NR 283 Pathophysiology Exam 2 Study Guide

NRI283IPathophysiologyIExamI2IStudyIGuide Chapter I8: ISkin IDisorders 1. Viral Iinfections a. Take Iantiviral Ito Ireduce Iviral Ishedding I(can’t Iproliferate) 2. Autoimmune skinI Idisorders a. Shingles b. PemphigusI Iblisters i. 2 IformsI= IvulgarisI&Ifoliaceus ii. Antibodies Idisrupt Ithe Icohesion Ibetween Ithe Iepidermal Icells Icausing Iblisters Ito Iform iii. Treatment I= Isystemic Iglucocorticoids Isuch Ias Iprednisone I& Iother Iimmunosuppressants 3. Psoriasis a. AIchronic Iinflammatory Iskin IdisorderIcaused Iby Iabnormal ITIcell Iactivation b. CellsIare Ishedding IepitheliumIa Ilot IfasterIthan Ithey Ishould I(increased Imitosis)I= Iflakiness c. lesionsIfound Ion Iface, Iscalp, IelbowsI&Iknees d. Treatment I= Iglucocorticoids, ItarIpreparationsI&Iantimetabolites 4. HSV IIIand IHSV IIII(HerpesISimplex IVirusIII&III) a. Type III=Icold IsoresI&IfeverIblister b. Type IIII= Igenital c. Spread Iby Idirect Icontact 5. HPV I(Human IPapilloma IVirus) a. TypesI1-4 I= IplantarIwarts b. TypesI6 I&I11 I=Igenital Iwarts c. Predisposing I factor: I CancerI ICervical 6. Fungal IinfectionsI(mycoses) a. Most Iare Isuperficial b. Diagnosed Iby Iskin Iscrapings c. Treatment I= Itopical Iantifungal d. AthletesIfoot I= ITinea IpedisI&ITinea IcapitisI= Icradle Icap 7. Scabies a. Invasion Iby Imite Ibite I(female Iburrows, Imale IfertilizesIthe Ifemale I&Idies, Ifemale IlaysIeggsI& Idies,repeat)I b. highly Icommunicable Iin Iany Isetting Iand IdoesInot Irespect Isocial Istatus i. put Ipatient Iin Ia Iprivate Iroom ii. nurse Ishould IwearIglovesI&Igown c. Itchy; IBurrowsIappearIon Ithe Iskin IasItiny, Ibrown Ilines d. Common IsitesI= Ibetween Ithe Ifingers, Iwrists, IinnerIsurface IofIelbowI&Iwaistline e. Treatment I= Ilindane I(gamma-hexachlorocyclohexane) 8. Contact Idermatitis a. Exposure Ito Ian Iallergen I= IPruritic Irash I(wool, Iitchy) b. No Iimmune Iresponse c. Treatment I= Itopical Iglucocorticoid 9. Atopic IdermatitisI(eczema) a. AIcommon IproblemIin Iinfancy I&Imay Ipersist Iin Iadulthood b. AIfamilial Itype IIIhypersensitivity Ioften Iassociated Iwith Ihay IfeverI&Iasthma c. Atopic I= IrefersIto Ian Iinherited Itendency Itoward Iallergic Iconditions d. Etiology I= Ichronic Iinflammation IresultsIfromIthe Iresponse Ito Iallergens; Ieosinophilia I(high Ilevel IofWBCsI Iin Ithe Iblood)I&Iincreased IserumIIgEIlevelsIindicate Ithe Iallergic Ibasis e. S&S I= Ipruritic Ilesions, Iskin IappearsIdry I&Iscaly f. Treatment I= Iavoid Iaggravating IagentsI&Itopical Iglucocorticoids 10. Hansen’sIdisease I(Leprosy) a. Myobacterium Ileprae b. InfectsIthe Iskin, ImucousImembrane I&Iperipheral Inerves c. Determined Iby Ia Iskin Ibiopsy d. Treatment I= Iantibiotics 11. Impetigo a. Very Icontagious b. Common Iin IinfantsIand Ichildren c. Cause Iby IS. IaureusI(antibiotic Iresistant IstrainsIare Iincreasing) d. Transmitted Iby Iclose Iphysical Icontact IorIfomites e. PruritisIisIcommon Iwhich IleadsIto Iscratching I&IfurtherIspread IofIinfection f. LesionsIusually Ion Iface g. Treatment I= Itopical Iantibiotic IforIearly IstagesI&Isystematic Iadministration IforIextensive Ilesions 12. Scleroderma a. Tight, Ithin, Ishiny, Ihard, Iimmovable Iskin b. increased Icollagen Ideposit Iin IarteriolesI&IcapillariesIreducesIblood Iflow