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NUR 376 Exam 1 Blueprint test
questions and answers
vascular permeability vasodilation increases permeability of the vessel wall to allow WBC, platelets, etc. to move to the site of injury. cellular chemotaxis during the cellular phase of inflammation, a chemical signal from microbial agents, endothelial cells, and WBCs attracts platelets and other WBCs to the site of injury. Brainpower Read More systemic responses fever pain general malaise lymphadenopathy anorexia sleepiness lethargy anemia weight loss titer blood test that measures the amount of antibodies to a specific pathogen in blood. HIV labs CD4 less than 500-immune impairment CD4 less than 200-AIDS Inversion of CD4 to CD8 ratio(2:1 changes to 1: Viral load-RNA assay <10,000 AIDS risk is low, >100,00 AIDS high Post seroconversion-ELISA, confirmed by Western blot E. coli portal of entry
Usually fecal oral-route causing GI signs. FECES Can adhere to bladder mucosa and cause UTIs, female anatomy increase risk d/t proximity to anus. Immunocompetence the ability of an individual to protect oneself from a specific infectious agent because of a strong immune system. Immunosuppression indicates a defective immune system putting an individual at risk for infection Innate immunity responses-1st defense inflammation and fever, granulocytes and macrophages (arise from monocytes), natural killer cells (t-lymphocytes), complement system, dendritic cells (APCs), antimicrobial proteins-lysozymes, interferon, cytokines (PG, TNF, IL), mucous membranes, coughing, sneezing, other natural barriers- skin, ciliated cells Adaptive immunity allows the body to recognize an antigen, target the specific antigen, limit its response to that antigen, and develop memory for the antigen for future reference. B-lymphocyte immunity humoral immunity-antigen stimulates b-lymphocyte to mature to plasma cell and secrete Ig T-lymphocyte immunity cell-mediated immunity-CD4 cells attack, CD8 (cytotoxic) attack when presented an antigen by dendritic cell. Adaptive immunity components b-cells, t-cells, MHC I and II, CD4, CD8, plasma cells, dendritic cells (APCs), immunoglobulins, antibodies. acquired (adaptive) immunity acquired through exposure to an antigen either from infection or immunization. passive (adaptive) immunity
A progressive depletion of CD4 T cells. Attacking CD4 cells allows the virus to destroy both immune mechanisms of the body. Macrophages act as reservoirs of HIV, allowing for viral persistence that can be undetectable in laboratory tests. Macrophages are believed to serve as vehicles for dissemination. Opportunistic infection Infections that occur when the body's defenses are weakened Clinical manifestations of HIV Early: (resembles Mono)- chills, fever, malaise, sore throat, nausea, rash, headache. Later: chills, fever, night sweats, cough, SOB, lethargy, confusion, seizures, headache, fatigue, oral lesions, diarrhea, weight loss, blindness, opportunistic infections-thrush, Kaposi's sarcoma, toxo, TB, herpes Influenza treatment and prevention Treatment: OTC for symptoms; Antiviral drugs Amantadine, Relenza and Tamiflu if taken by second day of disease process Prevention: Injected inactivated influenza vaccine (IIV) or nasal live attenuated influenza vaccine (LAIV) Due to viral mutations, new vaccine must be formulated each year Tamiflu, Handwashing Strep throat treatment and prevention Treatment: Antibiotics Presence of S. pyogenes should be confirmed by testing before antibiotics are prescribed Can prevent serious complications Prevention: Hand washing cell injury and death Occurs when cells are unable to adapt to stress or when they are exposed to damaging agents or suffer intrinsic abnormalities atrophy
to waste away- cells shrink metaplasia changing from one type of mature tissue to another Apoptosis programmed cell death osmotic pressure the external pressure that must be applied to stop osmosis. oncotic pressure The pressure of water to move, typically into the capillary, as the result of the presence of plasma proteins. hydrostatic pressure the pressure within a blood vessel that tends to push water out of the vessel. Hydrostatic (black) vs. Osmotic (blue) intracellular fluid compartment All fluids inside cells of body About 40% of total body weight extracellular fluid compartment The fluid located outside your cells. Interstitial fluids and fluids in the blood are extracellular fluids. interstitial space the space in multicellular organisms that is inside the outer sheet of cells, but outside any cells fluid compartments
Any fluid having the same solute concentration as another fluid to which it is being compared (blood) hypertonic solution A solution in which the concentration of solutes is greater than that of the cell that resides in the solution. Cells shrink. hypotonic solution A solution in which the concentration of solutes is less than that of the cell that resides in the solution. Cells swell magnesium normal range 1.5-2.5 mEq/L causes of hypermagnesemia
- Renal failure
- Excessive intake-antacids
- Lithium therapy
- Hypothyroidism
- Addison disease
- Familial hypocalciuric hypercalcemia
- Milk-alkali syndrome
- Hyperparathyroidism
- Excessive Mg++ containing cathartics or laxatives
- Excessive M++ treatment for eclampsia
- Tumor lysis syndrome in chemotherapy
- Rhabdomyolysis Signs of hypermagnesemia Facial flushing Decreased HR Decreased BP Arrhythmia Decreased DTRs Weakness Wide QRS Increased PR N/V Drowsiness Respiratory depression Cardiac arrest causes of hypomagnesemia
- Starvation
