Semana 15 - Capítulo 11: Fundamentos de la Electrocardiografía - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 13 - Capitulo 10: Excitación Rítmica del Corazón - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 14 - Capítulo 82: Fisiología Femenina antes del Embarazo y Hormonas Femeninas - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 16 - Capítulo 14: Visión General de la Circulación Presión, Flujo y Resistencia - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 13 - Capítulo 81: Funciones Reproductoras y Hormonales Masculinas (y Función de la Glándula Pineal) - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 15 - Capitulo 9: Músculo Cardiaco El Corazón como Bomba y la Función de las Válvulas Cardiacas - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Copia: Semana 22 - Cap 27: Filtración Glomerular, Flujo Sanguíneo Renal y su Control - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición

Geography module unit 1 first hald

Absolutely. Your list is very broad, so the best way to study it is not to memorize every disease. We can turn it into a high-yield nursing reviewer based on: What is it? → What will I see? → What should I assess? → What should I do? → What medications/treatments matter? → What is the priority/emergency? → What should I teach? Below is a condensed master reviewer. I’ll keep it nursing-focused and use simple language. ⸻ 🩺 MEDICAL-SURGICAL NURSING REVIEWER 1. ENDOCRINE SYSTEM Diabetes Mellitus Type 1 Type 2 Main problem Little/no insulin Insulin resistance + progressive insulin deficiency Usually Younger onset, but can occur any age More common in adults Treatment Insulin required Lifestyle + oral/injectable meds ± insulin Major acute problems DKA HHS Signs of hyperglycemia “3 Ps” * Polyuria – urinating frequently * Polydipsia – excessive thirst * Polyphagia – excessive hunger Other: * Fatigue * Blurred vision * Slow wound healing * Recurrent infections Hypoglycemia Think FAST: * F – Feeling shaky * A – Altered behaviour/confusion * S – Sweating * T – Tachycardia Treatment if conscious: 15 g fast carbohydrate → recheck glucose in 15 min → repeat if necessary. Examples: * Glucose tablets * Juice * Regular pop If unconscious/severe: * Glucagon if appropriate * IV dextrose in a healthcare setting DKA Usually associated with Type 1. Think: Hyperglycemia + ketones + metabolic acidosis Signs: * Dehydration * Abdominal pain * Nausea/vomiting * Fruity/acetone breath * Kussmaul respirations * Altered LOC Priority treatment: 1. IV fluids 2. Insulin 3. Monitor/correct electrolytes, especially potassium 4. Monitor glucose and acid-base status HHS Usually Type 2. * Extremely high glucose * Severe dehydration * Altered LOC * Little/no significant ketoacidosis Major nursing priority: fluid replacement and monitoring. Diabetes teaching Remember: * Foot care * Inspect feet daily * Proper footwear * Don’t walk barefoot * Don’t cut corns/calluses yourself * Monitor blood glucose * Know signs of hypo/hyperglycemia * Medication adherence * Sick-day management * Regular eye/kidney/foot assessments ⸻ ❤️ 2. CARDIOVASCULAR SYSTEM Stroke Two major types: * Ischemic → blocked blood vessel * Hemorrhagic → bleeding Recognize stroke: BE FAST B – Balance loss E – Eye/vision changes F – Face drooping A – Arm weakness S – Speech difficulty T – Time to call emergency services Nursing priorities * ABCs * Determine last known well * Neurological assessment * Blood glucose * Prepare for CT/imaging * Swallow assessment before oral food/fluids/medications * Prevent aspiration * Maintain safety Do not give food or water until swallowing is assessed. ⸻ Myocardial Infarction (MI) Think: “Time = muscle.” Common symptoms: * Chest pressure/pain * Radiation to arm/jaw/back * Dyspnea * Diaphoresis * Nausea * Anxiety Some patients, especially older adults and people with diabetes, may have atypical or minimal pain. Nursing priorities * ABCs * ECG * Vital signs * Cardiac monitoring * IV access * Blood work including cardiac biomarkers * Oxygen if hypoxemic/clinically indicated * Administer prescribed medications promptly Common medications: * Aspirin * Nitroglycerin * Antiplatelet drugs * Anticoagulants * Beta blockers * Statins Nitroglycerin Can cause: * Hypotension * Headache * Dizziness Never combine nitrates with PDE-5 inhibitors because of potentially severe hypotension. ⸻ Heart Failure Left-sided Think Lungs * Dyspnea * Crackles * Orthopnea * Pulmonary edema * Pink/frothy sputum in severe pulmonary edema Right-sided Think Body * Peripheral edema * Weight gain * JVD * Hepatomegaly * Ascites Nursing priorities * Daily weight * I&O * Respiratory assessment * Edema assessment * Fluid/sodium management as ordered * Medication adherence Sudden weight gain can indicate fluid retention. Common drugs: * Diuretics * ACE inhibitors/ARBs/ARNI * Beta blockers * Mineralocorticoid antagonists * SGLT2 inhibitors * Digoxin in selected patients Digoxin Watch for: * Bradycardia * Nausea/vomiting * Visual disturbances * Dysrhythmias Low potassium increases risk of digoxin toxicity. ⸻ Peripheral Vascular Disease Arterial Think: “Pain + Pale + Pulseless + Cold” * Cool extremity * Weak pulses * Pale colour * Pain with activity * Poor wound healing Venous Think: “Swollen + Warm + Edema” * Edema * Warm skin * Aching * Venous ulcers often near ankles ⸻ 🩸 3. HEMATOLOGY Anemia Reduced oxygen-carrying capacity. Signs: * Fatigue * Pallor * Weakness * Dyspnea * Tachycardia * Dizziness Iron-deficiency anemia May see: * Low hemoglobin * Low ferritin * Microcytic/hypochromic RBCs Iron teaching: * Take as directed * Vitamin C can improve absorption * Dark stools are common * Constipation can occur * Liquid iron may stain teeth ⸻ Leukemia Cancer of blood-forming tissues. Possible findings: * Infection → abnormal WBC function * Anemia → fatigue/pallor * Bleeding → low platelets * Bone/joint pain Think: Leukemia = infection + anemia + bleeding Nursing priorities: * Infection prevention * Bleeding precautions when indicated * Monitor CBC * Oral care * Avoid unnecessary invasive procedures * Monitor treatment adverse effects ⸻ 🍽️ 4. GASTROINTESTINAL SYSTEM Crohn’s vs Colitis Crohn’s Ulcerative Colitis Can affect anywhere mouth → anus Colon/rectum “Skip lesions” Continuous inflammation Transmural Mainly mucosal Fistulas common Bloody diarrhea common Strictures possible Toxic megacolon risk Crohn’s Watch for: * Diarrhea * Abdominal pain * Weight loss * Malnutrition * Fistulas Ulcerative colitis Watch for: * Bloody diarrhea * Abdominal cramps * Urgency * Risk of toxic megacolon ⸻ Diverticulitis Inflammation/infection of diverticula. Signs: * Usually LLQ abdominal pain * Fever * Change in bowel habits During acute inflammation: * Follow prescribed bowel-rest/diet plan * Monitor pain, fever and abdominal status * Watch for perforation/peritonitis ⸻ Colorectal Cancer Red flags: * Change in bowel habits * Blood in stool * Unexplained weight loss * Iron-deficiency anemia * Abdominal discomfort Important: Screening is important even before symptoms occur. ⸻ Constipation Risk factors: * Opioids * Immobility * Low fluid intake * Low fibre * Some medications Management: * Fluids if not contraindicated * Fibre * Activity * Bowel routine * Appropriate laxatives/stool softeners ⸻ Diarrhea Priority concerns: Fluid + electrolytes + cause Assess: * Frequency * Stool characteristics * Blood * Fever * Abdominal pain * Hydration * Recent antibiotics/travel/exposure ⸻ Peptic Ulcer Disease Major complications: * Bleeding * Perforation * Gastric outlet obstruction Warning signs: * Hematemesis * Melena * Sudden severe abdominal pain * Rigid abdomen Common causes: * H. pylori * NSAIDs ⸻ Appendicitis Classic: * Pain may begin around umbilicus and migrate to RLQ * Fever * Nausea/vomiting * Rebound/guarding may occur Priority Prevent rupture. Avoid: * Laxatives * Enemas * Applying heat to abdomen ⸻ 🚰 5. RENAL SYSTEM UTI Symptoms: * Dysuria * Frequency * Urgency * Suprapubic discomfort If infection reaches kidneys: * Fever * Flank pain * Chills * Nausea/vomiting Nursing * Obtain urine specimen correctly * Culture before antibiotics when ordered/appropriate * Encourage fluids if not contraindicated * Complete antibiotics ⸻ Renal Failure Major problems: Think: * Fluid overload * Electrolyte imbalance * Acid-base imbalance * Uremia * Anemia Possible findings: * Edema * Hypertension * Fatigue * Decreased urine output * Nausea * Confusion Particularly important: Hyperkalemia can cause life-threatening dysrhythmias. ⸻ Dialysis Hemodialysis Blood is filtered through a machine. Assess: * Weight * BP * Fluid status * Access site AV fistula Remember: “Feel + Hear” * Thrill → feel it * Bruit → hear it Protect the access: * No BP on that arm * No blood draws on that arm when avoidable * Don’t compress unnecessarily ⸻ Incontinence Types: Stress → coughing/sneezing Urge → sudden strong urge Overflow → bladder doesn’t empty Functional → can’t get to toilet Mixed → combination Management depends on cause. ⸻ 🫁 6. RESPIRATORY SYSTEM COPD Includes chronic bronchitis and emphysema. Common: * Dyspnea * Chronic cough * Sputum * Wheezing * Reduced exercise tolerance Nursing: * Position upright * Pursed-lip breathing * Energy conservation * Smoking cessation * Oxygen as prescribed * Inhaler technique Don’t automatically assume oxygen should be withheld from COPD patients. Oxygen is prescribed/titrated according to the patient’s clinical status and target saturation. ⸻ Asthma Usually reversible airway obstruction/inflammation. Symptoms: * Wheezing * Cough * Dyspnea * Chest tightness Rescue medication Short-acting bronchodilator, e.g. salbutamol. Controller Often: Inhaled corticosteroid Severe attack Red flags: * Difficulty speaking * Severe respiratory distress * Exhaustion * Altered LOC * Silent chest Silent chest = very serious. ⸻ Pneumonia Signs: * Fever * Cough * Sputum * Dyspnea * Crackles * Pleuritic chest pain Nursing: * Oxygen if needed * Antibiotics if bacterial/ordered * Hydration if appropriate * Mobilization * Cough/deep breathing * Monitor respiratory status ⸻ Lung Cancer Risk factors: * Smoking * Environmental/occupational exposures Symptoms: * Persistent cough * Hemoptysis * Weight loss * Dyspnea * Chest pain ⸻ Tuberculosis Classic: * Persistent cough * Fever * Night sweats * Weight loss * Possible hemoptysis Nursing priority Airborne precautions for suspected/confirmed infectious pulmonary TB according to institutional policy. ⸻ Atelectasis Collapsed alveoli, often after surgery. Prevention: * Deep breathing * Coughing * Incentive spirometry * Early mobilization * Adequate pain control ⸻ Pneumothorax Air in pleural space → lung collapse. Possible: * Sudden dyspnea * Chest pain * Decreased/absent breath sounds Tension pneumothorax Emergency. May cause: * Severe respiratory distress * Hypotension * Distended neck veins * Tracheal deviation * Cardiovascular collapse Requires immediate emergency treatment. ⸻ Hemothorax Blood in pleural space. Think: Respiratory compromise + blood loss. Chest tube may be required. ⸻ 🦴 7. MUSCULOSKELETAL Osteoporosis Loss of bone density. Risk: * Fractures * Vertebral compression * Hip fracture