c. Can Ibe Isystemic d. Raynaud I disease I Icold I fingerItips e. Treatment I= Ianti-inflammatory Idrugs Isuch Ias INSAIDs Ior Icorticosteroids I& IimmunosuppressanttherapiesI 13. Kaposi ISarcoma a. Usually Iin IpatientsIwith IHIV/AIDS I(immunocompromised) b. May Iaffect Ithe Iviscera IasIwell IasIthe Iskin c. Etiology I= IHerpesvirus I8 I(KSHV); Imalignant Icells Iarise Ifrom Ithe Iendothelium Iin Ismall Iblood Ivessels d. S&S I= IMultiple Iskin IlesionsI(large, IirregularIshaped, Imay Ibe IdarkerIin IcolorIaka Ipurple/brownish) Ioftenon I Ithe Iface, Iscalp, Ioral Imucosa, IorIlowerIextremities e. Treatment I= Icombination IofIradiation, Ichemotherapy, Isurgery I&Ibiologic Itherapy f. Put Ipatient Iin Iprotective Iisolation I(protect IthemIfromIourIgerms) 14. Malignant IMelanoma a. MelanocytesIeffected; Iusually Idetected Ilate I= Ia Ibad Iprognosis b. Itchy, IgrowsIrapidly, Imetastasizes, IirregularIborders c. Development IdependsIon Igenetics, Iexposure Ito IUV Iradiation I(sunbathing), Ihormones, I&immunosuppressed I d. Treatment I= Isurgery, Iradiation I&Ichemotherapy 15. Basal ICell ICarcinoma a. Pearly Iwhite Iborders 16. Cancer a. Radiation I= Ishrinks’Itissue b. Chemotherapy I= IeradicatesIcells c. Complete IBlood ICount I(CBC) d. MonitorIwhite Iblood Icount 17. PediculosisI=Ilice Chapter I13: IRespiratory IDisorders 1. Primary Icontrol IcentersIforIbreathing Iare Ilocated Iin Ithe Imedulla Iand Ipons 2. Pulmonary IVolumes a. Tidal IVolume I(TV)I=Iamount IofIairIentering IlungsIwith Ieach Inormal Ibreath I(500mL) b. Residual IVolume I(RV)I= Iamount IofIairIremaining Iin Ithe IlungsIafterIforced Iexpiration I(1200mL) c. Inspiratory IReserve I(IRV)I= Imaximal Iamount IofIairIthat Ican Ibe Iinhaled Iin IexcessIofInormal IquietinspirationI I(3000mL) d. Expiratory IReserve I(ERV) I= Imaximal Ivolume Iof Iair Iexpired Ifollowing Ia Ipassive Iexpiration I(1100mL) e. Vital ICapacity I(VC) I=Imaximal Iamount IofIairIexpired IfollowingIa Imaximal IinspirationI(4600mL) i. Incentive IspirometerIused Ito Imeasure Ithis f. Total ILung ICapacity I(TLC)I= Itotal Ivolume IofIairIin Ithe IlungsIafterImaximal Iinspiration I(5800mL) 3. Dyspnea I= Ia Isubjective Ifeeling IofIdiscomfort Ithat IoccursIwhen Ia Iperson IfeelsIunable Ito Iinhale Ienough Iair 4. CyanosisI= Ithe Ibluish Icoloring IofIthe Iskin Iand ImucusImembranesIthat IresultsIfromIlarge Iamounts Iofunoxygenated I Ihemoglobin Iin Ithe Iblood 5. GasIexchange a. Oxygen IdiffusesIinto Ithe Iblood Ithrough Ithe Ialveoli b. FlowIofIgasesIbetween Ithe IalveolarIairI&Iblood c. DependsIon Ithe3 Irelative IconcentrationsI(partial Ipressures)IofIthe IgasesI(PO2 I&IPCO2) d. Dalton’sIlawI= Ieach IgasImovesIalong IitsIpartial Ipressure Igradient, Iindependent IofIotherIgases 6. Oxyhemoglobin IDissociation ICurve a. Relationship Ibetween Ipercentage Isaturation IofIhemoglobin I&IPO2 7. Arterial Iblood IgasIlevels a. KnowIthe Ivalues: i. Oxygen I= ii. Carbone Idioxide I=Inormal IisI35-45 iii. Bicarbonate I=Inormal IisI24 iv. Serum IpH I= Iacidosis Iis Iless Ithan I7.35, Inormal Iis I7.36-7.44, I& Ialkalosis Iis Igreater Ithan I7.45 b. Hypoxemia I= Iinadequate Ioxygen Iin Iblood; Idecrease Ifrom I~105 Ito I60 Imm IHg; Ichemoreceptors Irespond c. Hypoxia I= Iinadequate Isupply IofIoxygen Ito Ithe Icells d. Hypercapnia