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NURS 487 WEEK 8 Midterm Exam 1 Latest 2025 Verified
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What is major depression? (how long does it last, Beck's triad, neurotransmitters affected)
- depressed mood lasting > 2 weeks.
- Beck's Triad: negative view of world, negative view of self, negative hope for the future.
- decreased norepinephrine, serotonin & dopamine. What is anhedonia? inability/ reduced ability to experience pleasure What is anxiety/ panic? feelings of uncertainty, dread, uneasiness What are the neurotransmitters affected in anxiety/ panic attacks?
- increased serotonin and norepinephrine
- decreased GABA what are the four types of anxiety? mild, moderate, severe, panic What is bipolar I disorder? when the individual has had one manic episode and major depressive episode
What is bipolar II disorder?
- major depression with hypomania
- individual has never has a full manic episode what is cyclothymic bipolar disorder?
- hypomania and depression lasting > 2 years What are the neurotransmitters affected with mania and depression? Mania- increased norepinephrine, serotonin, and dopamine depression- decreased norepinephrine, serotonin, and dopamine what is suicidal ideation? (what is the acronym for assessment) IS PATH WARM
- ideation, substance use, purposelessness, anxiety, trapped, hopelessness, withdrawal, anger, recklessness, mood changes What is psychosis? loss of reality what are hallucinations? false perceptions such as things seen or heard that are not real or present What are delusions?
(dramatic, emotional, erratic): antisocial, borderline, histrionic, narcissistic What is cluster C personality disorder? Anxious, fearful avoidant, dependent, obsessive compulsive What are the symptoms of personality disorder? impulsive, unstable, sensitive, angry, fearful What are the components of the mental status exam? observation, affect, mood, speech, thought process, thought content, judgement what conditions included in thought content? delusion, magical thinking, depersonalization, erotomania what is erotomania? belief that a famous person is in love with them what are the conditions included in thought process? clang association, neogisms, flight of ideas pressured speech
What is clang association? meaningless rhyming of words What are neogisms? using made up words or words out of context what are the 3 types of hallucinations? auditory- hearing voices visual- seeing things tactile- feeling things What does ADH regulate? water excretion from kidney (osmolality of body) What is SIADH?
- What are the symptoms
- What would the labs be? **syndrome of inappropriate antidiuretic hormone
- high antidiuretic production leads to water retention
- increased total body water
- "soaked inside"= increased ADH
- will see signs of fluid volume overload, changes in loc, weight gain w/o edema, hypertension, tachycardia, decreased urine output
- HYPONATREMIA, hypoosmalality
High TSH, low T What is Grave's disease? too much thyroid hormone What are the symptoms of hyperthyroidism? weight loss, increased goiter, protruding eyes What are the lab results for hyperthyroidism? Low TSH, high T What is a thyroid storm/ thyrotoxicosis? too much thyroid, overactive thyroid what is polyuria, oliguria, and anuria? polyuria= urine output >2500mL oliguria= urine output 100-400mL anuria= urine output <100mL What is type I diabetes? destruction of beta cells= decrease in insulin production
What are the diagnostic labs for type I diabetes blood sample & urine? (3) hemoglobin A1c= >6.5% fasting BG= >7. 2 hour oral glucose tolerance test= >11.1 with 75g urine= +++ ketones, protein, glycosuria What is type II diabetes? insulin resistance, non responsive
- eventually the pancreas tires out= no insulin What is metabolic syndrome? Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states What is the dawn phenomenon? high BG upon waking up (between 0200 - 0300) What is the Somogyi effect? low BG at 0200- 0300 What is polydipsia and polyphagia? excessive thirst, excessive hunger
What is the difference between DKA and HHS? DKA has ++ ketones but HHS does not, HHS has more neurological symptoms What are the counter-regulatory hormones? What is their purpose? glucagon, adrenaline, cortisol, growth hormone
- released during hypoglycemia
- DKA has excessive secretion What is hypoglycemia? low blood glucose levels, <4.
- SYMPTOMS: pallor, sweating, tachycardia, hunger, restlessness, anxiety what are obstructive uropathies? when urine flow is impaired, dilation of the urinary system occurs, damage occurs above the obstruction, hypertrophy of the bladder What are some causes of obstructive uropathies? calculi, BPH what is bladder diverticula? herniation of bladder mucosae what is hydronephrosis?
swelling to both or one of the kidneys What is nephrolithiasis? masses of crystals and proteins leading to kidney stones What is a calculus vs lithiasis? calculus= accumulation of salts lithiasis= formation of calculus what are the symptoms of a kidney stone? flank pain, urinary incontinence, hematuria What is lithiotripsy? radiofrequencies break up kidney stones what is the main cause for pediatric UTI? urinary stasis what are some symptoms for pediatric UTI? decreased appetite & growth, pallor, thirst, hematuria, painful urination, frequent urination, enlarged kidneys
- Blood volume decreases, fluid is lost= HYPOVOLEMIA
- RAAS starts, aldosterone is released
3.5g protein lost/ day
- symptoms: edema, hypoalbinuremia
- AT RISK FOR VT/ CLOTS
- labs: decreased protein and albumin What is acute glomerulonephritis/ nephritic syndrome? (symptoms, labs, what should you swab for?) The glomeruli are inflamed, which impacts the kidneys to filter the urine properly.
