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PN 4003 Midterm Exam and Final Exam (Latest
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PN 4003 Midterm Exam
If co2 increases, whats the result in ph? ---------CORRECT ANSWER-----------------it becomes acidic If co2 increases, what does your body do? ---------CORRECT ANSWER----------------- increases resp rate to remove co What is shock? ---------CORRECT ANSWER-----------------A failure of the circulatory system to support vital body functions. inadequate tissue perfusion. Neurogenic shock ---------CORRECT ANSWER-----------------Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries. Hypovolemic shock ---------CORRECT ANSWER-----------------shock resulting from blood or fluid loss
Caused by bleeding/hemorrhage, severe vomiting, severe diarrhea, third-spacing Cardiogenic shock ---------CORRECT ANSWER-----------------Shock caused by inadequate function of the heart, or pump failure. Anaphylactic shock ---------CORRECT ANSWER-----------------A severe reaction that occurs when an allergen is introduced to the bloodstream of an allergic individual. Characterized by bronchoconstriction, labored breathing, widespread vasodilation, circulatory shock, and sometimes sudden death. Septic shock ---------CORRECT ANSWER-----------------Shock caused by severe infection, usually a bacterial infection. Stages of shock ---------CORRECT ANSWER------------------Compensated
- Decompensated
- Irreversible What % of blood/fluid loss is hypovolemic shock? ---------CORRECT ANSWER--------- --------15%
C - Convulsions A- Arrhythmias T - Tetany (involuntary contraction of muscles) S - Spasms and stridor Sensible fluid loss ---------CORRECT ANSWER-----------------Measurable and perceived; urine, diarrhea, ostomy, gastric drainage. Insensible fluid loss ---------CORRECT ANSWER-----------------Occurs daily through lungs and skin--cannot be measured for accurate output Hypervolemia s/s ---------CORRECT ANSWER------------------Hypertension
- Bounding pulse
- JVD
- Peripheral edema
- ↑ urine output that is dilute
- Acute, rapid weight gain
- S3 heart sound in adults
- Bulging fontanels in infants
- Crackles on auscultation
- Dyspnea, cough and increased RR
- Mental status changes (headache, confusion, lethargy; seizures possible)
What is urine specific gravity? ---------CORRECT ANSWER-----------------The ratio of weight of a given volume of urine to the weight of the same volume of distilled water at a constant temperature Normal urine specific gravity ---------CORRECT ANSWER-----------------1.005 - 1. Dehydration - High (concentrated) Overhydration - Low (dilute) Diabetes insipidus - Low (inability to concentrate urine) Diabetes mellitus - High (due to glucose in urine) Chronic kidney disease (CKD) - Fixed, often around 1.010 (loss of concentration ability) Proteinuria (e.g., nephrotic syndrome) - High Heart failure - High (due to reduced perfusion to kidneys) What is creatine ---------CORRECT ANSWER-----------------A naturally occurring compound produced by your body that helps muscles produce energy and delays muscle fatigue. Normal creatine levels ---------CORRECT ANSWER-----------------0.6-1.2 mg/dL
High altitude long term = high concentration of RBC (less oxygen in atmosphere, body compensates) left vs right sided HF ---------CORRECT ANSWER-----------------Left sided: Blood backs into lungs, can't fill, CAD and HTN Side effects: Fatigue, activity intolerance, dyspnea, SOB, cough, orthopnea, inspiratory crackles, wheezes, S3 gallop. Right sided: Blood backs in the periphery. Third spacing. Side effects: COPD, Peripheral edema, JVD, hepatomegaly, anorexia true or false: S3 sound is an indicator of heart failure ---------CORRECT ANSWER---- -------------true myocardial infarction s/s ---------CORRECT ANSWER-----------------sudden sever chest pain pain radiates to neck and left arm indigestion fatigue
nausea hypotension rapid weak pulse low grade fever indication for a pacemaker ---------CORRECT ANSWER-----------------One major indication for a pacemaker is heart block, a condition where the electrical signals that control the heartbeat are delayed or completely blocked. true or false: a pacemaker is used for afib ---------CORRECT ANSWER----------------- false what is a risk of high bp? ---------CORRECT ANSWER-----------------stroke what is a tracheostomy ---------CORRECT ANSWER-----------------surgical procedure that involves inserting a tube into the trachea to open it up to airflow complications of a tracheostomy ---------CORRECT ANSWER-----------------Bleeding: During or immediately after surgery. Infection: At the surgical site.