I=Iincreased Icarbon Idioxide Iin Ithe Iblood; ICO2 IeasilyIdiffusesIinto ICerebrospinal Ifluid(I CSF); IcausesIrespiratory Iacidosis e. Hypocapnia I= Ilow Icarbon Idioxide Iconcentration I(low Ipartial Ipressure Iof ICO2) Iin Iblood; Imay Ibe Icaused by Ihyperventilation; IcausesIrespiratory Ialkalosis 8. Boyle’sIlaw: I“AsIthe Isize IofIthe Ithoracic Icavity Idecreases, Ithe Ipressure Iinside Ithe Icavity Idecreases” 9. Respiratory Imucosa I(where IisIit Ilocated) a. ConsistsIofIpseudostratified Iciliated IcolumnarIepithelial Icells, Iwhich IincludesImucous-secreting Igoblet Icells. IMucousIblanket ItrapsI&Icilia IsweepsIforeign IparticlesIout IofIthe Irespiratory Itract StartsIin InaresIand IendsIin Ithe Ialveoli Respiratory Imucosa IisICONTINUOUS 10. Chemoreceptors a. Central I= Imedulla b. Peripheral I=Icarotid Ibodies c. Purpose I= Idetects Ichanges Iin Icarbon Idioxide, Ihydrogen Iion, Iand Ioxygen Ilevels Iin Ithe Iblood Iorcerebrospinal I Ifluid I(CSF) 11. CharacteristicsIofIsputumIand Iwhat IvariationsIrepresent a. General Imanifestation IofIrespiratory Idisease b. Yellow/greenish, Icloudy, Ithick ImucusI= Iusually Ibacterial Iinfection c. Rusty/dark Icolored I= Iusually Ipneumococcal Ipneumonia d. Large IamountsIofIpurulent Iwith Ifoul IodorI=Imay Ibe Iassociated Iwith Ibronchiectasis e. Thick, Itenacious, ImucusI= Iasthma IorIcystic Ifibrosis i. blood-tinged Isputum—may Iresult IfromIchronic Icough; Imay Ialso Ibe Isign IofItumor IortuberculosisI f. HemoptysisI= IBlood-tinged I(bright Ired)Ifrothy Isputum, Iusually Iassociated Iwith Ipulmonary Iedema 12. Laryngotracheobronchitis a. Common Iin Ichildren I(3 ImonthsI-I3 Iyears) b. Gradual Ionset; Iinflammation IofIlarynx I&Itrachea; Ican Iobstruct Ithe Iairway c. CROUP I Iwhat I causesI it? I = I parainfluenza I virusesI &I adenoviruses 13. Tuberculosis a. Protect IourselvesIfromIthese IpatientsI(airborne I= Ineed Ito IwearImasks) b. Caused Iby ImycobacteriumItuberculosis c. Spread Iby Ioral IdropletsI(can Istay Ilive IforIabout I3 IweeksIwhen Idried) d. Common Iin Icrowded Iliving IconditionsI(poor)I&Ithe Iimmunocompromised e. It IisInot Ilimited Ito Ithe Ilungs f. S&S I= Iweight Iloss, Ifailure Ito Ithrive, Iinfection I(measles), Icavitation Iin Ithe Ilungs, Icough, Ipositivesputum, I Iradiograph, Iskin Itest g. Treatment I= Ia Icombination IofIdrugsIforI6-12 Imonths h. Types i. Primary Iinfection I= Iwhen Imicroorganism Ifirst IinfectsIlungs; Iengulfed Iby ImacrophagesI– Ilocalinfection I ii. Secondary I= Iactive Iinfection; Ioften Iyears Iafter Iprimary Iinfection; Ibrought Iback Ibecause Iof cellmediated Iimmunity IisIimpaired I(stress, Iage, Iinfection) iii. Miliary/Extrapulmonary I= Imore Icommon Iin Ikids; Irapidly Iprogressive Iform 14. Cystic IFibrosis a. Inherited Igenetic IdisorderIlocated Ion Ichromosome I7 b. TenaciousImucus; IaffectsIlungsI&Ipancreas c. MucusIblocksIairflowIin IbronchiolesI&Ismall Ibronchi d. InfectionsI(Pseudo. IAureusI&IStaph. IAureus) 15. AtelectasisI= Ithe Inon-aeration Ior Icollapse IofIa Ilung Ior Ipart IofIa Ilung Ileading Ito Ia Idecreased IgasIexchange I&hypoxia I a. AIcollapsed Ilung; Imarked Iby Iairway Iobstruction I(also Imay Ibe Ia Icause) b. Sound IofIlung IisIdecreased Ion Ithat Iside I&Ithe Ichest Idoesn’t Irise Ion Ithat Iside c. S&S