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NURS 316B EXAM 2 LATEST 2025 COMPLETE
EXAM WITH KEY CONCEPT Pathophysiological
and Pharmacology for Accelerated BSN
Students II GRADED A CSUSM
What is a life-threatening consequence of a ruptured cerebral aneurysm? Subarachnoid hemorrhage (SAH) What is a key sign/symptom of a Subarachnoid hemorrhage (SAH)? Sudden, severe headache Where in the aorta does aortic dissection usually occur? Aortic arch How does an aortic dissection interrupt normal blood flow?
The aortic dissection (tear in vessel lining) allows blood to flow between layers → Creating false pathway for blood to flow → Diverting blood from major arteries Name 3 etiologies of aortic dissection
- HTN
- Atherosclerosis
- Genetic disposition List 3 genetic dispositions that contribute to aortic dissection etiology
- African American male
- Connection tissue disorders (i.e. Marfan's Syndrome)
- Congenital aortic stenosis A patient is being followed by cardiology complaining of:
- Hearing an internal "ripping or tearing" sound
- Severe pain in upper back between scapula
What is happening with valvular heart disease classified as "Stenosis" or "Incompetent" Hardening of valve leaflets "Incompetent," refers to not enough blood will be let through What is happening with valvular heart disease classified as "Regurgitant" or "Insufficient" Leaflets of valves are floppy Valves are not closing properly and blood flows backwards What cardiac condition is rheumatic fever due to acute streptococcal infection an etiology for? Valvular Heart Disease
A nurse auscultates a murmur for a patient that has been diagnosed with rheumatic fever due to acute streptococcal infection, what diagnosis would they be suspicious of? Valvular Heart Disease What is Myxomatous Degeneration? A congenital defect that causes weakening of connective tissue of the valve, leading to valvular heart disease What type of valvular heart disease is characterized by a narrowed valve opening? Stenosis (Incompetent) What does the narrowed valve opening in stenotic heart disease cause the blood to do?
- Inefficient movement of blood forward
- Excess blood being "left behind"
- Palpitations
- Shortness of breath
- Fever What are Aschoff Bodies? Nodules found in the hearts of individuals with rheumatic fever What is Rheumatic Heart Disease? Valvular damage as a result of previous rheumatic fever and rheumatic carditis Is Rheumatic Heart Disease considered an autoimmune disease? If yes, why? Rheumatic heart disease is considered an autoimmune disease because it triggers a self-inflammatory response driven by Aschoff bodies
(Further explanation: Aschoff bodies produce antibodies → Next strep infection aschoff bodies go "overboard" with inflammatory response → Fibrotic stage → Valvular damage) A patient presents to the ED with erythema marginatum on their trunk, legs and arms and subcutaneous nodules on their elbows. What diagnosis does the nurse suspect? Rheumatic Fever Name 4 additional signs & symptoms of rheumatic fever provided in lecture (i.e. beyond respiratory and cardiac abnormalities)
- Arthritis
- Chorea
- Subcutaneous nodules
- Erythema marginatum Name 3 major imaging orders for diagnosis of valvular heart disease
What is an aneurysm? Weakening of arterial wall (causing bulging or dilation) What is the most common location for an aneurysm? Abdominal aortic aneurysm (AAA) Name 3 common causes of aneurysms
- Atherosclerosis
- Aging
- Genetic predisposition What is the difference between a true vs. false aneurysm?
- A true aneurysm goes through all 3 layers of the vessel wall (tunica intima, media & externa)
- A false aneurysm only goes through tunica media and externa (creates an out pouching)
Where is the most common region for an abdominal aortic aneurysm to occur? Infrarenal (below the kidneys) region of the aorta, above the iliac arteries What sound would you auscultate if a patient had an abdominal aortic aneurysm? Bruitis Upon assessment, a patient with a diagnosed AAA is noted to have an abdominal pulsatile mass? What action should be avoided by the nurse? Why? Deep palpation should not be performed due to risk of rupturing the vessel wall. Aneurysm is life threatening due to fatal loss of blood. If a patient diagnosed with an AAA complains about numbness and weakness in one leg, what does that tell you about the location of the aneurysm?
- MI and Heart Failure
- Dysrhythmias
- Thrombus formation
- Stroke Explain the pathology behind the development of dysrhythmias in more advanced valvular disorders Regurgitation and overstretching of ventricular hypertrophy (usually left ventricle) → Creates pressure on myocytes → Myocytes develop ectopic beats → Dysrhythmias Why does turbulent blood flow increase clot risk? Turbulent blood flow can break off plaque to move around Name 6 treatments used for valvular heart disease
- Surgical repair or replacement
- Nitrates
- Beta-adrenergic blockers
- Anti-coagulants: Warfarin
- Diuretics
- Antibiotic prophylaxis What are nitrates used for in valvular heart condition treatment? For symptom control (reduce ischemic chest pain) What are beta-adrenergic blockers used for in valvular heart condition treatment? Name a 1-2 examples. Take pressure off of the heart by decreasing HR and peripheral resistance Examples: Atenolol, metoprolol What should a patient with a heart valve replacement be educated on prior to having major dental work? Antibiotic prophylaxis (7 - 10 days prior to dental work)
List 5 risk factors for infectious carditis
- Prosthetic valves
- Pacemakers
- Internal Cardiac Defibrillator (ICDs)
- IV drug usage
- Gingivitis What has a poor prognosis: Subacute or acute infectious endocarditis (IE)? Why? Acute IE has a poorer prognosis because subacute IE is more gradual in development and is often caused by a less virulent pathogen A patient with a recently placed prosthetic heart valve is assessed and here are the nurses findings: New heart murmur, fever, shortness of breath, petechiae and splinter hemorrhages on nail beds. What diagnosis is the nurse suspicious of? Infective endocarditis (IE)
What is Duke Critera? Combination of major and minor factors used to diagnose infective endocarditis (IE) Name 2 types of antibiotics that may be used to treat infective endocarditis (IE)
- Penicillins
- Cephalosporings What is pericarditis? Inflammation of pericardium and epicardium What is Dressler's Sydnrome? Cardiac proteins released during MI stimulate inflammation and fluid accumulation
Colchicine is an anti-gout medication, that works well to reduce inflammation of pericarditis What is the main INHIBITORY neurotransmitter in the brain? Gamma Amino Butyric Acid (GABA( What is the main EXCITATORY neurotransmitter in the brain? Glutamate Name the 2 types of pathophysiologic etiologies of chronic neurogenic disorders (1) Ion Channel Disorders (2) Myelin Related Disorders Explain the pathophysiology of ion channel disorders (1) Mutation in normal gating function of the ion channels
(2) Channel is disrupted (3) Repetitive synchronous firing of neuronal action potential (4) Increasing excitability of ion gates Is epilepsy an example of an ion channel disorder OR myelin related disorder? Epilepsy an example of an ion channel disorder Explain the pathophysiology of Myelin Related Disorders (1) Autoimmune attack on myelin (2) Oligodendrocytes (repair cells) created (3) Oligodendrocytes form scar tissue (4) Plaque is formed (5) Plaque impairs neuronal conduction (6) Neuron electrical signals interrupted