Prevention: * Weight-bearing activity * Calcium/vitamin D as appropriate * Fall prevention * Avoid smoking * Limit excessive alcohol ⸻ Fractures Priority: ABCs → bleeding → neurovascular status Assess the 6 Ps: * Pain * Pallor * Pulselessness * Paresthesia * Paralysis * Poikilothermia/coolness Neurovascular assessment is critical. ⸻ Arthritis Osteoarthritis Think: Wear and tear * Pain with activity * Stiffness * Often affects weight-bearing joints Rheumatoid arthritis Think: Autoimmune * Symmetrical joint involvement * Morning stiffness * Systemic effects ⸻ Scoliosis Abnormal lateral curvature of spine. Assess: * Posture * Shoulder/hip asymmetry * Spinal curvature * Respiratory effects if severe ⸻ Multiple Sclerosis Autoimmune demyelinating disease affecting CNS. Possible: * Weakness * Fatigue * Visual disturbances * Sensory changes * Balance problems * Bladder dysfunction Important nursing concept: Fatigue and heat can worsen symptoms. ⸻ 🦠 8. INFECTION/IMMUNE SYSTEM MRSA Methicillin-resistant Staphylococcus aureus. Key: * Resistant to several antibiotics * Contact precautions may be required * Strict hand hygiene ⸻ VRE Vancomycin-resistant enterococci. Key: * Resistant organism * Contact precautions according to facility policy * Hand hygiene * Environmental cleaning ⸻ C. difficile Often associated with antibiotic exposure. Symptoms: * Frequent watery diarrhea * Abdominal cramping * Fever VERY IMPORTANT Soap and water handwashing is preferred because alcohol-based hand sanitizer does not reliably kill C. difficile spores. Use appropriate contact/spore precautions according to facility policy. ⸻ Influenza * Fever * Cough * Myalgias * Fatigue * Headache Prevention: Annual vaccination + respiratory hygiene. ⸻ Sepsis Think: Infection + organ dysfunction Potential signs: * Fever or hypothermia * Tachycardia * Tachypnea * Altered mental status * Hypotension * Reduced urine output * Elevated lactate Nursing priority Recognize early and escalate rapidly. Expect: * Cultures * Lactate * IV fluids when indicated * Prompt antimicrobials when sepsis is suspected * Source control * Frequent reassessment ⸻ 🔬 9. DIAGNOSTIC TESTS Don’t memorize only the test. For every test ask: 1. Why is it being done? 2. What does it tell me? 3. What does the nurse do before? 4. What does the nurse do after? 5. What complications should I watch for? ⸻ CT Uses X-rays to create detailed cross-sectional images. Contrast may be used. Nursing: * Check allergies/previous contrast reactions * Assess kidney function when appropriate * Follow contrast-specific instructions ⸻ MRI Uses magnetic field. NO metal/unsafe metallic objects. Assess: * Implanted devices * Metal fragments * Claustrophobia ⸻ X-ray Useful for: * Fractures * Chest conditions * Some abdominal problems ⸻ Ultrasound Uses sound waves. Common: * Pregnancy * Abdomen * Pelvis * Blood vessels No ionizing radiation. ⸻ Mammogram Breast imaging for screening/assessment. ⸻ Endoscopy Allows direct visualization of GI tract. Nursing: * Usually NPO beforehand * Sedation may be used * Monitor airway and vital signs afterward * Ensure gag/swallow reflex has returned before oral intake when applicable ⸻ Bronchoscopy Visualizes airways. Post-procedure: * Monitor respiratory status * Watch for bleeding * Keep NPO until protective reflexes return if sedated/topical anesthetic used ⸻ Pulmonary Function Tests Measure lung function. Important for: * Asthma * COPD * Other pulmonary disorders ⸻ 🧪 10. LABORATORY VALUES For exams, know what the lab means, not just the number. CBC Hemoglobin/Hematocrit Think: oxygen-carrying capacity Low → anemia/bleeding/etc. WBC Think: infection/inflammation/immune response Platelets Think: clotting Low → bleeding