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NUR3100 PATHOPHYSIOLOGY > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

Modifiable Risk Factors for Heart Failure

A
  • Blood pressure
  • Cholesterol lvls
  • Smoking
  • Diabetes
  • Obesity
  • Physical activity
  • Nutrition
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2
Q

Hypercholesterolemia

A

High cholesterol levels in the blood

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3
Q

COPD Complications

A
  1. Hypercapnia & hypoxemia; cause pulm. vascular shunting & vasoconstriction
  2. incrs vascular resistance
  3. Pulm. arterial HTN develops
  4. R side of heart pushes against high pressure in pulm. arteries
  5. RV hypertrophies
  6. RHF (cor pulmonale)
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4
Q

How to Identify Unstable Angina

A

Symptoms occur at rest and unrelieved; severe chest pain & SOA

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5
Q

Peripheral Venous Disease

A
  • When atherosclerosis narrows & thickens veins, dcring bld flow & oxygen delivery
  • CMs: pulse present, skin warm, irregular ulcer borders, skin swelling & weeping, surrounding skin brown/brawny, varicose veins
  • Elevation helps perfusion
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6
Q

RAAS - Activation to End Result

A
  1. Blood pressure drops
  2. Sympathetic Nervous System stimulates kidneys (fight or flight)
  3. Kidneys juxtaglomerular (JG) cells are stimulated to release RENIN
  4. Renin enters circulation; activates ANGIOTENSINOGEN
  5. Creates Angiotensin I
  6. ACE (Angiotensin-converting-enzyme); found on surface of lung & kidney
  7. ACE converts angiotensin I into angiotensin II - constricts vessels & incrs bld Vol
  8. Kidneys: keep Na+ * H2O
    Adrenal Cortex; Aldosterone: Na+, H20 & dcr K+
    Pituitary Gland: ADH; keep H2O
    End Result: INCR BLOOD PRESSURE
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7
Q

Patho for Asthma

A

IgE activation causes inflammatory response in airway

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8
Q

Patho for Chronic Bronchitis (in COPD)

A

Excessive mucous production, mucous plugging, and fibrosis of bronchial wall

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9
Q

Complications of Aortic Stenosis

A
  • Heart failure
  • Stroke
  • Blood clots
  • Bleeding
  • Arrhythmias
  • Endocarditis
  • Death
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10
Q

Hypoxemia

A

Reduction of oxygen in arterial blood

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11
Q

What is a Pathologic Fracture

A

Fracture due to bone weakened by an underlying disease
(osteoporosis, cancer, Paget’s)

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12
Q

Rheumatoid Arthiritis

A

T cell (type III) mediated response to immunologic trigger (body’s immune system attacks its own joints)

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13
Q

Osteoarthritis

A

Progressive loss of articular cartilage & synovitis due to overuse of joint

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14
Q

What are Venous Disorders?

A
  • Chronic Venous Insufficiency
  • Deep Vein Thrombosis (DVT)
    (disorders of veins; deoxygenated blood to lungs)
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15
Q

Reason for assessment of fracture

A

To obtain a baseline to watch for acute compartment syndrome
- Assess long bones; change in alignment, shape, deformity, internal or external rotation, shortened or lengthened
- Assess circulation; skin color & temp, cap refill, pulses distal to fracture

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16
Q

Peripheral Artery Disease (PAD)

A
  • When atherosclerosis narrows & thickens arteries in legs & feet; dcrd bld flow bc of ischemia
  • CMs: calf pain (claudication), poor/absent pulse, cool skin, dry/pale ulcers, surrounding skin dry & shiny, skin pale when elevated, rubor when dependent
  • Gravity (standing) helps perfusion
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17
Q

Hypoxemia Attempts to Decompensate

A
  • dcrd resp. effort
  • Bradycardia
  • Hypotension
  • Cyanosis
  • Arrhythmias
  • Metabolic acidosis
  • Death
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18
Q