I= Ismall Iareas Iare Iasymptomatic; Ilarge Iareas Icause Idyspnea, Iincreased Iheart I& Irespiratory Irates, I&chest I Ipain d. Treatment I= Itreat Ithe Icause I& Ire-expand Ithe Icollapsed Ilung; Ideep Ibreathing Iexercises, Ichanging Ibody positions, Iforced Icoughing; Iremoval Iof Ifluid, Itissue Ior Itumor; Ichest Iclapping Ior Ipercussion, Iposturaldrainage, I I&ImedicationsIto Iopen IairwaysI&Iloosen Imucus 16. Pneumothorax a. PatientsIwith IcancerI(branchiogenic Icarcinoma) b. HappensIbecause IofItumor, Iblood Iin Ilungs, Ipleural Ieffusion i. EatsIthrough IlungsI= IairIcan Iget Ithrough ii. AirIin Ilungs c. Hemothorax I= Iblood Iin Ithoracic Ispace 17. Pleural IEffusion I= Ithe Ipresence IofIexcessive Ifluid Iin Ithe Ipleural Icavity Chapter I10: IBlood IDisorders 1. Vitamin IK I= Ipurpose IofIit Iin Ithe IliverIisIbecause Iit IisIa Iclotting Ifactor a. PlateletsIand Iprothrombin Ihelp Iwith Iclotting Iin Iblood 2. ABO KnowIblood ItypesI– Ibased Ion IantigensIin Ithe Iplasma I&Imembrane IofIthe Ierythrocytes o O I= Ino Irbc Iantigen, Ianti-A I& Ianti-B Iantibodies Iin Iplasma, Ican Ionly Ireceive IO o AI=IAIrbc Iantigen, Ianti-BIantibodiesIin Iplasma, Ican Ireceive AI IorIO o BI=IBIrbc Iantigen, Ianti-AIantibodiesIin Iplasma, Ican Ireceive IB IorIO o AB I= IA I& IB Iantigen, Ino IantibodiesIin Iplasma, Ican Ireceive IA, IB, IO, Ior ABI What IantibodiesIare Ipresent I(A=A, IB=B, IO=NONE) Rh I(+ IorI-) o I + I= Iantigen ID Iin Iplasma Imembrane o -I= Iabsence IofIantigen ID O-I= Iuniversal Idonor ABI= Iuniversal Irecipient 3. Hyperchromic IErythrocytesI=IRBCsIthat Ilack Icolor a. indicative IofIiron Ideficiency Ianemia 4. AnemiasI= Ireduce Ioxygen Itransport Iin Iblood Idue Ito Ia Idecrease Iin Ihemoglobin Icontent a. Iron Ideficiency Ianemia i. Insufficient Iiron IimpairsIhemoglobin IsynthesisI= Ireducing Ithe Iamount IofIoxygen Itransportedin I Iblood ii. Microcytic I(small), Ihypochromic I(pale)IRBCsI= Inot Icarrying Ithe Ioxygen Ithey Ineed iii. Hemoglobin IlevelsIare Ilow I(hypochromic); Idecreased Iproduction iv. Frequently Ia Isign IofIan Iunderlying IproblemI(cancer) v. Etiology I= Idecreased Idietary Iintake, Imalabsorption, Ichronic Iblood Iloss, Isevere Iliver Idisease vi. S&S I= IpallorIofIskin, Ifatigue, Ilethargy, Iirritability, Itachycardia, Idelayed Ihealing, Imenstrualirregularities I vii. Treatment I= Igive Iiron Ito Itake Iwith Iorange Ijuice Ibecause Ivitamin ICIabsorbsIiron I(must Iuse Ia strawIto Iavoid Idiscoloration IofIteeth) b. Sickle Icell Ianemia i. Abnormal Ihemoglobin I(HbS)I= Iunstable I&IchangesIshape Iin Ihypoxemia; IRBCIelongates I&hardens I Iin Ia Isickle Ishape Iwhen Ioxygen Ilevels Iare Ilow I– Ihave Ia Ishort Ilife Ispan ii. OccursIwheneverIoxygen IlevelsIare Ilowered iii. CellsIare Itoo Ilarge Ito IpassI&Iobstruction IleadsIto Imultiple IinfarctionsI&IareasIofInecrosis iv. Etiology I= Irecessive Iinheritance; IappearsIat I12 Imonths Cause I= Iautosomal Irecessive I(genetic Idisorder) OccursIin IhomozygousIrecessive Common Iin IAfrican IAmericansI&IMiddle IEast S&S I= Ipallor, Iweakness, Itachycardia, Idyspnea, Ihyperbilirubinemia, Isplenomegaly, Igrowth I&development I Iare Idelayed Additional Ieffect I= Ipainful IcrisisIwith Imultiple Iinfarctions; Iorgan Ifailure c. Pernicious AnemiaI I= Ivitamin IB12 