170 Final Exam master set

Osmosis

Movement of water from lower solute concentration to higher solute concentration across semipermeable membrane.

Diffusion

Movement of particles from high concentration to low concentration until equilibrium is reached.

Filtration

Movement of water/solutes from high pressure to low pressure; driven by hydrostatic pressure.

Active Transport

Movement of molecules against concentration gradient requiring ATP; example sodium-potassium pump.

Intracellular Fluid

Fluid inside cells; about two-thirds of total body fluid; potassium major cation.

Extracellular Fluid

Fluid outside cells including interstitial, plasma, transcellular; sodium major cation.

Isotonic Solution

Same osmolality as plasma; no fluid shift. Examples NS and LR.

Hypotonic Solution

Lower osmolality than plasma; water moves into cells causing swelling. Example 0.45 NS.

Hypertonic Solution

Higher osmolality than plasma; pulls water out of cells. Example 3 percent saline.

Fluid Volume Deficit

Loss of water and electrolytes causing dehydration, hypotension, tachycardia, poor skin turgor.

Fluid Volume Overload

Excess fluid causing edema, crackles, JVD, hypertension, weight gain.

Third Spacing

Fluid shifts into interstitial spaces and is unavailable for circulation.

Hyponatremia

Na less than 135; confusion, seizures, headache, muscle cramps.

Hypernatremia

Na greater than 145; thirst, agitation, dry mucosa, neuro changes.

Hypokalemia

K less than 3.5; weakness, ileus, flattened T waves, arrhythmias.

Hyperkalemia

K greater than 5; peaked T waves, dysrhythmias, muscle weakness.

Hypocalcemia

Tetany, Chvostek sign, Trousseau sign, seizures.

Hypercalcemia

Stones bones groans psychiatric overtones.

Hypomagnesemia

Tremors, increased reflexes, torsades risk (prolonged QT intervals)

Hypermagnesemia

Hyporeflexia, respiratory depression, hypotension.

Hypophosphatemia

Weakness, respiratory muscle failure.

Hyperphosphatemia

Common in renal failure; often inverse with calcium.

Basic Metabolic Panel

Measures sodium potassium chloride CO2 glucose BUN creatinine calcium.

24 Hour Urine

Measures kidney function and protein excretion.

Insulin

Lowers blood glucose by moving glucose into cells.

Glucagon

Raises blood glucose by stimulating glycogen breakdown.

Cortisol

Stress hormone increases blood glucose.

Aerobic Metabolism

ATP production with oxygen.

Anaerobic Metabolism

ATP without oxygen; produces lactic acid.

Type 1 Diabetes

Autoimmune destruction of beta cells; no insulin production.

Type 2 Diabetes

Insulin resistance with impaired secretion.

DKA

Hyperglycemia ketosis metabolic acidosis; mostly type 1.

HHS (Hyperosmolar Hyperglycemic State)

Extreme hyperglycemia dehydration without significant ketosis; Mostly type 2.

Hemoglobin A1C

Reflects average glucose over 3 months; goal >7%

Venous Thromboembolism

Includes DVT and pulmonary embolism.

Deep Vein Thrombosis

Clot in deep vein; unilateral swelling pain warmth.

Virchow Triad

The cornerstone mechanism for thrombosis: venous stasis, endothelial injury, hypercoagulability.

Pulmonary Embolism

Clot in lung causing sudden dyspnea chest pain tachycardia.

Arteriosclerosis (-io)

Hardening/thickening of arteries.

Atherosclerosis (-o)

Plaque buildup in arteries causing narrowed blood flow.

Intermittent Claudication

Leg pain with exercise relieved by rest; PAD sign.

Ischemia

Inadequate tissue perfusion and oxygenation.

Ankle-Brachial Index (ABI) Test

Quick non-invasive procedure that compares BP in ankle w/ BP in arm — used to dx Peripheral Arterial Disease (PAD)

Ankle-Brachial Index (ABI) normal result

1.0-1.3

Cardiac Output

HR x SV

Preload

Volume filling ventricle before contraction.

