Chamberlain College of Nursing
NR283 Pathophysiology
Worksheet 4
NR 283 PATHOPHYSIOLOGY WORKSHEET 4
1. Define pathophysiology.
- involves the study of functional or physiologic changes in the body that result from disease
processes
2. Define homeostasis.
- a relatively stable or constant environment in the body, including blood pressure, temperature,
and pH, maintained by the various control mechanisms
3. Discuss the terms acute vs chronic. Provide examples.
- Acute rejection develops after several weeks when unmatched antigens cause a reaction
- Chronic or late rejection occurs after months or years, with gradual degeneration of the blood
vessels.
4. Define hypokalemia. Discuss common effects of hypokalemia.
- hypokalemia the serum level of potassium is less than 2 mmol per liter or 3.5 mEq per liter
- Effects: Cardiac dysrhythmias cardiac arrest. Hypokalemia interferes with neuromuscular
function, and the muscles become less responsive to stimuli, as shown by fatigue and muscle
weakness commencing in the legs. Paresthesias such as “pins and needles” develop. decreased
appetite (anorexia) and nausea. In people with severe potassium deficits, the respiratory muscles
become weak, leading to shallow respirations. In severe cases, renal function is impaired, leading
to failure to concentrate the urine, and increased urine output (polyuria) results.
5. Define hyperkalemia. Discuss common effects of hyperkalemia.
- hyperkalemia the serum level of potassium is greater than 2.6 mmol per liter or 5 mEq per liter
- Effects: The ECG shows typical cardiac dysrhythmias, which may progress to cardiac arrest.
Muscle weakness is common, progressing to paralysis as hyperkalemia advances and impairs
neuromuscular activity. Fatigue, nausea, and paresthesias are also common.
6. Define hyponatremia. Discuss common effects of hyponatremia.
- Hyponatremia refers to a serum sodium concentration below 3.8 to 5 mmol per liter or 135
- Effects: Low sodium levels impair nerve conduction and result in fluid imbalances in the
compartments. Manifestations include fatigue, muscle cramps, and abdominal discomfort or
cramps with nausea and vomiting. Decreased osmotic pressure in the extracellular compartment
NR 283: Worksheet 2 5/2016 JMC 1
,Chamberlain College of Nursing
NR283 Pathophysiology
may cause a fluid shift into cells, resulting in hypovolemia and decreased blood pressure. The
brain cells may swell, causing confusion, headache, weakness, or seizures.
7. Define hypernatremia. Discuss common effects of hypernatremia
- Hypernatremia is an excessive sodium level in the blood and extracellular fluids (more than
145 mEq per liter)
- Effects: The major effect of hypernatremia is a fluid shift out of the cells owing to the increased
osmotic pressure of interstitial or extracellular fluid; this effect is manifested by: Weakness,
agitation, firm subcutaneous tissues, increased thirst, with dry, rough mucous membranes,
decreased urine output because ADH is secreted
- Note that the manifestations can change depending on the cause of the problem: If the cause of
hypernatremia is fluid loss caused by lack of ADH, urine output is high.
8. Define hypocalcemia. Discuss common effects of hypocalcemia.
- In hypocalcemia, the serum calcium level is less than 2.2 mmol per liter or below 4 mEq per liter
- Effects: Low serum calcium levels increase the permeability and excitability of nerve
membranes, leading to spontaneous stimulation of skeletal muscle. This leads to muscle
twitching, carpopedal spasm (atypical contraction of the fingers), and hyperactive. Chvostek's
sign, spasm of the lip or face when the face is tapped in front of the ear, and Trousseau's sign,
carpopedal spasm when a blood pressure cuff blocks circulation to the hand, both indicate low
serum calcium and tetany, or skeletal muscle spasm. Severe calcium deficits may cause
laryngospasm, which obstructs the airway. Paresthesias are common, as are abdominal cramps.
Heart contractions become weak owing to insufficient calcium for muscle action, conduction is
delayed, arrhythmias develop, and blood pressure drops.
9. Define hypercalcemia. Discuss common effects of hypercalcemia.
- In hypercalcemia the serum calcium is greater than 5 mEq per liter or greater than 2.5 mmol per
liter
- Effects: High serum calcium levels depress neuromuscular activity, leading to muscle weakness,
loss of muscle tone, lethargy, and stupor, often with personality changes, anorexia, and nausea.
High calcium levels interfere with the function of ADH in the kidneys, resulting in less
absorption of water and in polyuria. If hypercalcemia is severe, blood volume drops, renal
function decreases, nitrogen wastes accumulate, and cardiac arrest may ensue. Cardiac
contractions increase in strength, and dysrhythmias may develop. Effects on bone vary with the
cause of hypercalcemia. If excess PTH is the cause, bone density will be decreased, and
spontaneous (pathologic) fractures may occur, particularly in the weight-bearing areas, causing
bone pain. If intake of calcium is high, PTH levels will be low, and more calcium will be stored
in the bone, maintaining bone strength.
