NUR 226 Exam 2 Fact Sheet: Pathophysiology and Pharmacology

Vocabulary flashcards covering core concepts of immunology, autonomic and respiratory pharmacology, antimicrobials, fluid dynamics, and fluid-electrolyte imbalances from NUR 226 Exam 2.

Innate Immunity

Rapid, nonspecific defenses that include anatomical and chemical barriers such as skin, mucosa, and stomach acid, as well as complement, neutrophils, macrophages, natural killer cells, mast cells, basophils, and eosinophils.

Adaptive Immunity

Antigen-specific immunity in which B cells generate antibodies, T cells coordinate immune responses or destroy infected cells, and memory cells accelerate responses upon re-exposure.

Active Immunity

An adaptive immune response produced following an infection or vaccination.

Passive Immunity

Temporary immune protection conferred via preformed antibodies acquired from a mother or through immune globulin.

Beta-1 Adrenergic Receptors

Adrenergic receptors that increase heart rate, augment myocardial contractility, and stimulate renal renin release.

Beta-2 Adrenergic Receptors

Adrenergic receptors that mediate bronchial smooth muscle relaxation.

Alpha-1 Adrenergic Receptors

Adrenergic receptors that mediate vasoconstriction.

Albuterol

A short-acting beta-2 agonist (SABA) used as a rapid rescue bronchodilator; adverse effects include tremor, tachycardia, palpitations, and potential hypokalemia.

Salmeterol

A long-acting beta-2 agonist (LABA) indicated for maintenance therapy rather than acute rescue; in asthma, it must be combined with an inhaled corticosteroid and never used as monotherapy.

Montelukast

A leukotriene receptor antagonist used for preventative asthma and allergy management, not acute rescue; requires monitoring for serious alterations in mood, behavior, sleep, and suicidal thoughts.

Sepsis

Life-threatening organ dysfunction resulting from a dysregulated host response to infection, wherein excessive inflammatory vasodilation and microvascular leakage compromise organ perfusion.

Vancomycin

A glycopeptide antimicrobial that inhibits Gram-positive cell-wall synthesis; IV dosing requires monitoring for renal toxicity and infusion reactions, whereas the oral formulation treats intestinal C. difficile.

Gentamicin

A bactericidal aminoglycoside antibiotic that inhibits the $30\text{S}$ ribosomal subunit; primary toxicities include nephrotoxicity and ototoxicity.

Ciprofloxacin

A fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase; associated with tendon rupture, peripheral neuropathy, CNS effects, and dysglycemia.

TMP-SMX (Trimethoprim-Sulfamethoxazole)

A sulfonamide/trimethoprim combination antibiotic providing sequential folate pathway inhibition; carries risks of rash, severe skin reactions, blood dyscrasias, and hyperkalemia.

$$\text{Na}^+/\text{K}^+\,\text{ATPase}$$

An ATP-driven membrane pump that exports $3\,\text{Na}^+$ ions while importing $2\,\text{K}^+$ ions, maintaining electrochemical gradients required for nerve, muscle, and cardiac activity.

Renin-Angiotensin-Aldosterone System (RAAS)

A neurohormonal cascade triggered by reduced renal perfusion: renin cleaves angiotensinogen to angiotensin I, ACE converts it to angiotensin II (causing vasoconstriction), which triggers aldosterone release to increase renal sodium and water retention while promoting potassium excretion.

Antidiuretic Hormone (ADH)

A hormone synthesized and secreted by the posterior pituitary that stimulates renal water reabsorption; pathological excess leads to dilutional hyponatremia.

Third Spacing

The sequestration of bodily fluid into compartments outside the effective circulating volume, leading to situations where peripheral edema coexists with intravascular hypovolemia.

D5W ($5\%$ Dextrose in Water)

An intravenous solution that is nearly isotonic in the infusion bag but acts as hypotonic free water once glucose is metabolized; it is not indicated as primary fluid resuscitation in shock.

Hyponatremia

A serum sodium concentration below $136\,\text{mEq/L}$; reduced extracellular tonicity drives water into brain cells, presenting with headache, nausea, muscle cramps, confusion, lethargy, seizures, or coma.

Hypernatremia

A serum sodium concentration exceeding $145\,\text{mEq/L}$; increased extracellular tonicity pulls water out of cells, resulting in cellular dehydration manifested by thirst, dry tongue, restlessness, weakness, lethargy, and disorientation.

Hypokalemia

A serum potassium level below $3.5\,\text{mEq/L}$; manifests as muscle weakness, leg cramps, fatigue, paresthesias, hyporeflexia, constipation/ileus, flattened T waves, and U waves on ECG.

Hyperkalemia

A serum potassium level exceeding $5.0\,\text{mEq/L}$; manifests as muscle weakness, paresthesias, palpitations, bradycardia, peaked T waves, and widened QRS complexes on ECG.

Sodium Polystyrene Sulfonate (Kayexalate)

A gastrointestinal cation-exchange resin that exchanges sodium for potassium in the gut to enhance fecal potassium excretion; does not act rapidly enough for emergency cardiac stabilization.

Hypomagnesemia

A serum magnesium level below $1.3\,\text{mg/dL}$; characterized by neuromuscular irritability, tremors, hyperreflexia, confusion, seizures, and dysrhythmias.

Hypermagnesemia

A serum magnesium level exceeding $2.1\,\text{mg/dL}$; impairs acetylcholine release and depresses neuromuscular transmission, presenting with diminished deep tendon reflexes, muscle weakness, flushing, hypotension, bradycardia, and respiratory depression.

Hypocalcemia

A serum calcium level below $9.0\,\text{mg/dL}$; increases neuronal excitability to cause perioral tingling, paresthesias, tetany, spasms, positive Chvostek/Trousseau signs, seizures, laryngospasm, and prolonged QT interval.

Hypercalcemia

A serum calcium level exceeding $10.5\,\text{mg/dL}$; depresses neuromuscular excitability, manifesting as muscle weakness, constipation, anorexia, polyuria, thirst, nephrolithiasis, bone pain, confusion, and shortened QT interval.

Chvostek and Trousseau Signs

Physical exam indicators of latent tetany and neuromuscular excitability characteristic of hypocalcemia, also observable in conditions like hypomagnesemia or hyperphosphatemia.

Hypophosphatemia

A serum phosphate deficit (below course threshold $3.0$ or clinical $2.5\,\text{mg/dL}$); causes cellular energy depletion resulting in muscle and bone pain, weakness, confusion, tremor, seizures, and potential respiratory muscle paralysis.

Hyperphosphatemia

A serum phosphate level exceeding the reference ceiling ($4.5$); typically results from renal failure and manifests primarily as secondary hypocalcemia signs, including tetany, hyperreflexia, and soft-tissue calcifications.

Trousseau Sign

When BP cuff is inflated over patients systolic reading & leaving if for 2-3 mins, A positive sign involves the patient arm muscles activating involuntarily making the wrist & parts of the hand move

Chvostek Sign

An involuntary twitch of the facial muscles on the same side elicited by lightly tapping the facial nerve just in front of the ear