Ideficiency i. Lack IofIabsorption Ibecause IofIlack IofIintrinsic IfactorI(owing Ito Iimmune Ireaction) ii. RBCsI= ImegaloblastsI(immature Inucleated Icells); Ishort Ilife Ispan iii. Very Ilarge, Iimmature, Inucleated Ierythrocytes iv. Vitamin IB12 IisIneeded IforIthe Ifunction I&Imaintenance IofIneurons v. Tongue IisItypically Ienlarged, Ired, Isore, I&Ishiny I(big I&Ibeefy) vi. Etiology I= Ideficit IofIintrinsic IfactorIowing Ito Iimmune Ireaction vii. Gastric IbypassIpatients viii. Additional IeffectsI= Ineurologic Idamage I&Iachlorhydria d. Aplastic IAnemia I=Iimpairment Ior Ifailure Iof Ibone Imarrow i. RBCsI= Ioften Inormal Icells; Ipancytopenia ii. May Ibe Itemporary IorIpermanent iii. Often Iidiopathic iv. Blood IcountsIindicate Ipancytopenia I(all/whole; Idecrease) v. Identification IofIcause I&Iprompt Itreatment Ineeded IforIbone ImarrowIrecovery Etiology I= Ibone ImarrowIdamage IorIfailure Additional IEffectsI= Iexcessive Ibleeding I&Imultiple Iinfections CancerIofIthe Iblood; IHIV Iare Iprone 5. LeukemiasI=Igroup IofIneoplastic IdisordersIinvolvingIWBCI(uncontrolled IproductionIinIbone IorIlymphInodes) a. WBCsI&IRBCsIare Ilow; IdepressesIthe Iimmune IsystemI= Iprone Ito IinfectionsIso Iput IpatientsIin IisolationroomsI I&Ilimit Ivisitors; IwearIgowns, IglovesI&ImasksIto Iprotect IthemIfromIyou; Ino Ifresh Ifruits Ior Iflowers b. Acute Ileukemias i. HighIproportionIofIimmature Inonfunctional IcellsIinIbone ImarrowI&Iperipheral Icirculation ii. Onset IisIusually Iabrupt; Icomplications; Iusually Iin Ichildren I&Iyoung Iadults iii. Acute Ilymphocytic Ileukemia I(ALL)I= IB-lymphocytesI&Iyoung Ichildren 1. Multiple Iopportunistic IinfectionsIoccurIbecause IcellsIare Iimmature I& Ihaveweakened I Ifunction 2. The Imost Icommon Ichildhood Icancer 3. Cause I= Iunknown; Iassociation Iwith Ichromosomal IabnormalitiesI(translocation) iv. Acute ImyelogenousI(orImyelocytic)Ileukemia I(AML)I= Igranulocytic IstemIcellsI&Iadults 1. Cause I= Iexposure Ito Iradiation, Ichemicals, I&Icertain Iviruses v. Acute Imonocytic Ileukemia I= ImonocytesI&Iadults c. Chronic Ileukemias i. Higher Iproportion Iof Imature Icells ii. Insidious Ionset Iwith Imild Isigns I& IbetterIprognosis; Icommon Iin IolderIadults iii. Chronic Ilymphocytic Ileukemia I(CLL) I= IB-lymphocytes I& Iadults Igreater Ithan I50 Iyears iv. Chronic Imyelogenous Ileukemia I(CML) I= Igranulocyte Istem Icells I& Iadults I30-50 Predisposing Ifactors 6. Polycythemia a. Primary I= IVera i.Increased Iproduction Iof Ierythrocytes I& Iother Icells Iin Ithe Ibone Imarrow I= Ithick Iblood I= Ihard Itoget I Ithrough IarteriesI& Ivessels ii. CellsIhave Ihypertrophy Ibecause IofIincreased Iwork iii. Blood Ivolume IisIincreased I(hematocrit Iincreased) iv. CausesIincrease Iin IBP v. Phlebotomy Idone Ito Iremove I500 Icc Iblood I&I500 Icc IofIIV Ito Idilute Iblood vi. Neoplastic Idisorder b. Secondary I= Ierythrocytosis i.Increase Iin IRBCsIin Iresponse Ito Iprolonged Ihypoxia ii. Increased Ierythropoietin Isecretion iii. Compensation Imechanism Ito Iprovide Iincreased Ioxygen Itransport 7. Warning IsignsIofIexcessive Ibleeding I&Ipossible Iblood-clotting Idisorders a. Persistent Ibleeding IfromIgumsI&Inosebleeds b. Petechiae I= Ipinpoint Iflat Ired IspotsIon Iskin IorImucousImembranesI(like Ia Irash) c. Frequent