NURS 5350 Exam 1 Units 1 - 4 | Complete Solutions (Verified)

NURS 5350 Exam 1 Units 1 - 4 | Complete Solutions (Verified) What are the two major classes of living cells? Prokaryotes and Eukaryotes What is a Prokaryote cell? Characterized by a LACK of distinct nucleus. What are examples of Prokaryotes? Cyanbacteria, Bacteria, and Rickettsiae. What is a Eukaryote cell? Cells WITH A WELL-DEFINED NUCLEUS and membrane bound organelles. What are examples of Eukaroytes? Higher animals, Plants, Fungi, and Protozoa. What are the cellular functions? movement, conductivity, metabolic absorption, secretion, excretion, respiration, reproduction, communication. What are the three general components of Eukaroytes? Plasma Membrane, Cytoplasma, and Intracellular organelles. What is the function of the nucleus in Eukaryotic cells? Cell division and control of genetic information. What is the function of the cytoplamsa in Eukaroytic cell? EGG WHITE Fills the space between the nucleus and cell membrane. Transports waste, metabolic processes, motility, and storage. Function of the Ribsomes in Eukaryotic cell? Synthesizes proteins and signaling. Function of the endoplasmic reticulum in Eukaroytic cell? Protein synthesis and senses cellular stress. Function of the Mitochondria in Eukaroytic cell? Power stations that produce energy. Function of the golgi complex in Eukaroytic cell? Refining plant Directs traffic especially transports proteins in and out of the cell. Function of lysomes in Eukaroytic cell? PAC MAN Eat anything in front of it, digestion, and nutrient signaling. What are peroxisomes? (Cellular parts) Major sites of oxygen utilization and help nerve myelination. What is the Cytsol? (Cellular Parts) 55% cell volume, storage, and metabolizes enzymes. What is the cytoskeleto? (Cell parts) The bones and muscles of the cell. Maintains cell shape, movement in and around cell. What is the plamsa membrane? (Cell Parts) Encases the cell, has transport systems, cell to cell recognition, and allows lipids to leave and transport things on hormones. Which cell has a polar end and non-polar end? Eukaryotic cells. Membrane composition of Eukaroytic cells/higher cells? Made up of PROTEINS. Made from a chain of amino acids known as POLYPEPTIDES. "WORKHORSES" of the cell. Functions: Receptors, transporters, enzymes, surface markers, adhesion molecules, and catalysts. What is the proteolytic cascade with Eukaroytic cells? How proteins breakdown and move. Tightly orchestrated sequence of events that cause the breakdown of protein. What is Apoptosis with Eukaroytic cells? Pre-programmed cell death. Every cell has an expiration date. RBCs 90 day expiration. What are the cellular receptors with Eukaroytic cells? Protein molecules on the plasma membrane, in cytoplasma, or in nucleus. Plasma membrane receptors: Make availability for membranes (EGG CARTON) Ligands: (BROKEN EGG STUCK IN CARTON): determine how cells bind or signals not to bind in surface or cell. What are the three mechanisms that bind cells together? Extracellular matrix, cell adhesion cells, and specialized cell junctions. What is the extracellular matrix and what are examples? Mesh of fibrous proteins: fibroblasts, hyaluronic acid, collagen (watery gel-like substance in complex carbs. These regulate cell growth movement, and differentiation. Extracellular matrix and basement membranes? (BASAL LAMINA) Lies beneath epithelial cells, surrounds individual cells, muscles, fat. Fat cells sticking together in basal lamina is why you don't lose cellulite. Surface proteins that bind to adjacent cells. EX: Immunoglobulin (Ig) Superfamiy. Adhesion cells or cell adhesion molecules. Hold cells together (Epithelial cells and has special kinds of CHEMICAL connections. Specialized Cell Junctions Signal transduction: First messengers? Signals one way (Conveys instructions to cells interior). Signal transduction: Second messengers? Signals two ways. (Cyclic adenosine monophosphate (cAMP) and Calcium (Ca) What are the two main processes associated with cellular metabolism? And why? Anabolism and Catabolism. Provides the cell with energy. What is Anabolism? Energy metabolism or energy moving forward. What is Catabolism? Energy releasing process of metabolism (Energy moving down). Energy is released from the cell in a form called ATP (FUEL OF THE CELL). What is the role of Adenosine Triphosphate (ATP)? Cell fuel: storage of energy and transport of energy. ATP/Fuel is