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NURS 316A Exam 1 2025 LATEST WITH KEY
Concepts Pathophysiology and Pharmacology
for Accelerated BSN Students I ALREADY
GRADED A+ CSUSM
What type of acidosis is insulin used to treat? Metabolic acidosis What type of acid-base imbalance are bronchodilators (albuterol) used to treat? Respiratory acidosis What is the anion gap used to for? Differentiate forms or the cause of metabolic acidosis (i.e. DKA vs. Lactic acidosis vs. renal failure vs. GI fluid losses) Most important objective data when determining if a patient is hypoxic? ABGs
Best diagnostic test to evaluate a patient's oxygenation & ventilation after a traumatic brain injury? ABGs What acid-based imbalance is a patient hyperventilating during a panic attack in? Respiratory Alkalosis (Explanation: More CO2 breathing out = Less Acid in body = More base in body = Alkaosis) What acid-base imbalance does a patient with sleep apnea have? Respiratory acidosis (Explanation: Hypoventilation = CO2 retained in body (CO2 not being breathed out) = Acidic)
(Explanation: Fluid build up in lungs = Impaired gas exchange = CO2 retained in body (CO2 not being breathed out) = Acidic) What acid-base imbalance does a patient having an asthma attack have? Respiratory acidosis (Explanation: Inflammation of lungs = Impaired gas exchange = CO2 retained in body (CO2 not being breathed out) = Acidic) What acid-base imbalance does a patient profusely vomiting have? Metabolic alkalosis (Explanation: H+ being vomitted out = Base (HCO3-) left over) What acid-base imbalance does a patient undergoing NGT suctioning have? Metabolic alkalosis
(Explanation: H+ being suctioned out = Base (HCO3-) left over) What acid-base imbalance does a patient with renal failure have? Metabolic acidosis (Explanation: H+ cannot be filtered out via kidneys = H+ retention) What acid-base imbalance does a patient with diarrhea have? Metabolic acidosis (Explanation: Intestines hold more base (HCO3-) and more base is being pooped out = More acid left in body) How does a patient with DKA try to compensate for acidosis? Kussmal respirations (rapid breathing)
- Nephrotic Syndrome What is Exudative Pleural Effusion? Cloudy & high in protein Causes of Exudative Pleural Effusion Inflammation, infection and/or blockage of lung or pleural membranes What type of pleural effusion has common etiologies of PNA, Trauma, cancer, PE, viral infection or pancreatitis? Exudative pleural effusion What diagnosis has the following signs and symptoms?:
- Dyspnea, tachypnea due to hypoxia
- Sharp pleuritic chest pain
- Diminished breath sounds on affected side
- Lack of breath sounds over affected area
- Decreased tactile fremitus over affected area
- Dullness to percussion Pleural Effusion Give 2 treatments for Pleural Effusion
- Thoracentesis
- Pleurodesis What is pleurodesis? Injection of chemical or irritant into affected area causing inflammation and fibrosis, which leads to the pleural membranes adhering to each other What is the difference between Primary Spontaneous Pneumothorax vs. Secondary Spontaneous Pneumothorax?
Closed, penetrating wound that allows air into pleural cavity, but NOT OUT What is a medical emergency: Traumatic pneumothorax or tension pneumothorax? Tension pneumothorax Why would you immediately want to let air out in the even of a tension pneumothorax? Air can compress cardiac structures (i.e, superior vena cava) → Leading to rapid changes in cardiac output → Which may lead to cardiac arrest Biggest concern for hemothorax Hypovolemic shock Treatment for hemothorax
- Thoracostomy (chest tube placement)
- Video Assisted Thoracoscopy (VATs)
- Hypovolemia regimens (fluids, blood transfusions) Why are antibiotics used for pneuomthorax and pleural effusions? Prophylaxis because open entry will be created Name 2 pleuodesis meds used to treat pneumothorax and pleural effusions
- Doxycycline
- Talc Powder What chemotherapy drug is used for treatement of pneumothorax and pleural effusions? Bleomycin What is ARDS (acute respiratory distress syndrome)?
ARDS
What is the difference between ARDS infiltrates vs. PNA or Pneumothorax infiltrates? ARDS = Bilateral pulmonary infiltrates PNA/Pneumothorax = Unilateral infiltrates What is the most important consideration for treating ARDs? Treatment of etiology is most important (what is the underlying cause of ARDS) What is paroxysmal noctural dyspnea? Waking up in the middle of the night and feeling sob or having to take a gasp What tool or test would you use to assess for decreased saturated oxygen readings (SaO2)?
Pulse oximetry What tool or test would you use to assess for decreased lung capacities? Pulmonary function tests (PFTs) What tool or test would you use to assess for alterations in ventilations/perfusion? (VQ) Scans What tool or test would you use to assess for respiratory acidosis? Alterations in arterial blood gases (ABGs) Optimal SaO2 % range 95 - 100%
Normal Ventilation (in L of air/min) 4 L/min Normal Perfusion or Q (in L of blood/min) 5 L/min Normal V/Q ratio 4/5 = 0. Term for PaCO2 > 45 Hypercapnia Term for PaO2 < 80 Hypoxemia
Term for insufficient O2 to tissues Hypoxia Term for PaO2 < 60 AND PaCO2 > 50 Acute respiratory failure Normal pH range 7.35 - 7. Normal PaCO2 range 35 - 45 mmHg Normal Bicarbonate range 22 - 26 mEq/L