Ipurpura I&IecchymosesI(large, Ipurplish Ired IorIgreenish Ibruises) d. HematemesisI= Ibleeding Iinto Ia Ijoint I(swollen, Ired I&Ipainful) e. HemoptysisI= Ibright Ired IflecksIin IsputumI(coughing Iup Iblood) f. HematemesisI= Ivomiting Iblood I(often Ibrown Ilike Icoffee Igrinds; Imay Ibe Ired) g. Blood Iin Ifeces h. Feeling Ifaint I&Ianxious, IlowIBP, Irapid Ipulse 8. Hemophilia IA I(classic Ihemophilia)I= Ia Ideficit IorIabnormality IofIclotting IfactorIVIII a. Most Icommon Iinherited Iclotting Idisorder; IX-linked Irecessive Itrait b. S&S I=Iprolonged IorIsevere Ihemorrhage IafterIminorItrauma, Ipersistent Ioozing IofIblood IafterIminor Iinjuries, Ihematomas Iis Icommon, Ihemarthrosis I(spontaneous Ibleeding Iinto Ijoints), Ihematuria I(blood Iinurine I IorIfeces)Imay Ioccur c. PrecautionsI= Iavoid ASAI Ior IASA-containing Idrugs, Ibe Iprepared Iwith IsuppliesIin Icase Iof Iemergency, Ilab tests Ito Icheck Ifor Icurrent Iblood-clotting Istatus; Iavoid Icontact Isports I& Isharp Iobjects, Iuse Ielectric Irazors I&Iavoid Ienemas d. Treatment I= Idesmopressin I(DDAVP), Ireplacement Itherapy 9. Disseminated IIntravascular ICoagulation I(DIC) I=Iexcessive Ibleeding I&Iclotting Iat Ithe Isame Itime a. An Ioften-life-threatening Icondition Ithat IinvolvesIboth Iexcessive Ibleeding I&Iexcessive Iclotting b. Consumption Iof Iclotting Ifactors Iand Ifibrinolysis Ileads Ito Ihemorrhage I& Ieventually Ihypertension I&shock I c. Etiology I= Ia Ivariety Iof IdisordersIcan Iinitiate Iit Isuch IasIobstetric IcomplicationsI(abruptio Iplacenta I= Irips offIuterine Iwall), IcarcinomasI&Itrauma d. S&S I= IlowIplasma Ifibrinogen Ilevel, Ithrombocytopenia Ioccurs, Iprolonged Ibleeding I(hemorrhage) Iaccompanied Iwith IlowIBP I&Ishock, Irespiratory Iimpairment, IseizuresI&Iacute Irenal Ifailure Iwith Ioliguria e. Treatment I= Idifficult I& Idepends Iif Ihemorrhages Ior Ithromboses Iare Idominant; Imust Itreat Iunderlying cause Isuccessfully; IprognosisIdependsIon Ithe Iseverity IofIthe Iproblem Chapter I12: ICardiac IDisorders 1. Stroke Ivolume Iand Icompensative Imechanisms 2. Systolic Ipressure I= Ithe Ipressure Iexerted Iby Ithe Iblood Iwhen Iejected IfromIthe Ileft Iventricle 3. Diastolic Ipressure I= Ithe Ipressure Ithat IisIsustained Iwhen Ithe IventriclesIare Irelaxed 4. Preload I=Ivolume IofIvenousIreturn Iback Ito Ithe Iheart; IrefersIto Ithe Imechanical Istate IofIthe Iheart Iat Ithe Iend Iofdiastole I Iwith Ithe IventriclesIat ItheirImaximumIvolume 5. AfterloadI=Ivolume/pressure IofIbloodIthat IcausesIthe IejectionIofItheIbloodIfromIthe Ileft Iventricle; Ithe Iforce required Ito Ieject Iblood Ifrom Ithe Iventricles I& Iis Idetermined Iby Ithe IPR Ito Ithe Iopening Iof Ithe Isemilunar Ivalves 6. Peripheral Iresistance I(PR)I= Ithe Iforce Iopposing Iblood Iflow, IorIthe Iamount IofIfriction Iwith Ithe Ivessel Iwallsencountered I Iby Ithe Iblood 7. Cardiac Ioutput I=volume IofIblood Iejected Iby Ia Iventricle Iin Ione Iminute; IdependsIon ISV I&IHR 8. Stroke IVolume I= Ithe Ivolume Ipumped IfromIone Iventricle Iin Ione Icontraction; IvariesIwith Isympathetic Istimulation&I IvenousIreturn 9. COI(cardiac Ioutput) I= ISV I(stroke Ivolume) I IHR I(heart Irate) a. CO IisIa Icombination IofIHRI&ISV I bloodI Ivolume Ipumped IperIminute I(~mL) b. Decrease Iin Ioutput