created when molecules of carbohydrates, lipids, and proteins are catabolized. ATP is used in synthesis of organic molecules, muscle contractions, and active transport. What is the citric acid cycle also known as? Krebs cycle. What is the Kreb Cycle or Citric Acid Cycle or Tricarboxylic Acid Cycyle (TCA)? Occurs in the mitochondria. Mechanism by which energy produced from carbohydrates, fats, and proteins is transferred to ATP (Fuel). Membrane transport: Passive transport? Occurs when water and small, electrically charged molecules move through pores. DOES NOT REQUIRE ENERGY. Membrane transport: Active transport? REQUIRES LIFE AND ENERGY and occurs across membranes that flow upwards. What is the biggest TWO-WAY channel messenger? Calcium (Ca). Membrane Transport: Solutes? Dissolved substances. What is diffusion in Passive transport? A solute is moved from an area of greater concentration to an area of lesser concentration. What is filtration in Passive transport? Hydrostatic pressure water and solutes move through a membrane because of a greater pushing pressure (FORCE) on one side of the membrane than on the other side (Coffee K Cup). What is Osmosis in Passive transport? Water moves DOWN a concentration gradient. Membrane transport: What is Osmolality? Measure of the number of milliosmoles per kg of water or the concentration of molecules per weight of water. Membrane transport: What is Isotonic, Hypertonic, and Hypotonic? Isotonic: Same osmolarity or concentration of particles. Hypertonic: Concentration of more than. Hypotonic: Lower concentration or more dilute. Active transport of NA and K+? Does it require energy? Source of energy? How many molecules of each are involved? NA moves out of the cell and K+ moves into the cell (Uses ATP). 3 molecules of NA are transported out of the cell and 2 molecules of K+ move into the cell. Active transport of NA+ and K+ (Vesicular Formation): What are the three sources of active transport? Endocytosis Phagocytosis Exocytosis Active transport: Endocytosis? Taking in cells from the outside the cell. Active transport: Phagocytosis? "PAC MAC" Large molecular substances engulfed and enter cell to be destroyed lysosomal enzymes. Active transport: Exocytosis? Expelling. What is the electrical activity of the cell? Action Potential Describe action potential I am K+ in this situation. I am oK+ inside the home (Cell) on the recliner at a resting state. Depolarization: Disturbed when kids come running in and jumping on lap. Kids=NA. Repolarization: Restart your evening by K+ getting out of the recliner or house (Cell) and kids (NA) stays in the both recliner and house (Cell). Cellular Adaptation: Atrophy? Decrease in cell size. Cellular Adaptation: Hypertrophy? Increase in cell size. (Inflammation) Cellular adaptation: Hyperplasia? Increase in number of cells. (Inflammation) Cellular adaptation: Metaplasia? Reversible replacement of one mature cell type by another less mature cell type. (Cancers) Cellular Adaptation: Dysplasia? Deranged cellular growth; not true cellular growth but rather an atypical hyperplasia. (Cancers) Cellular Injury: Ischemia? Hypoxia: lack of oxygenated blood and reduced blood flow. Cellular Injury: Infarction? Cell death as a failure of blood supply. Cellular Injury: Infection? Macrophages come and cause swelling and pressure. Cellular Injury: Physical Injury? Crush cells and cause swelling and temperature variations. Cellular Injury: Immune reactions? Cells start to attack neighboring cells as a threat when they are not. Cellular Injury: Chemical Agents? Changes the cytoplasm, transportation and signaling as changes environment where cells work. EX: Nicotine and lung cells. Cellular Injury: Genetics? Cells are screwed up as a result of Moms X chromosome. Cellular Injury: Free Radical? A molecule that has an unpaired electron that can pair with another molecules (catches good and bad). The Cell Cycle: Meiosis? Reproduction of gametes. The Cell Cycle: Mitosis? Prophase, Metaphase, Anaphase, Telophase. Two identical diploid cells or daughter cells are produced. 