Skin Protection, Immunology, and Wound Healing, Exams of Nursing

Download Skin Protection, Immunology, and Wound Healing and more Exams Nursing in PDF only on Docsity! Patho NR 283 exam 1 In regards to chromosomal mutation, nondisjunction is known as what? Correct answer- Failure of homologous chromosomes to separate during cell division What is an example of an autosomal-dominant disease? Correct answer- Huntington's disease What is an example of an autosomal-recessive disease? Correct answer- Cystic fibrosis What is an example of an X-linked condition? Correct answer- Red - green color blindness What is an example of multifactorial inheritance? Correct answer- Pyloric stenosis Knowing physiologic signs of injury you might expect the following system is consistent with systemic manifestations of cellular injury during a myocardial infarction (select all that apply) A. Elevated aspartate aminotransferase (AST/SGOT) C. Increased leukocytes D. Pain E. Increase heart rate F. Fever G. Elevated Creatinine Kinase H. Elevated alanin aminostransferase (ALT/SGPT) Correct answer- A. elevated aspartate aminotransferase C. increased leukocytes E. increased HR G. elevated creatinine kinase H. elevated alanin aminostransferase The nurse teaching an elderly client about the aging process includes which changes that occur as part of the normal aging process? (select all that apply) A. Increase in total body potassium concentration B. Increased gastric emptying C. Decreased muscle tone D. Wrinkling and atrophy of the epidermis E. Increase in peripheral resistance to blood flow F. Increased formation of autoantibodies Correct answer- A. Decreased muscle tone, wrinkling in atrophy of the epidermis E. increase in peripheral resistance to bloodflow F. increased formation of auto antibodies What else is it about the skin that protects individuals from injury and disease? Correct answer- Pathogens can be sloughed off by mechanical means, such as falling off in dead skin cells, coughing or sneezing, vomiting, or flushing from the urinary tract in urine. How might the characteristics of skin and the bodily fluids associated with it also help to protect us from infection? Correct answer- There is a low pH on the skin and stomach that generally inhibits microorganisms If inflammation is considered a first responder and may be considered to be a hero, at least when it is in a controlled state, what heroic acts may be attributed to it? How might the swelling associated with inflammation actually help with the healing process? Erythema and warmth at a site of injury typically cause discomfort, but how might one take solace in the fact that the response is being initiated? Correct answer- It prevents and/or limits infection and additional damage by initiating the influx of plasma, plasma proteins, plasma enzymes, and the distribution of leukocytes from the blood vessels to the injury. It recruits members of the adaptive immunity community to launch a more specific defense against the pathogens and enhances the healing process. What causes redness at the site of inflammation? Correct answer- Vasodilation of arterioles from the histamine triggered by mediators or mast cells but then spasm to stop the bleeding What is brought to the injured site when the vasodilation occurs? Correct answer- Neutrophils, monocytes, oxygen, nutrients to dilute toxins With vasodilation that dilates the capillaries, what lines the vessels? Correct answer- Leukocytes How do the traveling leukocytes (neutrophils and monocytes) arrive at the tissue where the site of the infection is present? Correct answer- The cell squeeze through the gaps in the capillary walls to enter at the site of the infection What does phagocytosis do at the site? Correct answer- Digests the foreign substances cellular debris Why is fibrinogen important at the site of injury? Correct answer- Fibrinogen transforms into fibrin to wall off the injured area, taking the foreign substances to make a mesh to support blood clotting and healing differentiate between the terms metaplasia and malignant neoplasm Correct answer- METAPLASIA - occurs when one mature cell type is replaced by different mature cell type is functional MALIGNANT NEOPLASM - referred to as cancer and involve dysplastic tissues Describe the changes in a cell that lead to: A. loss of function B. necrosis Correct answer- A. LOSS OF FUNCTION - preceded by changes in so metabolism because of changes in structure and function B. NECROSIS - the death of groups of cells caused by processes such as cells being liquefied by certain enzymes (liquefaction necrosis), cell proteins being altered or denatured (coagulative necrosis), breakdown of fats by enzymes (fat necrosis), or formative of a thick "cheesy" substance that later leads to liquefication (caseous necrosis) Apoptosis Correct answer- programmed cell death gangrene Correct answer- an are of ischemic and necrotic tissue that has been invaded by bacteria CJ is having surgery next week to remove a malignant breast tumor following discovery of a lump in the breast and a biopsy. her mother and aunt have had breast cancer. CJ is taking medication for high blood pressure. Match the significant information in the preceding question to the appropriate term: diagnosis, medical history, etiology, prognosis, benign neoplasm, iatrogenic, signs, complication, treatment, cancer, examination of living tissue. (some terms may not be used or may be used more than once) Correct answer- malignant breast tumor and high blood pressure = diagnosis high blood pressure and family cancer = medical history medication = treatment