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NUR3100 PATHOPHYSIOLOGY > Exam 3 > Flashcards

Exam 3 Flashcards

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1
Q

Recovery of AKI

A

Diuresis: excessive urine production; may cause excessive loss of water & electrolytes (creatinine)

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2
Q

Paraplegia

A
  • Loss of motor and/or sensory function in thoracic, lumbar, or sacral spine
  • Arm functioning is spared
  • Depending on level of injury; functioning of trunk, legs, & pelvic organs may be impaired
  • T1-T12: full UE control
  • L1-L5: hip & knee movement
  • S1-S5: full leg, foot, ankle control bowel, bladder, & sexual funcs
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3
Q

Intrarenal - Acute Kidney Injury (AKI)

A
  • Conditions that damage renal structures
  • Causes: ischemia (glomerulonephritis & pyelonephritis; sepsis, toxins from massive infections, nephrotic meds)
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4
Q

Benign Prostatic Hypertrophy (BPH) Clinical Manifestations

A
  • Weak stream
  • Difficulty emptying bladder
  • Urgency
  • Dysuria
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5
Q

Prerenal - Acute Kidney Injury (AKI)

A
  • Dcrd blood flow without ischemic injury
  • Causes: hypovolemia (hemorrhage, dehydration, shock), hypotension (poor perfusion)
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6
Q

Parkinson’s Disease Clinical Manifestations

A
  • Tremor
  • Pill Rolling (thumb&forefinger)
  • Rigidity: jerky, ratchet-like movements, difficulty swallowing; drooling
  • Bradykinesia: shuffle gait, freeze in place
  • Mask-like face: facial movements limited
  • Autonomic nervous system dysfunction
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7
Q

Common Clinical Manifestations of CVA/TIA (7)

A
  • Face drooping
  • Arm weakness
  • Speech difficulty (slurred, aphasia)
  • Sudden severe headache
  • Visual disturbances (loss in 1 eye)
  • Loss of balance/coordination
  • N/V
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8
Q

Concentrations of Intracellular Electrolytes

A
  • Small amnts of Sodium (Na), Chloride (Cl), Bicarbonate, & Phosphorus (P)
  • Almost no Calcium (Ca)
  • Moderate amnts of Magnesium (Mg)
  • Large amnts of POTASSIUM (K)
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9
Q

C3 Injury

A

C1-C3 injury requires mechanical ventilation

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10
Q

Acute Cystitis Clinical Manifestations

A
  • Urinary frequency, urgency
  • Suprapubic pain
  • Hematuria, dyspareunia
  • Urine cloudy w/ odor
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11
Q

Hypokalemia Causes

A
  • Renal losses
  • Inadequate intake
  • GI losses: severe N/V, diarrhea
    (K<3.5 mEq/L)
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12
Q

CKD Complications

A
  • Azotemia: accumulation of nitrogen waste, incrd lvls of blood urea nitrogen (BUN)
  • Uremia: urea in blood; “uremic state”, weakness, fatigue, nausea
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13
Q

Hypernatremia Clinical Manifestations

A
  • Thirst, dcr urine output; temp elevation, dry mucous membranes
  • Neuro: brain cells shrink; dcrd reflexes, headache, seizures
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14
Q

Post-Concussive Syndrome

A
  • Lasts days to months
  • Irritability, insomnia, impaired judgement, persistent headache, dizziness, attention deficits, anxiety, depression
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15
Q

Hyperkalemia

A
  • Potassium (K)>5.0 mEq/L
  • Incrd K intake & absorption, shift of K from cells into ECF & dcrd K output
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16
Q

Stress Incontinence

A

Incr intra-abdominal pressure causes urine loss

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17
Q

Guillain-Barre Syndrome (GBS) Clinical Manifestations

A
  • Progressive ascending muscle weakness of limbs (ground to brain)
  • Mild weakness to symmetric flaccid paralysis ventilator dependence
  • May cause autonomic dysfunction
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18
Q

Meningitis Patho

A
  • Pneumococcal or meningococcal bacteria
  • Microorganisms in CSF release endoroxins
  • Inflamm of brain tissue & CSF (purulent exudates)
  • Inflamm of vascular syst = congestion & infarction
  • Meninges thicken & adhesions form = impinge cranial nerves, impair outflow of CSF = hydrocephalus
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19
Q

Hyponatremia

A
  • Na<135 mEq/L
  • Loss of Na, water intoxication; dcr in Na in ECF, water moves into cells - cells swell
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20
Q

Hypovolemia Treatments

A

Crystalloids (IV solutions) & colloids (incr osmotic pressure); replace fluids & electrolytes

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21
Q

CKD Causes

A
  • Diabetic nephropathy
  • Uncontrolled HTN
  • Glomerulonephritis
  • PKD (Polycystic Kidney Disease)
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22
Q

