Pathophysiology Test 3

bulk-forming laxative

fiber supplements (metamucil) taken with 8 oz. of water

for constipation, diverticulosis, IBS, stool regulation

surfactant laxatives/stool softeners

colace and peri-colace

given w/ 8 oz of fluids

for constipation, preventing fecal impaction

stimulant laxatives

dulcolax given po or supp, for constipation from opioid use or slow intestinal transit

adminstering enema

have client lay on left side with right knee flexed, lubricate 2 inches of tube, lift upper buttocks and insert toward belly button 3-4 inches, raise enema 12-18 inches above rectum

Causes of erectile dysfunction

usually cardiovascular conditions, substance abuse, low testosterone, anxiety, obesity, arthrosclerosis, peyronie’s disease (scar tissue of penis), hypertension

hypospadias

urethral opening is on underside of penis, rather than the tip

Menorrhagia

woman’s menstrual flow is excessively heavy or long

Assessment for hydration

assess client’s mucous membranes’ moisture, skin turgor, urine output and concentration, mental status, orthostatic blood pressures, and vital signs

Affects of caffeine on hydration status

weak diuretic effect, increasing urine production

potassium always has to do with…

heart and dysrhythmias

when there is a potassium imbalance…

the client will have telemetry on

Magnesium has to do with

nerve and muscle function, smooth muscle relaxation

magnesium can be used as…

antacid

Low zinc can

delay wound healing

4 calories

Calories per gram of protein

essential amino acids

can not be synthesized by us

non-essential amino acids

we can synthesize these and do not need to get them through diet

Protein deficiency effects

decreased growth in children, anemia, increase infections, delayed wound healing, loss of muscle mass, decreased immunity, weakening of heart and respiratory system, death

Protein Excess Effects

Increase weight gain, renal damage, risk for kidney stones, higher sat fat leads to increased risk for heart disease

5 and 20% rule

5% or less is low in something

20% or more is considered high

Dumping syndrome

food moves too quickly from the stomach into the small intestine

Frontal lobe

reasoning, behavior, thinking initiation,t movement, speaking, memory

temporal lobe

understanding language, behavior, memory, hearing

Brainstem

breathing, BP, heartbeat, alertness/sleep

parietal lobe

understanding spatial relationships

knowing right from left

sensation

reading

Occipital lobe

vision

color-blindness

cerebellum

balance, coordination fine muscle coordination

Neocortex

affects decision-making, judgement, and insight while under stress

Amygdala

responsible for anxiety, anger, and fear

Neocortex starts with “n”

nurses start with “n” too and BLANK is costantly firing

Amygdala starts with “a”

anxiety and anger also start with “a” like this brain part

Cushing’s triad

caused by additional pressure on brain stem from the increased blood and volume in cranium

3 symptoms: slow, irregular respirations, slow heart rate, high BP

when acetylcholine is depleted…

this could be indicative of alzheimer’s

seratonin depletion

depression

dopamine depletion

parkinson’s disease

Glutamate depletion

memory loss issues

serotonin

mood neurotransmitter

dopamine

responsible for movement, behavior, pleasure doing things

GABA

inhibits CNS when its acting up

EEG

put electrodes on head and put video camera in client’s room

when client stars seizing, the tests start to record

what to do when client starts seizing

protect head and protect airway, ease client to ground, put pillow under head

after seizure ends, put them on their side

For epilepsy treatment…

the client must always take their meds

water is needed for…

being the basic solvent for body’s chemical processes, maintaining temp and body’s form

Water requirements depend on…

age, activity, temperature, losses, and alcohol intake

Young children and older adults with water

they dehydrate more rapidly

major minerals

sodium, potassium, chloride, calcium, magnesium, phosphorus, and sulfur

Trace minerals

iodine, iron, fluoride

Importance of nutrients

cell growth, cell function, enzyme activity, carbs fat and protein synthesis, muscle contractions, wound healing, and immune competence

micronutrients

help manufacture, repair, and maintain cells

Fat-soluble vitamins

dissolve in fat, stored in liver and fatty tissue, only need periodic renewal, possibility of overdosing on these is greater

water-soluble vitamins

dissolve in water, stored briefly in body and excreted in urine, must be replenished each day (think vitamin C)