- head/neck surgery
- copious secretions
- obstructive sleep apnea refractory to conventional therapy
- the need for long term mechanical ventilation or reconstruction after laryngeal trauma or laryngeal cancer surgery care for a tracheostomy ---------CORRECT ANSWER------------------ Protect from dust/foreign objects/threads of dressing/water
- Inner cannula needs cleaned/replaced at least daily
- PRN suctioning if cannot clear own secretions
- prevent infections
- monitor oxygen what is epistaxis ---------CORRECT ANSWER-----------------nose bleed some causes of epistaxis ---------CORRECT ANSWER-----------------Trauma, inflammatory disorders, structure abnormalities, or bleeding disorders what is emphesema ---------CORRECT ANSWER-----------------a type of COPD in which alveoli are damaged caused by smoking!!
what is ARDS ---------CORRECT ANSWER-----------------acute respiratory distress syndrome risks for ARDS ---------CORRECT ANSWER-----------------smoke inhalation, drowning CBC ranges ---------CORRECT ANSWER-----------------WBC: 4,000 - 11, RBC: 4ish - 6ish Hgb: 12 - 20 Hct: 35 - 50% Lactate: Less than 1 BNP: Below 100 sodium ranges ---------CORRECT ANSWER----------------- 135 - 145 mEq/L what is a key issue with sodium imabalance? ---------CORRECT ANSWER--------------- --affects your neuro system
fear Increased breathing and heart rate what is the makeup of the blood? ---------CORRECT ANSWER-----------------55% plasma, 45% erythrocytes, 1% leukocytes and platelets how much blood is in a person? ---------CORRECT ANSWER-----------------7% bodyweight, 4-6 litres where are erythrocytes recycled? ---------CORRECT ANSWER-----------------spleen lifespan of erythrocytes ---------CORRECT ANSWER-----------------120 days Erythropoietin ---------CORRECT ANSWER-----------------Hormone stimulating red blood cell production. made in the kidneys Hyponatremia (low Na⁺) - --------CORRECT ANSWER-----------------Causes: Excess water, heart/kidney failure, vomiting/diarrhea. S/S: Nausea, confusion, headache, seizures, coma, muscle weakness.
range: 135-145 mEq/L calcium range ---------CORRECT ANSWER-----------------calcium - range: 8.5-10. mg/dL phsophate range ---------CORRECT ANSWER-----------------Phosphate range: 2.5-4. mg/dL potassium range ---------CORRECT ANSWER-----------------Potassium - range: 3.5-5. mEq/L magnesium range ---------CORRECT ANSWER-----------------Magnesium - range: 1.5- 2.5 mEq/L chloride range ---------CORRECT ANSWER-----------------Chloride - range: 96- 106 mEq/L Hypernatremia (high Na⁺) ---------CORRECT ANSWER-----------------Causes: Dehydration, diabetes insipidus, excessive salt intake.
S/S: Tetany, paresthesia, Chvostek's and Trousseau's signs, seizures. calcium - range: 8.5-10.5 mg/dL Hypomagnesemia (low Mg²⁺) ---------CORRECT ANSWER-----------------Causes: Malnutrition, alcoholism, diuretics, diarrhea. S/S: Tetany, tremors, seizures, arrhythmias, increased DTRs. Magnesium - range: 1.5-2.5 mEq/L Hypermagnesemia (high Mg²⁺) ---------CORRECT ANSWER-----------------Causes: Renal failure, excessive intake. S/S: Lethargy, muscle weakness, hypotension, bradycardia. Magnesium - range: 1.5-2.5 mEq/L Hypochloremia (low Cl⁻) ---------CORRECT ANSWER-----------------Causes: GI losses, metabolic alkalosis. S/S: Irritability, muscle cramps, twitching.
Chloride - range: 96-106 mEq/L Hyperchloremia (high Cl⁻) ---------CORRECT ANSWER-----------------Causes: Dehydration, metabolic acidosis. S/S: Weakness, lethargy, deep rapid breathing. Chloride - range: 96-106 mEq/L Metabolic Acidosis (low HCO₃⁻) ---------CORRECT ANSWER-----------------Causes: Kidney failure, diarrhea, diabetic ketoacidosis. S/S: Kussmaul respirations, fatigue, confusion. Bicarbonate (HCO₃⁻): 22-28 mEq/L Metabolic Alkalosis (high HCO₃⁻) ---------CORRECT ANSWER-----------------Causes: Vomiting, antacid use. S/S: Weakness, cramps, confusion.
Excessive sweating Untreated diabetes mellitus No access to water Lack of thirst in elderly how does calcium effect blood clotting? ---------CORRECT ANSWER----------------- Calcium is a cofactor for several enzymes in the clotting cascade, particularly for converting prothrombin to thrombin (Factor II to IIa) and stabilizing fibrin clots. hypocalcemia can impair the activation of clotting factors, leading to slower or inefficient clot formation. hypercalcemia can make blood clot too easily s/s of excess fluid volume ---------CORRECT ANSWER-----------------edema, weight gain, high bp, crackles, JVD testing for excess fluid volume ---------CORRECT ANSWER-----------------!Serum Creatinine and BUN: Can indicate kidney function and fluid retention.
Serum Sodium (Na⁺): Hyponatremia may occur due to dilution (dilutional hyponatremia). Hematocrit and Hemoglobin: May be decreased due to hemodilution. Daily Weights and Intake/Output (I&O)!! excess fluid volume treatments ---------CORRECT ANSWER-----------------it depends on the cause, but in general sodium and water restrictions can help diuretics and vasodilators Venous insufficiency ---------CORRECT ANSWER-----------------inadequacy of the venous valves and impairment of venous return from the lower limbs (venous stasis), often with edema and sometimes with skin ulcers (particularly at the ankles) Heart failure ---------CORRECT ANSWER-----------------a chronic condition in which the heart is unable to pump out all of the blood that it receives
