Path 370 week 4

Croup is characterized by

A barking cough

Obstructive sleep apnea would most likely be found in a patient diagnosed with

Pickwickian syndrome

Metabolic alkalosis is often accompanied by

Hypokalemia

A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop

Hypophosphatemia

Diarrhea and other lower intestinal fluid losses will contribute to

Metabolic acidosis

Emesis causes

metabolic alkalosis

Respiratory acidosis may be caused by

hypoventilation

Individuals who have chronic bronchitis most often have

A productive cough

Decreased neuromuscular excitability is often the result of

Hypercalcemia and hypermagnesemia

The imbalance that occurs with oliguric renal failure is

Hyperkalemia

Which electrolyte imbalances cause increased neuromuscular excitability?

Hypocalcemia and hypomagnesemia

The hallmark manifestation of acute respiratory distress syndrome is

Hypoxemia

When exposed to inhaled allergens, a patient with asthma produces large quantities of

IgE

Allergic (extrinsic) asthma is associated with

IgE-mediated airway inflammation

A major risk factor for the development of active pulmonary tuberculosis (TB) disease is

Immunosuppression

To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke

Impairs α1-antitrypsin, allowing elastase to predominate

If an individual has a fully compensated metabolic acidosis, the blood pH is

In the normal range

What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?

Inadequate water intake

A patient has a positive Chvostek sign. The nurse interprets this as a sign of

Increased neuromuscular excitability

Uncompensated metabolic alkalosis would result in

Increased pH, increased HCO3-

Chronic bronchitis often leads to cor pulmonale because of

Increased pulmonary vascular resistance

The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by

Increased residual lung volumes

What age group has a larger volume of extracellular fluid than intracellular fluid?

Infants

Empyema is defined as an

Infection in the pleural space

A known cause of hypokalemia is

Insulin overdose

The primary cause of infant respiratory distress syndrome is

Lack of surfactant

Obstructive disorders are associated with

Low expiratory flow rates

The finding of ketones in the blood suggests that a person may have

Metabolic acidosis

Two primary acid-base disorders that are present independently are referred to as

Mixed acid-base imbalance.

Clinical manifestations of moderate to severe hypokalemia include

Muscle spasms and rapid respirations

The organism that causes pulmonary tuberculosis is

Mycobacterium tuberculosis

Which assessment would support a diagnosis of type A COPD rather than type B COPD?

Normal PaCO2, scant sputum, accessory muscle use, barrel chest

A person who experiences a panic attack and develops hyperventilation symptoms may experience

Numbness and tingling in the extremities

Asthma is categorized as an

Obstructive pulmonary disorder.

The process responsible for distribution of fluid between the interstitial and intracellular compartments is

Osmosis

A patient with flail chest will demonstrate

Outward chest movement on expiration.

Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration.

Decrease serum sodium

A patient diagnosed with chronic compensated heart failure reports that, "My feet swell if I eat salt but I don't understand why" The nurse's best response is

"Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell."

Signs and symptoms of extracellular fluid volume excess include

Bounding pulse

Causes of metabolic acidosis include

Tissue anoxia

Which complication of asthma is life threatening?

status asthmaticus

Which is indicative of a left tension pneumothorax?

Absent breath sounds on the left

Bacterial pneumonia leads to hypoxemia caused by

Accumulation of alveolar exudates

Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of

Acute respiratory distress syndrome

After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is

Associated with specific allergic triggers

Cystic fibrosis is associated with

Bronchiectasis

How do clinical conditions that increase vascular permeability cause edema?

By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure

Which acid are the kidneys unable to excrete?

Carbonic

Manifestations from sodium imbalances occur primarily as a result of

Cellular fluid shifts

A patient, who is 8 months pregnant, has developed eclampsia and is receiving intravenous magnesium sulfate to prevent seizures. To determine if her infusion rate is too high, you should regularly

Check the patellar reflex; if it becomes weak or absent, her infusion rate probably is too high and she is at risk for respiratory depression or cardiac arrest.

Causes of hypomagnesemia include

Chronic alcoholism

Total body water in older adults is

Decreased because of increased adipose tissue and decreased muscle mass.

Which alterations can lead to edema?

Decreased lymphatic flow

A restrictive respiratory disorder is characterized by

Decreased residual volume

Signs and symptoms of clinical dehydration include

Decreased urine output

A common characteristic of viral pneumonia is

Dry cough

Hyperaldosteronism causes

ECV excess and hypokalemia

What is likely to lead to hyponatremia?

Frequent nasogastric tube irrigation with water

A patient who reports an intestinal fistula also reports feeling "weak and dizzy" when she stands. While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into a supine position. What nursing interventions will the nurse implement before calling the physician?

Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.

The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient

Has chronic heart failure that is treated with diuretics

Accumulation of fluid in the pleural space is called

Pleural effusion

A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for

Pneumothorax

Legionnaires disease is characterized by

Presence of systemic illness

The person at highest risk for developing hypernatremia is a person who

Receives tube feedings because he or she is comatose after a stroke

Emphysema results from destruction of alveolar walls and capillaries, which is because of

Release of proteolytic enzymes from immune cells

All obstructive pulmonary disorders are characterized by

Resistance to airflow

The ________ system compensates for metabolic acidosis and alkalosis.

Respiratory

What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration?

Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid

How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone-related peptide monitored for the resulting electrolyte imbalance?

Serum calcium, bowel function, level of consciousness

Which change in a patient's assessment has the greatest urgency?

Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing

Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called

Tension Pneumothorax

The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment?

The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.

Osmoreceptors located in the hypothalamus control the release of

Vasopressin (antidiuretic hormone, ADH)

Clinical manifestations of extracellular fluid volume deficit include

Weak pulse, low blood pressure, and increased heart rate.

COPD leads to a barrel chest, because it causes

air trapping

Effects of hypernatremia on the central nervous system typically include

confusion

Respiratory acidosis is associated with

increased carbonic acid

A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician?

pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high

The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions.

sodium