Pathophysiology I
Labs and Diagnostics
Medications
Nursing Interventions
Pathophysiology II
100
Name the cause of esophageal varices.
What is the development of thin walled collateral blood vessels related to portal HTN?
100
Interpret the following ABG: pH 7.52 pCO2 45 HCO3 40
What is Metabolic Alkalosis?
100
These two medications are given IV concurrently to stop bleeding esophageal varices.
What are vasopressin (VP) and nitroglycerin (NTG)?
100
Name one cardiac assessment and one pulmonary assessment necessary for the ongoing care of a patient with pulmonary edema.
What is HR (also BP) and respiratory rate (rhythm, use of accessory muscles, auscultation)?
100
In the process of graft rejection what happens after the APC processes the foreign antigen and presents it to a T-cell.
What is Mature helper T-cell is produced Mature cytotoxic T-cell is produced Transplanted tissue is attacked
200
Name two pathophysiologic changes in liver failure that contribute to ascites.
What is elevated BP in the liver pushes proteins out of blood vessels into sinusoids then thru liver capsule into peritoneum, hypoalbuminemia decreases colloid oncotic pressure, aldosterone is not metabolized results in Na+ and H2O retention.
200
Identify two possible complications of liver biopsy.
What are peritonitis and pneumothorax?
200
How does cyclosporine act to prevent organ rejection?
What is interferes with T cell production?
200
This type of positioning my be helpful with patients with ARDS to better match perfusion to ventilation.
What is the prone position?
200
Distinguish between hyperacute and acute rejection related organ transplant.
What is : onset for hyperacute is immediate and involves hemodynamic instability.
300
What is the role of the cytotoxic T-cells in rejection of transplanted organs?
What is they directly attack the cells of the transplant?
300
These two laboratory tests can be useful in identifying HITTS.
What are platelet count (decreased) and platelet antibody detection tests?
300
This classification of medications can be used with transplant patients and patients diagnosed with ITP and TTP and how do they function.
What is corticosteroids? Act by suppressing inflammation and immune response.
300
Name three indications for endotracheal suctioning.
What is increased respiratory rate, decrease in SaO2, and visible secretions in the ET tube?
300
Name two categories of predisposing conditions for the development of ARDS and an example of each.
What is Direct Lung Injury-aspiration of gastric contents and Indirect Lung Injury-massive trauma.
400
Define hypoxemic respiratory failure.
What is paO2 of 60mmHG or less when the patient is receiving FiO2 concentrations of 60% or greater.
400
Serum ammonia levels become elevated in end stage liver disease/hepatic encephalopathy. Explain why.
Ammonia is a by product of protein metabolism and normally goes to the liver for conversion to urea. In liver disease ammonia is shunted past the liver and/or the liver is unable to convert to urea. Ammonia crosses blood-brain barrier leads to neuro manifestations
400
How can anticoagulation be maintained in a patient with HITTS?
What is by using a direct thrombin inhibitor like lepirudin or agatroban.
400
Name four interventions appropriate for patients with TTP or ITP related to patient safety/risk for bleeding.
What is use soft toothbrush, shave with electric razor, avoid venipuncture and IM injections, and assess for bleeding-EVERYWHERE?
400
Name the phases of ARDS and when each occurs.
What is: Injury/Exudative-1-7 days after initial injury Reparative/Proliferative-1 to 2 weeks after initial injury Fibrotic-2 to 3 weeks after initial injury
500
Hemorrhage and thrombus formation characterize this syndrome.
What is Disseminated Intravascular Coagulopathy?
500
Cirrhosis affects PT (prothrombin time) in this way and why.
What is PT is increased, synthesis of clotting factors does not occur.
500
This combination of medications is frequently used in the management of ascites secondary to cirrhosis.
What are spironolactone (aldosterone antagonist) and furosemide (loop diuretic)?
500
What are the dietary recommendations for a patient with cirrhosis?
What are high calorie (3000kcal/day), high carbohydrates, moderate to low fat, sodium restricted. For protein malnutrition: branched chain amino acid supplements.
500
Distinguish between ITP and TTP in terms of effect on platelets.
What is: ITP-platelets are covered in antibodies, destroyed by macrophages when they reach spleen, survive only 1-3 days TTP-deficient in enzyme that breaks down vWF clotting factor, vWF attach to platelets, increase aggregation causing microthrombi
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