NR 283: Worksheet 2 5/2016 JMC 2
, Chamberlain College of Nursing
NR283 Pathophysiology
10. Define normal serum pH, normal CO2, and normal HCO3-.
- Normal pH: 7.36-7.45
- Normal CO2: 95-100% 23-29
- Normal HCO3: 22-26
11. Define Trisomy 21. List five clinical manifestations of Trisomy 21.
- Trisomy 21: the most common form of Down Syndrome, caused by an extra copy of
chromosomes number 21
- Flattened face
- Small head
- Short neck
- Protruding tongue
- Upward slanting eye lids (palpebral fissures)
- Unusually shaped or small ears
- Poor muscle tone
- Broad, short hands with a single crease in the palm
- Relatively short fingers and small hands and feet
- Excessive flexibility
- Tiny white spots on the colored part (iris) of the eye called Brushfield's spots
- Short height
- Infants with Down syndrome may be average size, but typically they grow slowly and remain
shorter than other children the same age.
12. Define amniocentesis. What is the purpose of this test?
- Amniocentesis is a procedure in which amniotic fluid is removed from the uterus for testing or
treatment. Amniotic fluid is the fluid that surrounds and protects a baby during pregnancy. This
fluid contains fetal cells and various chemicals produced by the baby.
Purpose:
- Genetic testing: genetic amniocentesis involves taking a sample of amniotic fluid and testing it
for certain conditions, such as Down syndrome.
- Fetal lung testing: fetal lung maturity testing involves taking a sample of amniotic fluid and
testing it to determine whether the baby's lungs are mature enough for birth.
- Diagnosis of fetal infection: occasionally, amniocentesis is used to evaluate a baby for
infection or other illness. The procedure also can be done to evaluate the severity of anemia in
babies who have Rh sensitization: an uncommon condition in which a mother's immune system
produces antibodies against a specific protein on the surface of the baby's blood cells.
- Treatment: if you accumulate too much amniotic fluid during pregnancy, amniocentesis might
be done to drain excess amniotic fluid from your uterus.
NR 283: Worksheet 2 5/2016 JMC 3
NR283 Pathophysiology
Worksheet 4
NR 283 PATHOPHYSIOLOGY WORKSHEET 4
1. Define pathophysiology.
- involves the study of functional or physiologic changes in the body that result from disease
processes
2. Define homeostasis.
- a relatively stable or constant environment in the body, including blood pressure, temperature,
and pH, maintained by the various control mechanisms
3. Discuss the terms acute vs chronic. Provide examples.
- Acute rejection develops after several weeks when unmatched antigens cause a reaction
- Chronic or late rejection occurs after months or years, with gradual degeneration of the blood
vessels.
4. Define hypokalemia. Discuss common effects of hypokalemia.
- hypokalemia the serum level of potassium is less than 2 mmol per liter or 3.5 mEq per liter
- Effects: Cardiac dysrhythmias cardiac arrest. Hypokalemia interferes with neuromuscular
function, and the muscles become less responsive to stimuli, as shown by fatigue and muscle
weakness commencing in the legs. Paresthesias such as “pins and needles” develop. decreased
appetite (anorexia) and nausea. In people with severe potassium deficits, the respiratory muscles
become weak, leading to shallow respirations. In severe cases, renal function is impaired, leading
to failure to concentrate the urine, and increased urine output (polyuria) results.
5. Define hyperkalemia. Discuss common effects of hyperkalemia.
- hyperkalemia the serum level of potassium is greater than 2.6 mmol per liter or 5 mEq per liter
- Effects: The ECG shows typical cardiac dysrhythmias, which may progress to cardiac arrest.
Muscle weakness is common, progressing to paralysis as hyperkalemia advances and impairs
neuromuscular activity. Fatigue, nausea, and paresthesias are also common.
6. Define hyponatremia. Discuss common effects of hyponatremia.
- Hyponatremia refers to a serum sodium concentration below 3.8 to 5 mmol per liter or 135
- Effects: Low sodium levels impair nerve conduction and result in fluid imbalances in the
compartments. Manifestations include fatigue, muscle cramps, and abdominal discomfort or
cramps with nausea and vomiting. Decreased osmotic pressure in the extracellular compartment
NR 283: Worksheet 2 5/2016 JMC 1
,Chamberlain College of Nursing
NR283 Pathophysiology
may cause a fluid shift into cells, resulting in hypovolemia and decreased blood pressure. The
brain cells may swell, causing confusion, headache, weakness, or seizures.