Fat-soluble vitamins

Vitamin A, D, E, K

needed for metabolism and prevention of diseases

important for growth, pregnancy, lactation, and healing

help break down macros to be used for energy

vitamin A

vision, embryonic development

from fortified cereals, dark yellow or orange fruits, carrots, broccoli

if deficient: vision changes

vitamin D

fatty fish, tuna, mackeral, salmon, sunlight

maintain blood calcium and phosphorus

vitamin E

vegetable oils, almonds, peanuts, hazelnuts, green leafy veggies

protects A from oxidation

vitamin K

green leafy veggies, responsible for clotting factors

water-soluble vitamins

b-complex and C

B-complex

milk, cheese, eggs

vitamin c

citrus fruits

B6

cellular function, heme and neurotransmitter synthesis

found in meats, grains, and legumes

Folate

synthesis of amino acids, hemoglobin, formation of fetal neural tube

found in meats, clams, oysters, eggs, dairy

B12

folate activation, red blood cell maturation

found in meats, clams, oysters, eggs, dairy products

vitamin C deficiency

scurvy, decreased iron absorption, bleeding gums

Vitamin A deficiency

reduced night vision, dry corneas, mucosa changes

Vitamin D deficiency

rickets, fragile bones, osteomalacia

Vitamin E deficiency

anemia, edema, and skin lesions

Vitamin k deficiency

increased bleeding times

B6 deficiency

macrocytic anemia, CNS disturbances, poor growth

Folic acid deficiency

megaloblastic anemia, CNS disturbances

B12

folate activation, red blood cell maturation

Major minerals are needed…

100 mg a day or more

trace minerals are needed…

less than 100 mg per day

Sodium

maintains fluid volume, allows muscle contractions, contributes to nerve impulses

sodium deficiencies

muscle cramping, headache, confusion, memory loss, anorexia, tachycardia

monitor LOC, edema, and BP, treat w/ NaCl

potassium

maintains fluid volume inside cells, muscle action

from oranges, dried fruit, tomatoes, avocados, dried peas, meats, bananas

calcium

bones construction, teeth formation, bp, blood clotting, nerve conduction

sources of calcium

dairy, broccoli, kale, fortified grains

calcium deficiency

tetany, positive Chvostek’s and Trousseau’s signs, ECG changes, osteoporosis, poor growth, numbness and tingling

monitor ECG, respiratory status, give Vitamin D supplements

magnesium

for bone formation, catalyst for enzyme reactions, nerve/muscle function, smooth muscle relaxation

found in green leafy veggies, nuts, whole grains, tuna, chocolate

magnesium deficiencies

weakness, dysrhythmias, convulsions, increased BP, anorexia

follow seizure precautions and monitor LOC

iron

responsible for O2 distribution in hemoglobin and myoglobin

in meat, fish, legumes, grains, and veggies

iron deficiency

anemia, fatigue, SOB

zinc found in

at least 100 enzymes

obesity

excessive intake of calories that leads to storage of fat in tissues and organs

what can lead to obesity

cushing’s syndrome, hypothyroidism, pregnancy

adipocytes

endocrine cells that secrete adipokines, affect metabolism, affect insulin sensitivity

treatments for obesity

lifestyle changes such as weight-loss efforts, appetite suppressing meds, bariatric surgery, doctor-directed diet

female sexual health history

date of LMP, duration of period, sexual history, family history, length between periods, regularity of periods

Renal function

kidneys receive 1/5 cardiac output

and have a glomerular filtration rate (which reduces w/ aging)

Renal dysfunction

insufficient filtration w/ waste buildup, toxin buildup, neurological issues, excess renin (elevating BP)

decreased vitamin D which leads to decreased Ca++

increased BUN

decreased GFR, dehydration, common in extremely muscular persons, high protein diet

costovertebral angle tenderness

flank pain

hematuria

blood in urine, could be a tone

ischemic stroke

due to a clot, can be hour to days before full affect of ischemic stroke are present

causes of ischemic stroke

afib, clot disorders

hemorrhagic stroke

due to a bleed, a rupture in the brain caused by hypertension

TIA strokes

early signs of full ischemic stroke, mini stroke, last less than 24 hours

can progress

signs and symptoms of strokes

Neurological deficits on one side of body

Face drooping, Arm weakness, Speech difficulty, Time to call 911

acute phase of stroke diagnosis

CT scan w/out contrast, treatment based on whether stroke is hemorrhagic or ischemic

CT scan w/ dye

allow better visualization of ischemia