12-24 hrs for completed cycle. Epithelial Cell Skin? Covers most internal and external body surfaces. Connective Skin Type: Two types?: Examples? Loose and dense connective tissue EX: Cartilage, bones, vascular, adipose. Muscle Skin Type? Three types? Function? Skeletal, smooth, cardiac - helps move things around the body. Neural/Nervous Skin tissue Type: Function? Transmit and receive electoral impulses across synapses. Distribution of Body Fluids: What is the main electrolyte inside the cell (Intracellular Fluid ICF)? Potassium (K+) Distribution of body fluids: What is the main electrolyte outside of the cell (Extracellular fluid ECF)? Sodium (NA) How does increased capillary hydrostatic pressure contribute to the development of edema? PRESSURE!!! WHY? Accumulation of fluid in the interstitial space due to venous obstruction, salt and water retention, and heart failure. How does decreased capillary oncotic pressure contribute to the development of edema? Decreased synthesis of plasma protein or LOSS OR DIMINISHED PRODUCTION OF PLASMA ALBUMIN (Cirrohsis, malnutrition). Increased loss of plasma proteins (Nephrotic Syndrome) Increased plasma Na+ and H20 retention (Dilution of plasma proteins). DECREASED ONCOTIC ATTRACTION OF FLUID WITHIN CAPILLARIES CAUSES FLUID TO MOVE INTO INTERSTITIAL SPACE. How does increased capillary permeability lead to the development of edema? PERMEABILITY: STATE OF A MEMBRANE THAT CAUSES IT TO ALLOW LIQUIDS TO PASS THROUGH Inflammation and immune response. Ex: Burns, inflammation, and crushing injuries. Loss of plasma proteins to interstitial space resulting in edema. How does lymphatic obstruction led to the development of edema? Lymphedema: increased fluid pushed into the tissues related to lymphatic channel that is blocked due to infection or tumor. What does the renin-angiotensin-aldosterone system do? Regulates blood pressure. Explain the renin-angiotensin system Liver produces angiotensinogen. Angiotensinogen gets in blood stream and is mixed with extracellular serum NA and urine NA leading to the production of renin. Renin turns Angiotensinogen into Angiotensin I. Lungs produce Angiotensin-converting enzyme and convert angiotensin I to angiotensin II. Angiotensin II hits the Adrenal Cortex and produces Aldosterone. Aldosterone goes to the kidneys and causes potassium excretion, increased sodium (NA) and water retention, and increased extracellular fluid leading to increased blood pressure. What is the Water Balance ADH? Anti-Diuretic Hormone: Water balance regulated by thirst perception and the ADH. ADH is STOP SIGN for body to quit expelling water and increase reabsorption of water. Released when there is an increase in plasma osmolarity or decrease in circulating blood. Explain the Water balance ADH Pathway? Increased plasma osmolarity leads to detection by brain osmoreceptors lear fluid intake leading to decreased plasma osmolarity regulating blood pressure. Decreased circulating blood/plasma volume is detected by volume receptors which notifies the hypothalamus leading to secretion of ADH and renal water absorption increasing blood/plasma volume regulating blood pressure. What is Hypernatremia? Sodium 145 mEq/L. What are the causes of Hypernatremia? Related to sodium gain or water loss and H20 water movement from the ICF to the ECF (intracellular dehydration). What are the clinical manifestations of Hypernatremia? Intracellular dehydration, seizures, muscle twitching, hypperreflexia. Treatments for Hypernatremia? Isotonic salt free fluids. What are Isotonic solutions? - Water Deficit (Dehydration) clinical manifestations? Low blood pressure, weak pulses, postural hypotension, (20 systolic or 10 diastolic), dizziness, elevated hematocrit and serum sodium (NA) levels, headaches, dry skin, and dry mucous membranes. Water deficit (Dehydration) Treatment? Oral fluids Hypotonic saline solution (5% dextrose in water). What are Hypotonic Solutions? - Causes of Hyponatremia or free water excess? Compulsive water intoxication. Clinical manifestations of Hyponatremia? Cerebral edema, Pulmonary edema. Treatments for Hyponatremia? Hypertonic saline solutions. Normal range for Potassium? 3.5-5.0 mEq/L for normal, healthy people. 