Iand Istroke Ivolume I= Iincrease IofIHR c. IfIHRIincreases, ICO IdecreasesIbecause ISV IdecreasesI(doesn’t Ihave Ienough Itime Ito Irefill Isame IamountofI Iblood) d. BPI(blood Ipressure) I=ICOI(cardiac Ioutput) Ix IPR I(peripheral Iresistance) 10. Angina a. Chest Ipain; IoccursIwhen Ithere IisIa Ideficit IofIoxygen Ito Ithe Iheart Imuscle b. Precipitating IfactorsI= Irunning Iupstairs, Igetting Iangry, Irespiratory Iinfection Iwith Ifever, Iexposure ItoweatherI IextremesIorIpollution, IorIeating Ia Ilarge Imeal c. S&S I= Isubsternal Ichest Ipain Idescribed Ias Ia Itightness Ior Ipressure, Ipallor, Idiaphoresis I(excessive sweating), I&Inausea d. Treatment I= Icoronary IvasodilatorsIsuch IasInitroglycerin e. Stable i. when Ia Icertain Iactivity IcausesIchest Ipain Iit IisIstable; Iusually Itriggered Iby Iphysical Ioremotional I Istress f. Unstable i. More IseriousIform; IrefersIto Iprolonged Ipain Iat Irest I& IofIrecent Ionset; Imay Ibe Ithe Iresult Iof Iabreak I Iin Iatheroma; Imay Iprecede Ia IMI ii. Random Ichest Ipains IwhetherIorInot Iactivities/exertion Iare Iperformed 11. Deep IVein IThrombosisI(DVT) a. Patients Iwho Iare Ipost Iop Iare Iat Irisk I– Iput Isequential Icompression Idevices Ion Ithem Ior IantiembolicstockingsI I(ted Istockings) b. Do Inot Imassage ItheirIlegsIbecause Iit Ican Imove Ithe Iclot c. Thrombophlebitis I= Irefers Ito Ithe Idevelopment Iof Ia Ithrombus Iin Ia Ivein Iin Iwhich Iinflammation Iis Ipresent d. PhlebothrombosisI= Ia IthrombusIformsIspontaneously Iin Ia Ivein Iwithout Iprior Iinflammation(I inflammation Imay Idevelop Isecondarily Iin Iresponse Ito Ithe Ithrombus) e. Critical IproblemIisIthat IvenousIthrombosisImay Ilead Ito Ipulmonary Iembolism f. S&S I= Iaching, Iburning, Ior Itenderness Iin Ithe Iaffected Ileg, Ileg Imay Ibe Iwarm Iand Ired, Imay Icause Iedema, Iapositive I IHomansIsign I(pain Iin Ithe IcalfImuscle Iwhen Ithe Ifoot IisIdorsiflexed), Isystemic Isigns Isuch Ias Ifever, Imalaise I&Ileukocytosis g. Treatment I= Icompression Ior Ielastic Istockings, Iexercise Ito Ireduce Istasis, Ianticoagulant Itherapy, fibrinolytic Itherapy, I&Ithrombectomy 12. MyocardiumIInfarction I(MI) a. An IMII(heart Iattack)IinvolvesIthe Ideath IofImyocardial Itissue Idue Ito Iischemia I(deficiency Iof Iblood); IoccursIwhen Ia Icoronary Iartery IisItotally Iobstructed, Ileading Ito Iprolonged Iischemia I& Iinfarction I(celldeath)I IofIthe Iheart Iwall b. Pathophysiology I ITOTALI OCCULTION c. Warning Isigns: IChest Ipain I(feeling IofIpressure, Iheaviness, IorIburning Iespecially Iwith Iincreased Iactivity), Isudden IshortnessIofIbreath, Isweating, Ifatigue, Iweakness, Inausea, Iindigestion, Ianxiety I& Ifear d. Most Icommon Icause: IAtherosclerosisIinvolving Ithrombosis e. S&S I= Ipallor, Idiaphoresis, Idizziness, Idyspnea, Ihypotension I&Ilow-grade Ifever f. Cardiac Ipatient Iwho IisIsuspected IofIhaving Ian IMIImust Icheck IforIlevelsIofItroponin I(protein Ireleasedwhen I Icardiac Imuscle IhasIbeen Idamaged)/CPK Iwhich IisIindicative IofIcardiac Imuscle Ideath g. Total I blockage I occursI Ipart I ofI myocardiumI isn’t I getting I blood I Ithat I part I of Ithe I heart I diesI Ishock occurs 13. Tetralogy Iof IFallout a. Disease IofIinfant Ithat IisIborn Icyanotic; Icaused Iby Ia Ihole Iin Ithe Iheart b. Surgery