surgery = treatment and diagnosis biopsy = examination of living tissue Describe the locations of intracellular and extracellular fluids Correct answer- INTRACELLULAR FLUID: fluid contained within the cells EXTRACELLULAR: includes all fluids outside the cells, such as blood, interstitial fluid, CSF, digestive tract secretions, plural fluid, and lymph which makes up the higher proportion of body fluid: intracellular fluid or extracellular fluid? Correct answer- intracellular fluid makes up the higher proportion of body fluid how does the proportion of fluid in the body change with age? Correct answer- The proportion of fluid in the body decreases throughout the lifespan Why does dehydration affect cell function? Correct answer- dehydration affects cell function because the transport of nutrients into the cell and removal of wastes from cell are decreased impairing cell metabolism and function Is the function of sodium ion in the body? Correct answer- Sodium ions help me teen extracellular fluid (as the major cation exerting osmotic pressure), contribute to neuromuscular function and play a role an acid-base balance in metabolic processes Describe the effect of hypernatremia on extracellular fluid volume and on intracellular fluid volume Correct answer- Hypernatremia tends to increase extracellular fluid volume by drawing water out of the cells thus decreasing intracellular volume state the primary location (compartment) of potassium Correct answer- the primary location of potassium is in the intracellular compartment how are sodium and potassium levels controlled in the body? Correct answer- I'll Doster own in the kidney control sodium and potassium levels through the exchange of Na+ and K+ in the renal tubes describe the signs and symptoms of hypocalcemia Correct answer- Signs and symptoms of hypocalcemia include skeletal muscle twitches and tetany numbness in tingling in the face and fingers and weak cardiac contraction describe how a deficit of vitamin D would affect: A. bones B. serum calcium level Correct answer- A. vitamin D deficit would lead to bone demineralization and decrease bone density B. a low serum calcium level explain how hypochloremia affects acid-base balance Correct answer- Hypochloremia leads to increased serum bicarbonate levels as bicarbonate moves out of the red blood cells to maintain an electrochemical neutrality by making up for a low chloride level. Increased serum bicarbonate results in higher serum pH or alkalosis state the normal range for pH for: A. blood B. urine Correct answer- A. blood 7.35 - 7.45 B. urine 4.5 - 8 Describe how very slow, shallow respirations are likely to affect: A. PCO2 B. serum pH Correct answer- A. increase PCO2 B. decrease serum pH (increase carbonic acid) state 3 possible causes of metabolic acidosis Correct answer- Metabolic acidosis may occur with infection (increased BMR), renal disease (retention of acids), severe vomiting or diarrhea (loss of bicarbonate and increased acids), starvation, or diabetic ketoacidosis (increased acid production). A diabeitc client is producing excess amounts of ketoacids. A. describe the effects of this excess on serum bicarbonate levels and serum pH. B. explain the possible compensation for this imbalance C. describe the signs of this compensation Correct answer- A. Ketoacids bind with bicarbonate ions, decreasing serum bicarbonate and serum pH. B. Respirations increase. Kidneys excrete more acids and increase bicarbonate production and reabsorption. C. Rate and depth of breathing increase, and urine has a low pH (pH = 5). The respirations that accompany metabolic acidosis are frequently called Kussmaul's respirations or "air hunger". What is the purpose of such respirations Correct answer- Carbon dioxide or carbonic acid levels in the blood decrease, resulting in decreased total acid levels in the body. A person is found unconscious. He is wearing a Medic-Alert bracelet for diabetes and his breath has the typical odor of acetone (ketoacids) A. predict the serum pH and the rationale for this prediction B. predict his serum potassium level Correct answer- A. Serum pH is less than 7.35 because acidosis depresses CNS function. Bicarbonate raises serum pH to normal by combining with ketoacids. B. The serum potassium level is elevated because of acidosis. how does insulin administration affect serum potassium? Correct answer- Insulin reduces serum potassium by promoting the movement of potassium into cells. A person will probably become very dehydrated as ketoacidosis develops. what hear rate and pulse characteristics would you expect to be present in this dehydrated condition? Correct answer- The pulse would be weak and thready because of hypovolemia. When CNS function is decreased, the heart rate is slow or irregular. prolonged strenuous exercise usually leads to an increase in lactic acid. given your knowledge of normal circulation, explain why it is helpful to have a cool-down period with mild exercise rather than total rest immediately after strenuous exercise. Correct answer- Mild exercise promotes continued circulation to remove lactic acid from muscle tissue, decrease acidosis, and restore oxygen reserves. C. it can cause left sided heart failure D. it may result from changes in the pulmonary vasculature E. it can cause right sided heart failure F. it is caused by stress Correct answer- A. it may result from hyposemia due to COPD B. it is known as a cor pulmonale E. it can cause right sided heart failure a pulmonary embolism is which? (select all that apply) A. caused by walking too much, biking, and swimming B. caused by a blood clot in