Mixed Incontinence

A

Mix of stress & urge, CM of both

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23
Q

Most Common Kidney Stone (renal calculi)

A

Calcium oxalate

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24
Q

Autonomic Dysreflexia Clinical Manifestations Above Level of Injury

A
  • Bradycardia
  • Vasodilation
  • Flushed & profuse sweating
    HTN will cause brain to lower BP bc of baroreceptors by dcring CO (bradycardia), vasodilation to lower BP; blood will pool = flushing & sweating
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25
Neurogenic Bladder Incontinence
Loss of nervous system control of bladder
26
Urge Incontinence
Loss of urine with strong urge to void (overactive bladder) - neural control or smooth muscle problem
27
Incrd ICP Late Clinical Manifestations
- Worsening tissue hypoxia: lethargy > stupor > coma - HTN - Bradycardia - Abn. resp. patterns - Pupils large & unreactive (one side): brain herniation
28
What is Increased Cranial Pressure (ICP)
Incr in one compartment places pressure on another; disrupts tissue perfusion Can be caused by an incr in brain tissue, fluids, or brain tumor
29
Postrenal - Acute Kidney Injury (AKI)
- Urine outflow blocked - Causes: bilateral ureteral obstruction/bladder obstruction (BPH/tumor), stones
30
Quadriplegia
- Damage in cervical spine; impairment of function from neck down - C3: resp. arrest; loss phrenic nerve - C3-C5: resp. insufficiency of diaphragmatic innervation - C6 & T8: loss of intercostal innervation; weak cough
31
Fluid Excess Treatments
- Diuretics: reduce fluid buildup in the body by incring urine production - Dialysis: removes waste products & excess fluid from the blood
32
Meningitis Clinical Manifestations
- Sudden onset headache & fever - Stiffness of neck (nuchal rigidity) - Others related to meningeal inflamm & incrd ICP
33
Renal Calculus Clinical Manifestations
- Pain (back/flank, groin, lower abdomen) - N/V - Hematuria
34
Spinal Cord Injury (SCI) Patho
- Damage to neural elements of spinal cord - Most SCIs involve damage to vertebral column or supporting ligaments & to spinal cord
35
Hypovolemia
- Loss of water & electrolytes from ECF w/ near normal water/electrolyte proportions - Loss of volume in blood vessels
36
Risk Factors for Incrd ICP
- Hemorrhage: (brain bleed or CVA), blood leaks out of intravascular space incring blood to >10% - Brain tumor: incrs brain tissue to >80% - Hydrocephalus: excess CSF or obstruction of CSF - Anything causing cerebral edema (brain swelling)
37
Concussion
- Force to brain (TBI) causes temporary axonal disturbance - Diagnosed based on CMs - Headache, dizziness, sleepiness, memory loss/amnesia, confusion, N/V, balance problems
38
Myasthenia Gravis (MG) Clinical Manifestations
- Fluctuating weakness of skeletal muscle groups (no sensory) - Commonly involves facial & throat muscles - 90% only involves eyes & eyelids (ptosis) & dysphagia - Better in AM; worse as day progresses
39
CKD Labs
- GFR: <60ml/min/1.73m(2) - Serum BUN: elevated - Serum Creatinine: elevated, >1.2mg/dL - Proteinuria: elevated
40
Postictal State
- Period immediately following a seizure - Recovery after intense brain stimulation - 5-30mins - Unconsciousness/deep sleep, headaches, confusion, dysphagia, memory loss, HTN
41
Mechanism of Action of ADH
- Released by pituitary gland when high osmolarity detected in ECF - Acts on distal tubules of kidney to retain H2O - Dcrs osmolarity
42
Nocturnal Enuresis Incontinence
"Bed wetting" loss of urine during sleep
43
Hypokalemia
- Potassium (K) < 3.5 mEq/L - Dcrd K intake & absorption, a shift of K from ECF into cells & incrd K output
44
Hypovolemia Causes & High Risk
- Dehydration, shock, & hemorrhage - Very young, very old, very ill
45
Seizure Patho
Sudden, transiet disruption in brain electrical function caused by abnormal excessive discharges of neurons
46
Tonic Phase
- Immediate loss of consciousness - Sharp tonic contraction of muscles w/ extension of extremities - Incontinent of bowel & bladder - Cyanosis if airway is compromised
47
Amyotrophic Lateral Sclerosis (ALS) Patho
Autoimmune - destruction of motor neurons in brain & spinal cord (5% genetic) Men > Women (50s-60s)
48
Hyponatremia Causes
- Excess ADH/hypotonic fluids/diuretics - Vomiting/diarrhea/sweating (Na<135 mEq/L)
49
Overflow Incontinence
Leakage associated with retention (enlarged prostate)