Right-Sided Heart Failure

A
  • Patho: impaired contractility of RV; incrd fluid pressure backing up from left side
  • Caused by: LHF, cor pulmonale (COPD), pulmonary HTN, valve dysfunction (tri or pulm)
  • CMs: SWELLING
  • Risk Factors: family hx, age, obesity, high BP, diabetes, anemia, afib, arrhythmias
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19
Q

2nd Step of Atherosclerosis

A

Plaque Structure: smooth muscle cells of tunica media form fibrous cap of collagen & elastin over fatty streaks & lay down calcium deposits - plaque build up is a repetitive process

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20
Q

Systemic Lupus Erythematosus (SLE)

A
  • Patho: type III; immune complexes invade connective tissue, antinuclear antibodies (ANA)
  • Comps: complexes deposit in joints, joint pain & Inflammation, Malar rash
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21
Q

What is Pneumothorax

A

Presence of atmospheric air (+) in pleural space (-); breach of parietal or visceral pleura causes lung to collapse

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22
Q

What is Cardiac Output?

A

Product of stroke volume X HR per minute

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23
Q

Character of Fracture Pieces

A
  • Comminuted: more than 2 pieces
  • Impacted: 2 wedged pieces together
  • Compression: 2 bones crushed together
  • Transverse: across bone at right angle
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24
Q

Acute Compartment Syndrome

A

Decrease in compartment size by cast or dressing, increases compartment volume caused by bleeding or swelling which increases pressure of area