- symptoms: proteinuria, HEMATURIA IS PRESENT, decreased urine, hypertension, edema
- labs: increased BUN, creatinine & WBC
- SWAB FOR STREP (could be causing nephritic) what is the difference between nephritic and nephrotic syndrome? HEMATURIA IS PRESENT IN NEPHRITIC SYNDROME What is HUS? (symptoms, diagnostic triad) ** hemolytic uremia acute renal disease, cause of AKI/ renal failure
- symptoms: petechiae, jaundice, dysuria, AHF, bruising
- TRIAD: thrombocytopenia, anemia, renal failure What is AKI? (symptoms, diagnostics, acronym) ** acute kidney injury a sudden decrease in renal fx, kidneys have trouble filtering blood and concentrating urine
- symptoms: pain, urinary retention, hypertension
- labs: increased creatinine, decreased urine volume and GFR
- RIFLE: risk, injury, failure, loss, end-stage renal disease What is prerenal AKI? Reduced blood delivery to the kidney; if the kidney doesn't get the blood then it can't filter it What is intrarenal AKI? direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply What is postrenal AKI? Obstruction of urinary outflow, this backs up the urine into the kidney and causes damage What are the phases of AKI? Initiation Maintenance Recovery what is nausea? feeling of discomfort in the epigastrium with a conscious desire to vomit What is vomiting?
how do you assess dehydration for children? (what is the test called, symptoms) Gorelick score capillary refill >2 seconds, absent tears, sunken fontanelle, general ill appearance, decreased urine output what are the two types of hernias? sliding and paraesphogeal/ rolling hernia what is a sliding hernia? part of the stomach goes into the diaphragm what is a rolling/ paraoesophageal hernia? the greater curvature of the stomach rolls into the diaphragm creating a pocket beside the esophagus what are the symptoms/ causes/ diagnostics for a hernia? symptoms: heartburn, dysphagia, reflux causes: weak diaphragm, increased abdominal pressure diagnostics: endoscopy, barium swallow what is gastritis? (causes/ symptoms) inflammation of the gastric mucosa causes: ASA and NSAID use
symptoms: N&V, full feeling, epigastric tenderness What is the difference between acute and chronic gastritis? acute- injury of the mucosa chronic- atrophy of the epithelium what is the purpose of intrinsic factors/ what happens to it in gastritis? if cells become damages= lost intrinsic factor= decreased B12 in liver What is diarrhea? a. Passage of frequent, watery, loose stools. b. Results in loss of fluids, certain minerals, and nutrients risk of dehydration. Many causes including microorganisms, stress, or excessive fiber intake. what is constipation? A symptom, not a disease; infrequent stool and/or hard, dry, small stools that are difficult to eliminate What is a peptic ulcer? A break in the mucosal lining of the esophagus, stomach, or small intestine. what is the difference between acute and chronic peptic ulcers? acute- superficial, heals quickly chronic- erodes through the mucosa and muscle, forms scar tissue
What is bleeding from a duodenal origin indicative of? ulcer, acute gastritis, ASA/ NSAID/ corticosteroid use What is bleeding from an esophageal origin indicative of? chronic esophagitis, Mallory Weiss tear, esophageal varicosities What are types of lower GI bleeding? anal fissures, IBS, Crohn's/ colitis, internal hemorrhoids, polyps, diverticular disease, hematochezia What is diverticular disease? small, bulging pouches (diverticula) develop in your digestive tract. When one or more of these pouches become inflamed or infected, the condition is called diverticulitis. What is hematochezia? bright red blood in stool What are some symptoms and causes of GI bleeds? symptoms: orthostatic hypertension, palpitations, cool extremities, altered LOC, jaundice causes: ASA/ NSAID/ corticosteroid use, stress related, liver failure What does bright red stool indicate?
bleeding in lower GI tract, has not been in contact with stomach acid What are some lab findings associated with GI bleeds?
- decreased hematocrit/ hemoglobin, hematuria
- dehydration, electrolyte imbalance
- hypokalemia
- increased BUN
- increased risk for MI What is appendicitis? inflammation of appendix caused by obstruction of the appendiceal lumen What are symptoms and labs associated with appendicitis? symptoms: periumbilical pain, RLQ pain/ McBurney's point, N/V, low-grade fever labs: increased WBC, CRP What are some assessments for appendicitis? (4) McBurney's point- RLQ pain Rovsing sign- tenderness of RLQ when LLQ is palpated Psoas sign- pain on extension of right leg Blumberg sign- rebound tenderness What is peritonitis? inflammation of the peritoneum, due to leak of GI contents