the deep veins C. a roadblock to gas exchange D. damaging to the lung E. caused by injury, surgery or inherited disorders Correct answer- B. caused by a blood clot in the deep veins C. a roadblock to gas exchange D. damaging to the lung E. caused by injury, surgery or inherited disorders symptoms of TB include A. increase in energy B. weight gain C. weight loss D. bloody sputum E. daytime fever F. night sweats Correct answer- C. weight loss D. bloody sputum F. night sweats Which are risk factors for TB (select all that apply) A. inadequate nutritional support B. diminished immune system C. crowded living conditions D. homelessness E. adequate nutritional support Correct answer- A. inadequate nutritional support B. diminished immune system C. crowded living conditions D. homelessness TB disease progression can be stopped by which? (select all that apply) A. Appropriate antibiotics B. TB skin test C. Appropriate antivirals D. A healthy immune system Correct answer- A. appropriate antibiotics D. a healthy immune system Tuberculosis is A. caused by mycobacterium B. diagnosed by a chest X-ray and sputum culture C. caused by human immunodeficiency virus D. highly contagious E. difficult to catch Correct answer- A. caused by mycobacterium B. diagnosed by a chest X-ray and sputum culture D. highly contagious viral pneumonia has the following characteristics (select all that apply) A. diagnostic tests include spiral CT , BMP B. S/S include cough, fever chills and malaise C. more virulent than bacterial pneumonia D. less virulent than bacterial pneumonia E. can lead to bacterial infections F. diagnostic tests include chest X-ray, CBC G. high risk if immunocompromised Correct answer- B. S/S include cough, fever, chills and malaise D. less virulent than bacteria pneumonia E. can lead to bacterial infections F. diagnostic tests include chest X-ray, CBC G. high risk of immunocompromised Can you think of conditions where the person is not exhaling the CO2 and why? Correct answer- hypoventilation as in respiratory failure, drug overdose, central nervous depression not telling the brain to breathe due to high CO2 levels, COPD due to trapped air in alveoli that can't remove the stuck CO2, conditions where the lungs are not able to expand (e.g., pulmonary edema) or bronchi are inflamed with bronchoconstritction and filled with mucus (asthma, pheumonia), or airway obstruction not allowing the CO2 to escape through the trachea Describe the client who is in a state of respiratory acidosis with symptoms based on the high levels of CO2 that crossed the blood brain barrier. Correct answer- headache, blurred vision, muscle twitching or tremors, dizziness, diaphoresis, irritability, disorientation, lethargy, blood pressure and heart rate fluctuations, coma To remove the CO2, we want the person to be ventilated, which also will relieve the associated hypoxia from not breathing adequately. Describe the measures needed to alleviate the contributing factors in the development of the respiratory acidosis. Correct answer- provide oxygen or mechanical ventilator if the patient is unable to breathe on his or her own. put the patient in a high fowlers breathing position to allow greater movement of the chest cavity, begin medications that increase dilation of bronchi and removal of mucus (liquefy and cough up mucus secretions), remove obstructions (e.g., food or toy in airway), provide antibiotics for infectious organisms. What conditions could cause a mild chronic level of respiratory acidosis due to the lungs never exhaling the CO2 adequately? Correct answer- obstructive sleep apnea or extreme obesity Describe conditions that would lead to a client breathing faster or hyperventilating, which leads to respiratory alkalosis Correct answer- Acute anxiety or panic attack, pain, fever that tells the body to breathe faster to increase the oxygen that is needed, gram- negative septicemia triggering the respiratory center to increase breathing, levels of mechanical ventilation that are too high, and any state that causes the metabolism to increase to speed up breathing because more oxygen is needed. Describe the symptoms observed with respiratory alkalosis Correct answer- dizziness, muscle irritability, anxiety, inability to concentrate, numbness, dry mouth, diaphoresis, seizures, feelings of faintness, coma What symptoms are the same for both alkalosis and acidosis? Correct answer- dizziness, muscle twitching and irritability, disorientation and confusion, diaphoresis, coma What would the respiratory rate range be like if you are experiencing respiratory alkalosis? Correct answer- it can be as high as 40/minute, like panting A. explain why a cast placed around a fractured leg in which extensive tissue damage has occured might be too tight after after 24 hrs? B. explain why such a cast might become loose in 3 weeks Correct answer- A. Inflammation related to tissue damage causes increasing edema for at least 48 hours under the rigid, non-expandable cast. B. Inflammation has subsided and muscle atrophy has occurred because of immobility. list specific reasons why the inflammatory response is considered a body defense mechanism Correct answer- Pain and visible redness provide warning of tissue injury. Increased fluid at the site dilutes any toxic material. Fibrin mesh and leukocytes localize (wall off) the causative agent. Migration of phagocytic cells, leukocytes, and antibodies (globulins) to the area combat or destroy the agent, and remove debris in preparation for healing. A. explain the rationale for each of the following with acute inflammation: (i) warmth, (ii) fever.