7. Define hypernatremia. Discuss common effects of hypernatremia
- Hypernatremia is an excessive sodium level in the blood and extracellular fluids (more than
145 mEq per liter)
- Effects: The major effect of hypernatremia is a fluid shift out of the cells owing to the increased
osmotic pressure of interstitial or extracellular fluid; this effect is manifested by: Weakness,
agitation, firm subcutaneous tissues, increased thirst, with dry, rough mucous membranes,
decreased urine output because ADH is secreted
- Note that the manifestations can change depending on the cause of the problem: If the cause of
hypernatremia is fluid loss caused by lack of ADH, urine output is high.
8. Define hypocalcemia. Discuss common effects of hypocalcemia.
- In hypocalcemia, the serum calcium level is less than 2.2 mmol per liter or below 4 mEq per liter
- Effects: Low serum calcium levels increase the permeability and excitability of nerve
membranes, leading to spontaneous stimulation of skeletal muscle. This leads to muscle
twitching, carpopedal spasm (atypical contraction of the fingers), and hyperactive. Chvostek's
sign, spasm of the lip or face when the face is tapped in front of the ear, and Trousseau's sign,
carpopedal spasm when a blood pressure cuff blocks circulation to the hand, both indicate low
serum calcium and tetany, or skeletal muscle spasm. Severe calcium deficits may cause
laryngospasm, which obstructs the airway. Paresthesias are common, as are abdominal cramps.
Heart contractions become weak owing to insufficient calcium for muscle action, conduction is
delayed, arrhythmias develop, and blood pressure drops.
9. Define hypercalcemia. Discuss common effects of hypercalcemia.
- In hypercalcemia the serum calcium is greater than 5 mEq per liter or greater than 2.5 mmol per
liter
- Effects: High serum calcium levels depress neuromuscular activity, leading to muscle weakness,
loss of muscle tone, lethargy, and stupor, often with personality changes, anorexia, and nausea.
High calcium levels interfere with the function of ADH in the kidneys, resulting in less
absorption of water and in polyuria. If hypercalcemia is severe, blood volume drops, renal
function decreases, nitrogen wastes accumulate, and cardiac arrest may ensue. Cardiac
contractions increase in strength, and dysrhythmias may develop. Effects on bone vary with the
cause of hypercalcemia. If excess PTH is the cause, bone density will be decreased, and
spontaneous (pathologic) fractures may occur, particularly in the weight-bearing areas, causing
bone pain. If intake of calcium is high, PTH levels will be low, and more calcium will be stored
in the bone, maintaining bone strength.
NR 283: Worksheet 2 5/2016 JMC 2
, Chamberlain College of Nursing
NR283 Pathophysiology
10. Define normal serum pH, normal CO2, and normal HCO3-.
- Normal pH: 7.36-7.45
- Normal CO2: 95-100% 23-29
- Normal HCO3: 22-26
11. Define Trisomy 21. List five clinical manifestations of Trisomy 21.
- Trisomy 21: the most common form of Down Syndrome, caused by an extra copy of
chromosomes number 21
- Flattened face
- Small head
- Short neck
- Protruding tongue
- Upward slanting eye lids (palpebral fissures)
- Unusually shaped or small ears
- Poor muscle tone
- Broad, short hands with a single crease in the palm
- Relatively short fingers and small hands and feet
- Excessive flexibility
- Tiny white spots on the colored part (iris) of the eye called Brushfield's spots
- Short height
- Infants with Down syndrome may be average size, but typically they grow slowly and remain
shorter than other children the same age.
12. Define amniocentesis. What is the purpose of this test?
- Amniocentesis is a procedure in which amniotic fluid is removed from the uterus for testing or
treatment. Amniotic fluid is the fluid that surrounds and protects a baby during pregnancy. This
fluid contains fetal cells and various chemicals produced by the baby.
Purpose:
- Genetic testing: genetic amniocentesis involves taking a sample of amniotic fluid and testing it
for certain conditions, such as Down syndrome.
- Fetal lung testing: fetal lung maturity testing involves taking a sample of amniotic fluid and
testing it to determine whether the baby's lungs are mature enough for birth.
- Diagnosis of fetal infection: occasionally, amniocentesis is used to evaluate a baby for
infection or other illness. The procedure also can be done to evaluate the severity of anemia in
babies who have Rh sensitization: an uncommon condition in which a mother's immune system
produces antibodies against a specific protein on the surface of the baby's blood cells.
- Treatment: if you accumulate too much amniotic fluid during pregnancy, amniocentesis might
be done to drain excess amniotic fluid from your uterus.
NR 283: Worksheet 2 5/2016 JMC 3
