the electrolyte most affected by ADH - Correct AnswerSodium- inversely affected (low ADH=high Na, high ADH=low Na) What is hypothyroidism caused by? - Correct Answercells 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. Causes goiters Lab results in one that has hypothyroidism - Correct Answerhigh TSH, low T3/T4 What are the clinical manifestations for hypothyroidism? - Correct Answerlow metabolism, weakness, lethargy, cold intolerance, low appetite, bradycardia, weight gain, dry skin, constipation, depression, difficulty concentrating, menstrual problems What is hyperthyroidism caused by? - Correct Answeroverstimulation of the thyroid gland and autoimmune conditions like graves disease. The autoantibodies bind and stimulate TSH receptors Lab results in one that has hyperthyroidism - Correct AnswerHigh T3/T4 levels and low TSH What are the clinical manifestations for hyperthyroidism? - Correct Answerexophthalmos 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 What is the purpose of parathyroid hormone PTH? - Correct Answerincreases the calcium levels in the blood to be released from bone reservoirs by activating osteoclasts. It also increases calcium absorption in the intestines and excretion in urine Which electrolyte is most affected by PTH disorders - Correct Answercalcium What is Cushings disease caused by? - Correct Answercaused by excessive glucocorticoids from either a pituitary tumor or tumor or adrenal cortex or secondary to prescribed glucocorticoids What are clinical manifestations of chronic hyperglycemia? - Correct Answerhypertension, cardio vascular disease from damage to the blood vessels from excessive sugar, retinopathy or blindness from excessive sugar, neuropathy, nephropathy What types of disorders are Ulcerative colitis and Crohn's disease? - Correct Answerinflammatory bowel disorders What is diverticulosis? - Correct Answerthe out pocketing of the walls of the bowel, making it so that fecal material can become trapped in the intestine What is diverticulitis? - Correct Answerinflammation of the diverticulitis due to retained fecal material What changes are associated with esophageal cancer? - Correct AnswerGERD associated, Barretts esophagus due to the tissue changes in the esophagus from the regurgitation of acids What disorder is based from overuse of broad spectrum antibiotics? - Correct Answerpseudomembranous colitis What is intussusception? - Correct Answertelescoping of the bowel into each other What type of blockages does intussusception lead to? - Correct Answermechanical obstructions What is a classic symptom of a glomerularnephorpathy? - Correct Answerproteinuria; when protein spills into the urine What things will diabetics possibly have in their urine? - Correct Answerketones and glucose What things will someone who is pregnant have in their urine? - Correct Answerprotein What are example of post renal causes for AKI - Correct Answerstones, bladder tumors, enlarged prostate What are example of pre renal causes for AKI - Correct Answerhypertension, hypotension, hyper/hypovolemia, low kidney perfusion, renal artery occlusion What are example of intra renal causes for AKI - Correct Answerfrom medicine, contrast, chemo, or prolonged post renal failure What is the disorder that causes tissue growth outside of uterus - Correct Answerendometriosis What two things cause pelvic inflammatory disease - Correct Answerchamydia and gonorrhea What things is one with hyperemesis gravidarium at risk for - Correct Answerdehydration and loss or electrolytes as well as hypovolemia What are some signs one has Diabetes insipidous - Correct Answerdilute urine, hypovolemia, concentrated electrolytes and high osmolarity What are some signs one has SIADH - Correct Answerconcentrated urine, hypervolemia, low numbers of electrolytes and low osmolarity What is the concern with Cushings disease and Addisons disease? - Correct Answerthey cause or have been caused by fluctuations in glucocorticoid levels, causing different things What is cholecystitis - Correct Answerinflammation of the gallbladder What type of pain does one experience with cholecystitis? - Correct AnswerBoring RUQ pain What type of disorder is type 1 diabetes - Correct Answerinsulin dependent due to destruction of the beta cells of pancreas or receptors not present for insulin What type of disorder is type 2 diabetes - Correct Answerinsulin resistant because over time the cells desensitize to insulin or receptor numbers decrease on the cells What disorder causes inflammation of bladder lining - Correct Answercystitis What disorder causes inflammation of the kidneys - Correct Answerpyelonephritis Which hormone increases calcium in blood stream - Correct AnswerPTH Which hormone put calcium back in the bones - Correct AnswerCalcitonin What type of bowel obstruction is based on movement of the intestine, medication, diet or anesthesia given - Correct Answerfunctional- how it functions to move things through What lowers blood glucose level by putting glucose into cells - Correct Answerinsulin What increases sugars from the pancreas - Correct Answerglucagon What is the name of the infection given to newborns who have blindness at birth from chlamydia - Correct AnswerOphthalmia Neonatorum How is syphillis transported in the body? - Correct Answerthrough the vascular system and blood stream What is rebound tenderness? - Correct Answeroccurs when there is pressure taken off the abdomen. indicative of appendicitis When do gastric ulcers form? - Correct Answerright after eating When do duodenal ulcers form? - Correct Answer2-3 hours after eating Why might someone have confusion or dementia when they have liver disease? - Correct Answerthey have high ammonia levels in their blood which can affect the brain and neurological pathways What does someone loose in their cellular fluids that causes ascites in one with liver disease - Correct Answeralbumin; it will cause hypo albumin from the condition since there is more fluid accumulation outside of the cells that leads into the peritoneum, causing the problem