Pathophysiology Test #3

Define HYPERCAPNIA

Too much CO2 in the bloodstream(>45mm/hg).

what are respirations like if the patient is hypercapneic?

Respirations with hypercapnia are usually slow and shallow.

Define HYPOCAPNIA

Reduced CO2 in the blood

what are the respirations like if the patient is hypocapneic?

Respirations would be frequent. the patient would be hyperventilating, meanining rapid or deep breathing.

Hyperventilation is _____ and the CO2 will be ______

Hyperventilation is rapid breathing and the CO2 will be decreasing (low).

Hypoventilation is ______ and the CO2 will be _______

Slow breathing; A respiratory rate of <8 breaths per minute. Their CO2 will be increased due to retention, or less exhalation.

If the patient is HYPOventilating and their CO2 is elevated what will their neurological status be?

Patient mental status would be less responsive

What is the normal range of pH? Provide a value that is ACIDODIC

Normal Blood pH is 7.35-7.45. A value this is acidodic would be 7.21

What is the normal range of CO2 - provide a value that is ACIDODIC

Normal: 35-45 mm/Hg, Any value greater than 45 mm/Hg is considered acidic. CO2 is acidic itself!

What is the normal range of HC03 - provide a value that is ACIDODIC

22-26 meq , acidotic=18 meq( less than 22)

What respiratory pattern occurs in Diabetic Ketoacidosis?

Kussmal breathing (rapid, deep and labored breaths)

A patient with COPD will likely have a HIGH OR LOW CO2 ?

High CO2

What is a normal PaO2?

80-100 mmHg

What is a normal Oxygen saturation?

92%-100%

How does diabetes contribute to cardiac disease? What conditions?

Diabetes contributes to cardiac disease by causing chronic high blood sugar, which damages blood vessels and nerves, leading to accelerated plaque buildup (atherosclerosis), stiffened artery walls, and increased inflammation. This can lead to drastically increased risks of coronary artery disease and heart attack.

What is one thing you can teach your patient to do if they are prone to UTI's?

Proper hygiene after urination, increase fluids to keep bacteria out, circumscision if currently uncircumscised (in males), cranberry juice

A patient has BPH(benign prostatic hyperplasia) - what are 2 signs of urinary retention?

Two common signs of urinary retention are: Difficulty initiating urination- the patient strains or waits for the urine stream to start. Weak or decreased urine stream- urine flow is slow, intermittent, or dribbling, also frequent urination in small amounts

What is minimal normal urine output / hour?

0.5-1 ml/kg/hr or 30 ml/hr minimum

After a cystoscopy what do you monitor for?

Urinary retention, bleeding, signs of infection, and pain.

What position is the patient placed in for a cystoscopy?

lithotomy; This involves lying on their back with knees bent and feet placed in stirrups

List 2 causes of intrarenal therapy

trauma to kidneys, nephrotoxic drug damage, medications, CT contrast

list 2 causes of prerenal failure

Hypertension, Severe Dehydration(hypovolemia) (Also: Urinary obstructions ((kidney stones)), Heart failure)

List 2 causes of post renal failure

Benign Prostatic Hyperplasia (BPH)-enlarged prostate and Stones in the ureter (Uretolithiasis), pyleonephritis (sometimes considered intrarenal but, bacterial travels from the bladder up the ureters to the kidneys)

What are 2 S+S of BPH in an elderly patient?

Nocturia, weak/slow urine stream, urinary hesitation or freqeuency.

What are 3 S&S of hypoglycemia?

shakiness, sweating, confusion, tachycardia, hypotension

What is HgBA1C?

It's a type of test that measures the amount of glucose attached to your hemoglobin in RBCs, it represents a 3 month reflection of the average blood glucose

What is the normal range for Fasting Blood Glucose?

70-99 mg/dL normal 100-125 prediabetes, 126 and above diabetes

Why do diabetic patients experience POLYURIA?

Polyuria is caused hyperglycemia exceeding the kidneys ability to reabsorb glucose. Excess glucose spills into the urine, drawing in large amounts of water, resulting in excessive urinaton.

Why do diabetic patients experience POLYPHAGIA?

When the pancreas can't produce insulin, glucose then builds up in the blood. Because your body cannot process glucose without insulin, so it starts to rapidly break down fat and muscle for energy instead. The "starving cells" send out signals to your brain that you need energy in the form of glucose - the brain then signals that you need to eat (phagia) Poly - meaning many

Why do diabetic patients experience POLYDIPSIA?

Excess glucose in the blood forces the kidneys to produce more urine to expel the sugar, leading to significant fluid loss and triggering the brain to demand more water intake.