4.0-4.2 for CHF patients. What hormones facilitate the potassium into cells? Aldosterone, insulin, and epinephrine. What facilitates potassium out of the cell? Insulin deficiency, aldosterone deficiency, acidosis, and strenuous exercise. What is the purpose of the Sodium Potassium pump and does it require energy? Does not require energy. Essential for transmission and conduction of nerve impulses, normal cardiac rhythms, and skeletal and smooth muscle contractions. Regulates ICF osmolarity and deposits glycogen in liver and skeletal muscle cells. Kidneys, aldosterone, and insulin secretion, and changes in pH regulate K+ balance. Causes of Hypokalemia? Potassium 3.5 Reduced potassium intake, increased potassium entry into the cell, increased potassium loss. Clinical manifestations of hypokalemia? -Decreased neuromuscular excitability, skeletal muscle weakness, loss of smooth muscle tone, cardiac dysrhythmias, U wave on ECG, weakness, leg weakness. Treatments for Hypokalemia? Replace potassium orally and/or intravenously. Causes of Hyperkalemia? K+ 5.0 mEq/L. Increased intake of potassium, shift from K+ from ICF to ECF, decreased renal excretion, hypoxia, acidosis, insulin deficiency, cell trauma, and digitalis overdose. Clinical manifestations of hyperkalemia? Tingling of lips and fingers, restlessness, intestinal cramping and diarrhea, T waves on ECG, muscle weakness, loss of muscle tone, and paralysis. Treatment for Hyperkalemia? Calcium gluconate, insulin and/or glucose, and buffered solutions, dialysis. Normal range for Calcium? 5.5-5.6 mg/dL What is the purpose of calcium? Structure of bones and teeth, blood clotting, hormone secretion, cell receptor function, and muscle contractions. Normal levels of Phosphate? 2.5-4.5 mg/dL Function of phosphate? Necessary for high energy bonds located in creatine phosphate and ATP and acts as an anion buffer and is needed for muscle contraction energy. What three hormones regulate calcium and phosphate and how? Parathyroid hormone (PTH): Increases plasma calcium levels via kidney reabsorption. Vitamin D: Fat soluble steroid; increases calcium absorption from the GI tract. Calcitonin: Decreases plasma calcium levels. What are the causes of hypocalcemia? Calcium levels 9.0 Inadequate intake or absorption, decreases in PTH and vitamin D, blood transfusions. Clinical manifestations of Hypocalcemia? Increased neuromuscular excitability (partial depolarization), muscle spasms, Chvostek and Trousseau signs, convulsions, and tetany., prolonged QT interval. Causes of Hypercalcemia? Calcium levels 10.5 mg/dL Hyperparathyroidism Bone metastasis Excess Vitamin D Immobilization Acidosis Sarcoidosis Manifestations of hypercalcemia? Decreased neuromuscular excitability, weakness, kidney stones (calcium deposits), constipation, heart block/shortened QT, and depressed widened T wave. Causes of hypophosphatemia? Serum phosphate level 2.0 mg/dL. Intestinal malabsorption, renal excretion, vitamin D deficiency, antacid use, alcohol abuse, malabsorption syndromes, refeeding syndromes. Clinical manifestations of hypophosphatemia? Diminished release of oxygen, osteomalacia (soft bones), muscle weakness, bleeding disorders (platelet impairment), leukocyte alterations, rickets. Causes of Hyperphosphatemia? Serum level 4.7 mg/dL Exogenous or endogenous addition of phosphate to ECF, chemotherapy, long term use of phosphate enemas or laxatives, renal failure. Clinical manifestations in hyperphosphatemia? MANIFESTATIONS ARE RELATED TO LOW CALCIUM LEVELS (HYPOCALCEMIA) SO SIGNS ARE THE SAME AS HYPOCALCEMIA. Increased neuromuscular excitability (partial depolarization), muscle spasms, Chvostek and Trousseau signs, convulsions, tetany, with possible calcification of soft tissue. Causes of Hypomagnesemia and clinical manifestations? Malabsorption. Associated with hypocalcemia and hypokalemia. Neuromuscular irritability, tetany, convulsions, increased reflexes. Causes of Hypermagnesemia and clinical manifestations? Renal failure. Skeletal muscle depression, muscle weakness, hypotension, respiratory depression, bradycardia. Normal range for magnesium? 1.5-3.0 Acid-Base balance scale for pH: What is it? 0-14 scale Closer to 0 is acidic with increasing Hydrogen (H+) Closer to 14 is alkaline with decreasing Hydrogen (H+) If H+ is high, pH is low (acidic). If H+ is low, pH is high (alkaline). What is the Acid-Base Balance? Acids formed as end products of protein, carbohydrates, and fat metabolism. To maintains the bodys normal pH (7.35-7.45) the H+ must be neutralized by the retention of bicarbonate or excreted. Acid base balance is mainly concerned with two ions: Hydrogen (H+) and Bicarbonate (HCO3). If pH is low, what will the lungs and kidneys do? Lungs will give off C02. Kidneys will increase rate of hydrogen secretion. What is the role of buffering systems? Buffers: Chemicals that can bind excessive H+ or OH- without significant change in pH. Most important plasma buffering systems: carbonic acid-bicarbonate system and hemoglobin. Normal arterial blood pH? 7.35-7.45 Acidosis level?