Afterload

Resistance heart pumps against.

Stroke Volume

Amount ejected per beat.

Renin Angiotensin Aldosterone System (RAAS)

System that increases blood pressure and fluid retention.

Primary Hypertension

Elevated BP without identifiable cause.

Preeclampsia

HTN in pregnancy with proteinuria and organ involvement.

Hypoxemia

Low oxygen in arterial blood.

Hypercapnia

Elevated CO2.

ABG Normal Values: pH

pH 7.35-7.45

ABG Normal Values: PaCO2

PaCO2 35-45

ABG Normal Values: HCO3

HCO3 22-26

ABG Normal Values: PaO2

PaO2 80-100

Respiratory Acidosis

Low pH high CO2; hypoventilation.

Respiratory Alkalosis

High pH low CO2; hyperventilation.

Metabolic Acidosis

Low pH low HCO3; DKA renal failure.

Metabolic Alkalosis

High pH high HCO3; vomiting diuretics.

COPD

Chronic airflow limitation; emphysema and chronic bronchitis.

Asthma

Reversible airway inflammation and bronchoconstriction.

Benign Neoplasm

Localized noninvasive growth.

Malignant Neoplasm

Cancerous invasive growth with metastasis.

Differentiation

How mature and specialized a cell is.

Metastasis

Spread of cancer to distant sites.

Neutropenia

Low neutrophils increases infection risk.

Thrombocytopenia

Low platelets increases bleeding risk.

Leukemia

Cancer of blood forming tissues.

Chemotherapy

Kills rapidly dividing cells; causes marrow suppression.

Radiation

Uses ionizing energy to destroy cancer cells.

Bone Marrow Transplant

Replaces diseased marrow.

HPV Vaccine

Prevents HPV related cancers.

Pap Smear

Screening for cervical cancer.

PSA

Test associated with prostate screening.

Menopause

Permanent cessation of menses due to ovarian decline.

Erectile Dysfunction

Inability to achieve or maintain erection.

Peaked T waves

Hyperkalemia

Muscle cramps confusion seizures

Check sodium imbalance

Unilateral calf warmth swelling

Suspect DVT

Sudden dyspnea pleuritic chest pain

Suspect PE

Crackles JVD edema

Fluid overload

Polyuria polydipsia polyphagia

Diabetes

Kussmaul respirations fruity breath

DKA

Positive Chvostek sign

Hypocalcemia

Leg pain relieved by rest

PAD

Pregnant patient HTN proteinuria

Preeclampsia

Hypertension Pathophysiology

Chronic elevated arterial pressure increases afterload and damages vessels, heart, kidneys, brain, and eyes.

Hypertension Risk Factors

Age, family history, obesity, smoking, diabetes, high sodium diet, sedentary lifestyle, stress.

Hypertension Signs and Symptoms

Often silent; may include headache, vision changes, dizziness; severe HTN can cause organ damage.

Hypertension Diagnostics

Repeated BP readings, BMP, urinalysis, renal labs, lipid panel, ECG.

Hypertension Nursing Interventions

Monitor BP, low sodium diet, administer antihypertensives, teach adherence, monitor for end organ damage.

Hypertension NCLEX Clues

Hypertensive emergency with neuro changes/chest pain requires immediate treatment.

Peripheral Arterial Disease Pathophysiology

Atherosclerotic narrowing decreases arterial blood flow causing ischemia.

Peripheral Arterial Disease Risk Factors

Smoking, diabetes, HTN, hyperlipidemia, age.

Peripheral Arterial Disease Signs

Intermittent claudication, cool extremity, diminished pulses, pallor, ulcers on toes.

Peripheral Arterial Disease Diagnostics

ABI, Doppler studies, angiography.

Peripheral Arterial Disease Nursing Care

Promote walking, foot care, smoking cessation, avoid crossing legs, monitor circulation.

Peripheral Arterial Disease NCLEX Clues

Pain relieved by dangling legs and diminished pulses suggests arterial disease.