IisIusually IlaterIon Ibecause Iit Imay Iheal Ion IitsIown c. Most Icommon Icyanotic Icongenital Iheart Icondition d. FourIdefectsIare I= i. Pulmonary Ivalve IstenosisI= IrestrictsIoutflowIfromIthe Iright Iventricle, Ileading Ito Iright Iventriclehypertrophy I I&Ihigh Ipressure Iin Ithe Iright Iventricle ii. VSD I= iii. Dextroposition IofIthe Iaorta I(to Ithe Iright IoverIthe IVSD)I= iv. Right Iventricle Ihypertrophy I= e. Blood IfromIright IatriumIto Ileft Iventricle; Imixing Ideoxygenated Iblood Iwith Ioxygenated Iblood IandsendingI Iout f. VSD I Iblood I fromI left Ito I right I Inot I blue I because I blood I isI oxygenated I twice 14. Cardiac IDysrhythmias a. Bradycardia I= Islower Ithan I60/minute; IStroke IVolume Iincreased I& Ipossibly Ireduced ICardiac IOutput b. Tachycardia I= Ifast I100-160/minute; Ipossibly Ireduced ICardiac IOutput c. Atrial IflutterI= I160-350/minute; IlessIfiling Itime I&Ioften Ireduced ICardiac IOutput d. Fibrillation I= Iover I300/minute; Iuncoordinated Imuscle Icontractions; Ino Ifilling, Ino Ioutput, Icardiacstandstill I 15. Congestive IHeart IFailure I(CHF)= Iinability Iof Ithe Iheart Ito Ipump Iblood Ito Imeet Ithe Idemand Iof Ithe Ibody a. Left-sided ICHF i. Causes I= Iinfarction Iof Ileft Iventricle, Iaortic Ivalve Istenosis, Ihypertension, Ihyperthyroidism ii.Basic IeffectsI= Idecreased Icardiac Ioutput, Ipulmonary Icongestion iii. Forward IeffectsI= Ifatigue, Iweakness, Idyspnea, Iexercise Iintolerance, Icold Iintolerance iv. Compensations I= Itachycardia I&Ipallor, Isecondary Ipolycythemia, Idaytime Ioliguria v. Backup IeffectsI= Iorthopnea, Icough Iproducing Iwhite IorIpink-tinged Iphlegm, Ishortness Iofbreath I, Iparoxysmal Inocturnal Idyspnea, Ihemoptysis, Irales b. Right-sided ICHF i. CausesI= Iinfarction IofIright Iventricle, Ipulmonary Ivalve Istenosis, Ipulmonary Idisease I(corpulmonale)I ii. Basic Ieffects I= Idecreased Icardiac Ioutput, Isystemic Icongestion, I& Iedema IofIlegsI&Iabdomen iii. Forward IeffectsI= Ifatigue, Iweakness, Idyspnea, Iexercise Iintolerance, Icold Iintolerance iv. Compensation I= Itachycardia I&Ipallor, Isecondary Ipolycythemia, Idaytime Ioliguria v. Backup IeffectsI= Idependent Iedema Iin Ifeet, Ihepatomegaly I&Isplenomegaly, Iascites, Idistendedneck I Iveins, Iheadache, Iflushed Iface 16. Coronary IArtery IDisease I(CAD) a. IncludesIangina IpectorisIand Imyocardial Iinfarction b. ArteriosclerosisI= Igeneral ItermIforIall ItypesIofIarterial Ichanges; Iusually Idegenerative IchangesIin Ipeople IoverI50 I&Idiabetes; Ielasticity IisIlost, IwallsIbecome Ithick I&Ihard, Ilumen InarrowsI&Imay Ibecome Iobstructed c. Risk IfactorsI= i. Nonmodifiable I= Iage, Igender, Igenetic Ifactors, ii. Modifiable I= Iobesity Ior Idiets Ihigh Iin Icholesterol I& Ianimal Ifat, Icigarette Ismoking, Isedentary Ilifestyle, IdiabetesImellitus, Ipoorly Icontrolled Ihypertension, Icombination IofIoral Icontraceptives&I Ismoking, Icombination IofIhigh Iblood Icholesterol I&Ihigh IBP d. Treatment I= Ilose Iweight, Iminimize IsodiumIintake, Icontrol IdiabetesI&Ihypertension, Istop Ismoking, exercise, I&Ipotentially Ioral Ianticoagulant I&Isurgical Iintervention 17. Lipids a. LDLI= Ibad Iso Iyou Iwant IthemIto Ibe ILow b. What Iit IpromotesIifIuntreated: IATHROMA c. HDLI= Igood Iso Iyou Iwant IthemIto Ibe IHigh