50
Cervical Cancer Prevention
- Gardasil vaccine - Screen pelvic exam / PAP smears every 3 yrs
51
Benign Prostatic Hypertrophy (BPH) Risk Factors
- Older age (1/3 of men >50yrs, 90% by 85yrs) - African American - Family hx - Obesity
52
Nephrotic Syndrome Patho
Damage to Bowman's capsule incrs permeability of glomerulus = loss of serum protein
53
Risk Factors for Seizures
- Genetic predisposition - Acute febrile state* - Head trauma* - Cerebral edema* - Abrupt withdrawal of anti-epileptic drugs - Infection - Metabolic disorder - Cerebrovascular disease* - Exposure to toxins - Brain tumor - Hypoxia - Acute drug & ETOH withdrawal - F&E imbalances
54
Myasthenia Gravis (MG) Patho
- Antibody-mediated (autoimmune) loss of acetylcholine receptors (AChR) in neuromuscular junction - Abnormal thymus in 70% of pts - Female to male; 3:2
55
Hyperphosphatemia Causes
- Impaired kidney excretion - Hypoparathyroidism (P >4.5 mg/dL)
56
Clonic Phase
Rhythmic bilateral contraction & relaxation of extremities
57
Concentrations of Extracellular Electrolytes
- Large amnts of SODIUM (Na) & Chloride (Cl) - Moderate amnts of bicarbonate - Small amnts of Calcium (Ca), Phosphorus (P), Magnesium (Mg), & Potassium (K)
58
Hypernatremia Causes
- Retained: kidney disease - Water Loss: diarrhea, burns, low intake
59
Hemorrhagic CVA
- 13% of strokes - More fatal due to brain bleed that can incr ICP - Commonly caused by a rupture of intracerebral vessel, hemorrhage causes hematoma; edema
60
Which Lab Value Shows Early Renal Damage?
- Glomerular filtration rate <60ml/min/ 1.74m(2) - Microalbuminuria > 30mg/day
61
Hyperkalemia Causes
Renal failure; excess intake, intracellular release
62
Ischemic CVA
- 87% of strokes - More treatable; easier to treat an emboli - Obstruction = no oxygen due to thrombosis (atherosclerotic plaque) or embolism (blood clot)
63
Incrd ICP Early Clinical Manifestations
- Change in LOC: restless, irritability, confusion, drowsiness - Headache - Pupils small & sluggish
64
Multiple Sclerosis Patho
Autoimmune - inflammation & destruction of CNS myelin with plaque formation and gliosis (scarring); nerve conduction interrupted
65
Basilar Skull Fracture Clinical Manifestations
- Headache - *CSF otorrhea (ear) or rhinorrhea (nose)* - Facial nerve palsy - *Periorbital ecchymosis* (raccoon eyes) - *Mastoid ecchymosis* (battle sign)
66
Hyponatremia Clinical Manifestations
- GI: N/V, abdominal cramping; diarrhea - MS: muscle cramps, weakness - Neuro: brain swelling ; headaches, seizures (Na<135 mEq/L)
67
Nephrotic Syndrome Clinical Manifestations
- Heavy proteinuria (>3.5g/day): high urine protein - Hypoalbuminemia: low serum protein - Severe edema: loss of protein & salt and water retention - Hyperlipidemia: compensatory synthesis of proteins by liver
68
Hypernatremia
- Na>145 mEq/L - Excess Na or loss of water; water leaves cells - cell shrinks (cellular dehydration)
69
Chronic Kidney Disease (CKD) Patho
Gradual dcr in renal function that is not reversible; result of loss of nephrons & progressive decline in renal function GFR < 60 ml/min for 3+ months
70
"Third-Spacing"
Loss or trapping of ECF into transcellular space (serous cavities); pleural space, peritoneal cavity, percardial sac, joint cavities, bowels, interstitial space
71
Pathophysiologic Mechanisms of Edema Formation
- Incr capillary filtration pressure; incr vascular vol (heart failure), venous obstruction (liver failure) - Dcr capillary colloidal osmotic pressure; incr loss of serum proteins (kidney disease), dcr production proteins (liver) - Incr capillary permeability; inflamm, allergies, ascites - Produce obstruction to lymph flow; surgical removal of lymph nodes, tumor obstruction
72
Risk Factors for Pelvic Inflammatory Disease (PID)
- <25yrs - Multiple sex partners - STIs
73
Guillain-Barre Syndrome (GBS) Patho
Acute onset immune-mediated demyelination of nerves following influenza-like illness
74
Hypokalemia Clinical Manifestations
- Weakness - Muscle cramps & pain - Polyuria - Hypotension - EKG changes; dysrhythmias, cardiac arrest
75
Autonomic Dysreflexia
Triggered by an impacted or over-distended bladder
76
Best Way to Measure Fluid Status
- Daily Weights (gain & loss) - Rapid gain or loss of 1 kg (2.2lbs) = 1L of fluid - Edema not apparent until 5-10lbs excess fluid

NUR3100 PATHOPHYSIOLOGY (5 decks)

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