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25
3rd Step of Atherosclerosis
Artery Lumen Narrows: dcrs blood flow = less O2 to tissues (ischemia)
26
LHF CMs
- Activity intolerance/dyspnea - Pulmonary congestion; impaired gas exchange, cyanosis/hypoxia - Pulmonary edema; orthopnea, paroxysmal nocturnal dyspnea, cough w/ frothy sputum
27
Short Term BP Control - Neural Control
- (Brain) Vagal stimulation > PNS, parasympathetic = slow HR & dilates vessels - (Spinal cord) PNS, sympathetic = incrs HR & contractility > vasoconstriction - Baroreceptors; pressure sensitive
28
Stenosis
Valve does not OPEN completely
29
Patho for Emphysema (in COPD)
Abnormal permanent enlargement and destruction of air spaces distal to terminal bronchioles
30
What are Arterial Disorders?
- Atherosclerosis - Peripheral Arterial Disease (PAD) - Raynaud's Phenomenon - Abdominal Aortic Aneurysm - Coronary Artery Disease & Myocardial Infarction - Hypertension (disorders of arteries; oxygenated blood to body)
31
Gout
- Patho: incrd uric acid leads to formation of urate crystals which deposit in joints initiating an inflammatory response - Risk Factor: males 40+
32
Disorders Leading to Poor Perfusion
- Pulmonary embolism - Pulmonary HTN
33
Long Term BP Control
- Controlled by kidneys, regulate extracellular body fluid; RAAS - High BP = kidneys excrete more sodium + water (less aldosterone) - Low BP = kidneys retain more sodium + water (more aldosterone)
34
Communication w/ external environment (fracture)
- Open: exposed to environment - Closed: skin intact
35
Unstable Plaque (atherosclerosis)
DANGEROUS Plaque rupture & migration through vessel - thrombus may cause occlusion in artery of heart, brain, or limb - can cause severe ischemia & infarction
36
What is Pleural Effusion
Abnormal collection of fluid in pleural cavity causes lung to collapse
37
Chronic Stable Angina
Intermittent imbalance; coronary blood flow & metabolic demands of myocardium = chest pain & SOA, relieved by rest & nitro tabs
38
RHF CMs
- Peripheral edema; fluid weight gain (2lbs/day, 5lbs/wk) - Liver congestion; impaired liver function - GI congestion; anorexia, tissue wasting, GI distress
39
Where does gas exchange happen?
Alveoli in lungs
40
Risk Factors for HTN
- Family hx - Age related incr - Race (African Amer) - Insulin resistance / hyperinsulinemia - High salt intake = incrd fluid - Obesity - Excessive alc. consumption - Stress - Smoking - Diet high in saturated fats / cholesterol
41
Patho for Atrial Fibrillation
Rapid, disorganized atrial activation causing uncoordinated atrial contraction and V response - most common arrhythmia
42
Regurgitation
Valve does not CLOSE completely (commonly mitral & aortic)
43
Latent TB Infection
T cells & macrophages surround organism in granulomas and limit spread, this is NOT an active disease; will not spread
44
What is Congestive Heart Failure
The back up of fluid into lungs and/or peripheral tissues secondary to HF
45
Patho of Endocarditis
Invasion of valves/endocardium by microbial agent (staph aureus) - formation of vegetations & destruction of underlying cardiac tissues = new heart murmur
46
Stable Plaque (atherosclerosis)
Fibrous atheromatous - progressive narrowing of artery dcring blood flow = ischemia bc of inadequate oxygenation & perfusion to distal tissue
47
1st Step of Atherosclerosis
Foam Cells: LDL cholesterol invades tunica intima layer; macrophages eat up LDL & die; accumulate & build fatty layers (streaks)
48
Cause of Rheumatoid Heart Disease
Rheumatic fever caused by group A streptococcus bacteria inflammatory reaction
49
Hypercapnia
Inadequate ventilation; blood carbon dioxide incrs
50
Unstable Angina
MORE SERIOUS Possible myocardial infarction = severe chest pain & SOA
51
Risk Factors for Pneumonia
- Recent exposure - Tobacco use/substance abuse - Chronic lung disease - Aspiration risk - Mechanical ventilation - Immune compromised/age - Atelectasis; immobility
52
Degree of Break
- Complete: bone completely broken - Incomplete: (crack-greenstick) partially broken
53
Hypoxemia Attempts to Compensate
- incr RR - Tachycardia - incr CO - Vasoconstriction - incr BP
54
Left-Sided Heart Failure
- Patho: reduced ejection fraction; ventricle cannot pump bld to body - Causes: acute MI (left main coronary artery & left anterior descending artery), valve dysfunction (aortic stenosis), cardiomyopathy (hypertrophic), HTN - CMs: DROWNIN - Risk Factors: diabetes, obesity, sleep apnea, age, smoking
55
What does Atherosclerosis Result in
Impaired blood flow: (can be...) - Ischemia: dcr in arterial flow that dcrs O2 demands & nutrients - Infarction: total block off, area of ischemia necrosis in an organ produced by occlusion (block off) arterial blood supply or venous drainage
56
Short Term BP Control - Humoral Control
- Renin-Angiotensin-Aldosterone (RAAS); angiotensin II = vasoconstriction - Antidiuretic hormone (ADH/Vasopressin) = vasocontriction - Epinephrine = incr HR & vasoconstriction
57
Patho for Atelectasis
Incomplete lung expansion
58
Ventilation without perfusion affects...
Oxygen saturation in blood flow bc in not being perfused
59
Treatment of Osteomyelitis
- LONG TERM ANTIBIOTICS - Surgery debridement - Hyperbaric - Avoid limb loss
60
DROWNIN (LHF)
Dyspnea (SOB) Rales Orthopnea Weakness & fatigue Nocturnal dyspnea Impaired gas exchange Nagging cough
61
Pathology of Atherosclerosis
Formation of fibrofatty plaques in intima (inner) of arteries - fibrous plaque form over fatty deposit that result in hypercholesterolemia & inflammation
62
Cystic Fibrosis CMs
Airway obstruction - Accumulation of thick mucus in bronchi (dehydrated mucous) - Impaired mucociliary clearance - Chronic inflammation
63
Perfusion without ventilation affects....
AIRWAY (poor ventilation) - :shunting" causes alveoli to fill with fluid & cannot exchange gas with bld
64
Patho of Pericarditis
Inflammation of pericardial sac
65
SWELLING (RHF)
Swelling of legs, liver, GI Weight gain Edema Large neck vein Lethargy Irregular HR Nocturia Girth
66
How to Identify Chronic Stable Angina
- Physical exertion - Exposure to cold - Emotional stress
67
Disorders Leading to Poor Ventilation
- Pneumonia - Cystic fibrosis - Lung cancer - Pleural effusion

NUR3100 PATHOPHYSIOLOGY (5 decks)

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