What are the 3P's of Hyperglycemia?

polyuria, polyphagia, polydispia

How can patients with diabetes prevent long term complications?

Managing thier diabetes by taking insulin when necccessary so there isn't excess glucose in the blood vessels that can cause damage. Maintaing normal glucose levels and control

What is diabetic nephropathy?

Diabetic neuropathy is a type of nerve damage caused by extremely high blood sugar levels. it affects about 50% of diabetics and most commonly damages nerves in the feet and legs.

what is diabetic peripheral neuropathy?

Nerve damage in the hands and feet caused by high blood sugar from diabetes (hyperglycemia), leading to symptoms like numbness, tingling, or pain.

Why do we do foot exams on all patients with diabetes?

We perform foot exams on all patients with diabetes to observe for any signs of peripheral neuropathy and poor circulation as detecting these conditions aat early stage can reduce the risk of severe infections, ulcers, gangrene, and amputations.

What is diabetic retinopathy?

Diabetic retinopathy is a complication of diabetes where chronic high blood sugar damages retinal blood vessels, causing blurred vision and even vision loss if left untreated.

What are 2 signs that the patient is in DKA?

Two signs that the patient is in DKA are fruity breath and kussmaul respirations

What is the serum osmolality in HHNK?

The serum osmolality in HHNK range is 320-400m0sm/kg. Prevents the formation of ketones since their is some insulin.

What are the glucose levels in HHNK? (Generally)

> 800

What is the primary cause of Type I DM?

Autoimmune- T-cell mediated attack of beta cells and genetic influence

What is the primary cause of Type II DM?

Result of an imbalance over time, cells become resistant to insulin (most seen in patients with chronic conditions)

Why do patients with high glucose and Type I DM develop KETONES?

lack of insulin prevents cells from using glucose for energy, which forces the body to break down fat for fuel

Why do patients with hyperglycemia and Type I DM develop acidosis? What do they break down for energy when they cells do not have access to glucose?

when insulin is deficent, glucose cannot enter the cells properly and are unable to be broken down into energy, this causes an uncotrolled fat breakdown in the liver which is converted into ketone bodies, which lowers the blood pH, leading to metabolic acidosis.

What is a clinical sign of Emphysema?

end expiratory wheezing

What is a clinical sign of Chronic Bronchitis?

Dyspnea, whezing, persistent productive cough that lasts atleast 3 months but can last up to 2 consecutive years INCREASED IN CO2 d/t mucous

What is a clinical sign of a patient who has COPD?

Dyspnea, wheezing, chronic productive cough, barrel chest

What will a patient with respiratory acidosis look like? (Clinical S&S)

hypoventilation, decreased responsiveness, muscle twitching, elevated heart rate

What will a patient with respiratory alkalosis look like? (Clinical S&S)

hyperventilation, anxious, may feel dizzy or faint

What is beta-hydroxybutyrate? How is it used to monitor patients in DKA?

Beta hydroxybutyrate is the main ketone made during DKA and is used to monitor the progression of ketone buildup in the body and the primary indicator for how far its built up

What is the treatment for HHNK?

Insulin and glucose intravenously.

What is the treatment for DKA?

Insulin and glucose intravenously.

Why does the patient have KUSSMAUL respirations in DKA?

Kussmaul respirations are the body’s attempt to correct metabolic acidosis by “breathing off” CO₂.- deep rapid breathing

What shape the chest of a person with long standing COPD?

Barrel Chest. This shape is characterized by an increased, rounded, and bulging appearance of the chest, where the diameter from front to back (anterior-posterior) becomes nearly equal to the width from side to side. It resembles a permanent, deep inhalation

What lung sounds will you hear on a patient with COPD?

A patient with COPD will experience abnormal lung sounds like high-pitched wheezing, crackles, and rhonchi. These indicate that there is airway obstruction and inflammation.

What are 2 signs of respiratory distress?

Rapid breathing and labored breathing (using accesory muscles, or SOB)

What are 2 S&S of a UTI in the elderly patient population?

confusion, malodorous urine(smelly), cloudy urine

What does a high creatinine indicate?

indicates that levels of this waste product are elevated in the blood, often signaling that the kidneys are not filtering waste efficiently

What is the normal specific gravity of urine?

1.010-1.030

Does urine normally have protein?

Yes in small amounts. ; Proteinuria (aka Microalbuminuria) - high levels of protein in urine (urine will appear foamy)

What does the Urinalysis of a patient with a UTI look like - what laboratory values will you see?

high leukoytes in a labratory results. cloudy or murky colored urine. + nitrates