- Alcohol dependence and withdrawal
- Total parenteral nutrition
- Hungry bone syndrome
- Treatment of diabetic ketoacidosis
- Refeeding syndrome
- Acute pancreatitis
- Diarrhea
- Vomiting and nasogastric suction
- Gastrointestinal fistulas and ostomies
- Hypomagnesemia with secondary hypocalcemia (HSH)
- Renal tubular defects
- Gitelman's syndrome
- Classic Bartter's syndrome (type III Bartter's syndrome)
- Diuretics
- Antimicrobials: amphotericin B, aminoglycosides, pentamidine, capreomycin, viomycin, foscarnet
- Chemotherapeutic agents: cisplatin, cetuximab
- Immunosuppressants: tacrolimus, cyclosporine
- Proton pump inhibitors
- Primary hyperaldosteronism signs of hypomagnesemia Increased HR Increased BP Arrhythmia Increased DTR Tetany Confusion Agitation Wide QRS Decreased ST Insulin Resistance Sodium normal range 135-145 mEq/L Causes of hyponatremia
- Adrenal insufficiency
- Burns
- Cirrhosis
- Congestive heart failure
occurs where there is loss of sodium accompanied by a relatively greater loss of body water hypervolemic hypernatremia type of hypernatremia with excessive gain of Na and water-fluid overload pH reference range 7.35-7. CO2 reference range 35- HCO3 reference range 22- uncompensated metabolic cidosis low pH, low HCO3, normal PCO uncompensated metabolic alkalosis high pH, high HCO3, normal PCO uncompensated respiratory acidosis low pH, high CO2, normal HCO uncompensated respiratory alkalosis high pH, low CO2, normal HCO respiratory compensation for metabolic acidosis hyperventilation to decrease CO respiratory compensation for metabolic alkalosis hypoventilation to increase CO renal compensation for respiratory acidosis kidneys excrete more acid (H+) and reabsorb more base HCO renal compensation for respiratory alkalosis kidneys reabsorb more H+ and excrete more HCO antherosclerosis
a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls. Development of atherosclerotic plaque hypertension risk factors smoking, obesity, sedentary lifestyle, genetics, age, poor diet Hypertension Pathophysiology causes damage to endothelial linings of the arteries, increases SVR against left ventricle, BP in aorta is elevated, increased workload on left ventricle, left ventricle hypertrophy, increased myocardial oxygen demand. Susceptible to ischemia, MI and CHF. RAAS is stimulated Hypertension signs and symptoms blurred vision, angina (chest pain), vertigo (dizziness), dyspnea, headaches, flushing, nosebleeds and palpitations Hypertension diagnosis history, physical examination, multiple blood pressure (usually three) readings at varying times of the day, and laboratory tests to determine the presence of complications hypertension treatment Lifestyle (weight loss, diet, exercise, low alcohol, smoking cessation) Diuretics Beta Blockers Alpha blockers ACE inhibitors ARBs Calcium Channel Blockers (CCB) Vasodilators Normal blood pressure range below 120/
atherosclerosis of the coronary arteries that reduces the blood supply to the heart muscle HDL good cholesterol excreted from the body. LDL bad cholesterol deposits at cite of endothelial injury, WBC phagocytose and form foam cells that harden to form plaque. Stable angina predictable and consistent pain that occurs on exertion and is relieved by rest and/or nitroglycerin. Chronic chest pain. Transient ischemia causes chest pain. Chronic coronary artery disease. Unstable angina chest pain at rest or chest pain of increasing frequency. First time causes of increased myocardial oxygen demand increase HR, muscle mass and systemic BP acute coronary syndrome sudden symptoms of insufficient blood supply to the heart indicating unstable angina or acute myocardial infarction. Ischemia untreated leads to MI MI reperfusion injury attempt to restore myocardial blood flow to quickly contributes to injury because ischemic tissue is less able to respond. Caused by oxidized free radicals generated by WBC and the cellular response to restored blood flow. Characterized by arrhythmias and reduced contractility. Pulmonary and systemic circulation ventricular fibrillation
the rapid, irregular, and useless contractions of the ventricles. Ventricles can not expel adequate stoke volume, lethal rhythm. atrial fibrillation rapid, random, ineffective contractions of the atrium. Causes decompensation of the ventricle leading to ischemia or HF, thrombus formation. endocarditis inflammation of the inner lining of the heart. Infectious in 90% of cases. Infection with implants, IV drug users, healthcare. S. aureus main pathogen. myocarditis inflammation of the muscle of the heart. Caused by viral pathogens DVT (deep vein thrombosis) formation of a blood clot in a deep vein of the body, occurring most commonly in the legs or thighs. DVT pathophysiology hemostasis-activation of intrinsic clotting cascade-thrombus formation that is the source of blood clots that break off and travel to different parts of the body-usually to lungs and causing P.E. Chronic Venous Insufficiency (CVI) a condition in which venous circulation is inadequate due to partial vein blockage or leakage of venous valves. chronic venous insufficiency treatment Non-operative: compression stockings, leg elevation, Unna's boots for ulcers Operative: ligation of responsible perforators, valvuloplasty, venous reconstruction with grafting chronic venous insufficiency etiology results from persistent venous hypertension caused by venous incompetence or occlusion. Avoid bx b/c results in non healing ulcer. ejection fraction measurement of the volume percentage of left ventricular contents ejected with each contraction. <40% is heart failure
