412 Patho Exam 3

The 7-P's of acute embolism are?

1. pistol shot (acute onset), 2. pallor, (loss of color of the skin) 3. polar (cold), 4. pulselessness, 5. pain, 6. paresthesia, (pins and needles) 7. paralysis.

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for:

A major symptom of a dissecting aneurysm is the abrupt presence of excruciating pain, described as tearing or ripping. Pain associated with dissection of the ascending aorta frequently is located in the anterior chest, and pain associated with dissection of the descending aorta often is located in the back.

A 23-year-old man is admitted to the hospital. He is experiencing polyphagia, polyuria, and polydipsia. He states that the condition has come on very suddenly. This client is likely to require what treatment?

Exogenous insulin injections

cardiac output

The volume of blood ejected from the left side of the heart in one minute.

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for treatment of hypertension. What expected outcome does the nurse expect this medication will have?

Will prevent the conversion of angiotensin I to angiotensin II

ACE inhibitors

"PRIL" Captopril, Enalapril, Afosiopril Antihypertensive. Blocks ACE in lungs from converting angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP, Decreased Aldosterone secretions, Sodium and fluid loss. Check BP before giving (hypotension) *Orthostatic Hypotension

circulatory system

(aka cardiovascular system) This system works as the transportation highway for the body. It consists of the heart, blood, and blood vessels. It transports substances such as oxygen, carbon dioxide, and nutrients in the body.

Diuretics

*medications administered to increase urine secretion in order to rid the body of excess water and salt. *Diuretics, such as the thiazides, *Aldosterone antagonist (potassium depletion) diuretics, *Lower blood pressure initially by decreasing vascular volume (by suppressing renal reabsorption of sodium and increasing salt and water excretion) and cardiac output.

The nurse knows that the renin-angiotensin-aldosterone system (RAAS) is an important mechanism in blood pressure control. Which physiologic events will activate this system? Select all that apply.

-Adrenergic (sympathetic) stimulation -Decreased blood sodium -Fall in blood pressure -Decreased blood volume

Diuretics

Diuretics are usually the least expensive, and are usually well tolerated by most clients.

1. The nurse and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. The nurse teaches the student that epinephrine will cause which effect on blood glucose levels?

Blood glucose will elevate.

Which criterion about insulin would prompt a diagnosis of type 1 diabetes?

Complete failure of insulin secretion

An older adult client is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an older adult taking this class of drug?

Particular caution should be used in people who are at risk for orthostatic hypotension (e.g., those with diabetes, autonomic nervous system dysfunction, and older adults).

A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 218 mg/dL (12.1 mmol/L) and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject?

Short-acting (regular) insulin is used to facilitate metabolism of the food that is being eaten.

peripheral vascular resistance

The force exerted against the blood flow and is determined by the diameter of the vessel. The lower the vascular resistance the less force is needed to eject the blood out of the heart during systole.

cardiac function

The heart generates high hydrostatic pressure to pump blood (o2 rich) out of the heart (through the arteries), while also creating low pressure (o2 poor through veins) to bring it back in.

The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which risk factor in the teaching?

Woman with a family history of diabetes

A nurse is evaluating clients for the risk of developing type 2 diabetes. Which client has the highest risk for developing this metabolic disorder?

a) A middle-aged obese adult with a sedentary lifestyle

Angina

chest pain, reduced blood flow to the heart. Signs are the typical displays of cardiac distress: jaw chest, neck or back pain

Somogyi effect

early-morning hyperglycemia that occurs as a result of nighttime hypoglycemic episodes snack in the middle of the night

venous insufficiency

edema, brown pigmentation, ulcers, impaired nutrition of tissues, stasis dermatitis. Caused by varicose veins or valvular incompetence (spreading apart too far not able to do its job, putting double load on closest valve)

cardiac tamponade

pressure on the heart caused by fluid in the pericardial space

venous stasis

stagnation of normal blood flow, blood not moving,

Afterload

the amount of resistance to ejection of blood from the ventricle

stroke volume

the volume of blood pumped out by a ventricle with each heartbeat

Preload

volume of blood in ventricles at end of diastole

A client has been prescribed a thiazide diuretic, hydrochlorothiazide (HCTZ), for the initial treatment of hypertension. What effect does the nurse know this drug will have on the body to consequently decrease blood pressure?

Decrease vascular volume

Artery walls

Has three layers, thick walled, high blood pressure 1. Tunic 2. Tunic media 3. Tunic

Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often follows the vascular response in anaphylaxis?

Laryngeal edema R: The vascular response in anaphylaxis is often accompanied by life-threatening laryngeal edema and bronchospasm, circulatory collapse, contraction of gastrointestinal and uterine smooth muscle, and urticaria (hives) or angioedema.

A client who has just been diagnosed with mitral valve stenosis tells the nurse that he has heard of the disease but he does not know anything about it. What would be the nurse's best response?

Mitral valve stenosis is a defect of the mitral valve which causes obstruction of blood flow

Research has identified a cycle of insulin-induced posthypoglycemic episodes. What is this phenomenon called?

The Somogyi effect describes a cycle of insulin-induced posthypoglycemic episodes

varicose veins

abnormally Dilated, swollen and twisted veins, usually occurring in the legs cased by gravity

Dawn phenomenon

an increase in blood glucose in the early morning, most likely due to increased glucose production in the liver after an overnight fast

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

beta cells that secrete insulin and amylin

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which organ does the nurse recognize is reliant on glucose as the major energy source?

brain and nervous system rely almost exclusively on glucose as a fuel source.

valvular regurgitation

leaking of blood backward through a valve that does not close tightly