Exam 1 Study Guide

Question 1

Normal white blood cell count

Answer 1

5,000-10,000mm3

Question 2

Leukopenia

• definition
• causes

Answer 2

• Definition: WBC count less than 4,300mm3

- Causes: chemotherapy, compromised immune system, some viral infections

Question 3

Leukocytosis

• definition
• causes

Answer 3

• Definition: WBC count great than 10,000mm3

- Causes: idicates an inflammatory response too a pathogen or disease

Question 4

Adaptive immunity

Answer 4

develops as a result of prior exposure too an antigen through immunizations, or by contacting a disease, both of which generate a protective immune response

Question 5

Active acquired immuntiy

• definition
• time frame of immunity

Answer 5

• Definition:immunologic defenses developed by the person’s own body
• Time: many years or even a lifetime

Question 6

Passive acquired immunity

Answer 6

temporary immunity that has developed through previous diseases or immunizations (example is breastfeeding)

Question 7

Normal CD4 T lymphocyte count

Answer 7

500-1500 cells/mm3

Question 8

During primary HIV infection, 40-90% of patients will experience acute retro-viral symptoms.
-symptoms

Answer 8

• Fever
• Enlarged lymph nodes
• Pharyngitis
• Flu-like symptoms for a few days

Question 9

Chronic asymptomatic infection

-CD4 count

Answer 9

more than 500 CD4 T lymphocytes

Question 10

HIV symptomatic

-CD4 count

Answer 10

200-499 CD4 T lymphocytes

Question 11

Symptoms of HIV

Answer 11

• Thrush
• Cervical dyplasia (in women)
• Shingles
• Peripheral neuropathy

Question 12

AIDS

-CD4 count

Answer 12

fewer than 200 CD4 T lymphocytes

Question 13

Normal adult dose of epinephrine (allergic reactions)

Answer 13

IM 0.3cc

-wears off in 20-30 minutes

Question 14

Intracellular fluid contains what?

Answer 14

Potassium

Question 15

Extra cellular fluid is made up of what 2 components?

Answer 15

• interstitial fluid (fluid that surrounds the cell)

- blood vessels

Question 16

Osmosis

• definition
• goal

Answer 16

• water moves through a semipermeable membrane

- balance the fluid

Question 17

Diffusion

-definition

Answer 17

-transport of most electrolyses and particles through cell membranes

Question 18

Glucose cannot enter most cell membranes without the help of __________.

Answer 18

Insulin

Question 19

Minimum amount of urine need to excrete toxic waste products.

Answer 19

400 to 600 mL

Question 20

Normal adult output

Answer 20

1-2 liters

Question 21

Hypovalemia

-definition

Answer 21

-low blood pressure and dehydration; fluid intake is less than what is needed to meet the body’s fluid needs, resulting in a fluid volume deficit

Question 22

Major electrolyte imbalance with dehydration (2)

Answer 22

• Sodium goes up
• Potassium goes down
• *if patient is in renal failure may seem Potassium go up some

Question 23

Hypovolemia (dehydration/ low blood volume)

• cardiac changes (4)
• respiratory changes (1)
• skin changes (3)
• neuro changes (4)
• renal changes (3)
• lab assessment (4)

Answer 23

Cardiac Changes: decreased BP, orthostatic HTN, increased HR (in response to to BP and ortho HTN)
*flat neck veins

Respiratory
: shallow, rapid respirations

Skin Changes: dry mucous membrane, sunken eyeballs, cool & clammy skin due to vasoconstriction

Neuro Changes: confusion, lethargy, seizures, decrease level of consciousness

Renal Changes: decreased output, very concentrated urine, crystals

Lab Assessment: increased BUN, hemoglobin and hematocrit; elevated or decreased electrolytes

**patient should stay away from caffeine, will aggravate the GI system

Question 24

Hypervalemia (excess of fluid)

• reasons (3)
• cardiac changes (5)
• respiratory changes (3)
• skin changes (2)
• neuro changes (3)
• renal changes (2)
• lab assessments (4)

Answer 24

Reasons: heart failure, renal failure, water intoxication

Cardiac Changes: S3 sound, bounding pulse, fast cap. refill, increase BP
*distended neck veins

Respiratory Changes: crackles (indication of pulmonary edema), dyspnea, labored breathing

Skin Changes: edema, moist mucous membranes

Neuro Changes: headaches, cerebral edema=seizures, decrease consciousness

Renal Changes: increase output, increase weight

Lab Assessment: decrease BUN, hemoglobin, hematocrit, and sodium

Nursing Assessment: edema, ascultating lungs (monitoring fluid in lungs), I/O, semi-fowlers position to maximize breathing

Question 25

Hyponatremia - causes (4) - cardiac changes (2) - skin changes (2) - neuro changes (5) - renal changes (1) - nurse implications (2)

Answer 25

<135 mEq/L Causes: increase fluid, diuretics, burns, profuse sweating Cardiac Changes: decrease BP, decrease HR (depending on the cause) Skin Changes: edema, moist and/or dry mucous membranes (dependent on cause) Neuro Changes: decrease DTR, lethargy, cramps, confused, seizures Renal Changes: increase urinary output Nursing Implications: sodium supplements (deli meat, canned foods, fried foods), fluid restrictions (800mL/24hrs)

Question 26

Sodium - primary issues - vital for what functions

Answer 26

135-145mEq/L Primary issue: neurological Vital for: skeletal muscle contraction, cardiac contraction, nerve impulse transmission

Question 27

Hypernatremia - causes (1) - cardiac changes (2) - skin changes (2) - neuro changes (3) - renal changes (1) - nurse implications (4)

Answer 27

Cause: dehydration Cardiac changes: increase HR, decrease contractility Skin Changes: dry mucous membrane, rough/dry tongue Neuro Changes: twitching, seizures, coma Renal Changes: decreased urinary output Nursing Implications: low sodium, increase water, seizure precautions, fall precautions

Question 28

Potassium - primary issues - vital for what functions - regulator of potassium(organ)

Answer 28

3.5-5mEq/L Primary issue: cardiac Vital for: depolarization and generation of action potentials, regulates protein synthesis and glucose use and storage Regulator: kidneys

Question 29

Hypokalemia - causes (3) - respiratory changes (3) - neuro changes (4) - cardiac changes (4) - intestinal changes (3) - implications (5)

Answer 29

>3.4mEq/L Causes: diuretics, GI losses, dietary intake Respiratory Changes: weak, shallow respirations, dyspnea Neuro Issues: weakness, leg cramping, increased anxiety, lethargy Cardiac Changes: EKG changes: ST segment depression and U wave (very abnormal), weak/thready pulse, decrease BP, orthostatic HTN Intestinal Changes: decrease peristalsis, constipation, nausea Implications: monitor O2 stats,open airway, fall precautions, heart monitor, increase potassium in diets (bananas, OJ, citrus fruits NEVER IVP POTASSIUM

Question 30

Hyperkalemia - causes (3) - cardiac changes (5) - neuro changes (2) - intestinal (2) - drug therapy (4)

Answer 30

>5.0 mEq/L Causes: salt substitutes, renal failure, burns Cardiac Changes: decrease BP, irregular HR, decrease HR, QRS widened, peaked T wave Neuro Changes: cramps, paralysis Intestinal Changes: increase bowel sounds, diarrhea Drug therapy: Kayexalate, insulin, cardiac monitoring, health teachings