risk. ⸻ INR Measures effect of warfarin therapy. Higher INR generally = increased anticoagulation and bleeding risk. Monitor for: * Bleeding * Bruising * Hematuria * Melena ⸻ Glucose Think: current blood glucose ⸻ HbA1c Think: “3-month-ish glucose picture.” Used for longer-term diabetes management. ⸻ BUN + Creatinine Think: Kidney function. Creatinine is particularly useful when evaluating renal function. ⸻ GFR Estimates kidney filtration. Lower GFR generally = worse kidney function. ⸻ Electrolytes Sodium Think: water balance + neurological function Potassium Think: heart rhythm Abnormal potassium can cause dangerous dysrhythmias. Calcium Think: bones + muscles + nerves ⸻ Cholesterol LDL “Lousy” cholesterol Higher LDL → increased cardiovascular risk. HDL “Healthy” cholesterol Generally protective. ⸻ Urinalysis Can help identify: * UTI * Protein * Blood * Glucose * Ketones * Kidney problems ⸻ Culture & Sensitivity Culture = What organism? Sensitivity = Which antibiotic is effective? ⸻ 💊 11. PHARMACOLOGY For every medication, memorize: Class → Why given → Major adverse effects → Contraindications/precautions → Nursing assessments → Patient teaching ⸻ Acetaminophen (Tylenol) Used for: * Pain * Fever Major concern: Liver toxicity with excessive dosing. ⸻ NSAIDs Examples: * Ibuprofen * Naproxen Watch for: * GI bleeding * Kidney injury * Fluid retention * Cardiovascular risks ⸻ Morphine Opioid. Watch: * Respiratory depression * Sedation * Hypotension * Constipation * Nausea Antidote for opioid-induced respiratory depression: Naloxone ⸻ Antibiotics Key nursing principle: Complete the prescribed course unless directed otherwise. Watch: * Allergic reactions * Diarrhea * Superinfection * C. difficile ⸻ Warfarin (Coumadin) Anticoagulant. Monitor: INR Major complication: Bleeding Teaching: * Consistent vitamin K intake rather than suddenly changing intake * Drug interactions matter * Report unusual bleeding ⸻ Heparin Anticoagulant. Monitor: * Bleeding * Platelets * aPTT for unfractionated heparin, depending on protocol Major complication: Bleeding Important adverse reaction: HIT – heparin-induced thrombocytopenia ⸻ Insulin Major adverse effect: HYPOGLYCEMIA Know: * Onset * Peak * Duration * Administration technique * Glucose monitoring ⸻ Nitroglycerin Used for angina. Can cause: * Headache * Hypotension * Dizziness Avoid with PDE-5 inhibitors. ⸻ Digoxin Remember: “Slow heart + low potassium = danger.” Monitor: * Apical pulse * Potassium * Signs of toxicity ⸻ Diuretics Example: Furosemide (Lasix) Causes: * Increased urine output * Decreased fluid volume Watch: * BP * Electrolytes * Dehydration * Potassium ⸻ Corticosteroids Example: Prednisone Long-term effects: * Infection risk * Hyperglycemia * Osteoporosis * Fluid retention * Skin changes * Adrenal suppression Do not abruptly stop long-term corticosteroids without medical direction. ⸻ Bronchodilators Example: Salbutamol Can cause: * Tremor * Tachycardia * Nervousness ⸻ Inhaled corticosteroids Important: Rinse mouth after use. Helps prevent oral candidiasis. ⸻ Statins Example: Atorvastatin Used to lower cholesterol. Watch: * Muscle pain/weakness * Liver-related adverse effects ⸻ Stool medications Psyllium Bulk-forming. Requires adequate fluid intake unless contraindicated. Docusate Stool softener. Stimulant laxatives Increase intestinal motility. ⸻ 🧠 12. NEUROLOGICAL Seizure During seizure: Protect, don’t restrain. * Protect from injury * Turn to side if possible * Protect airway * Remove nearby hazards * Don’t put anything in mouth * Time the seizure After: * Assess airway * Vital signs * Neurological status * Document characteristics Status epilepticus Emergency. ⸻ Increased Intracranial Pressure Think: Headache + vomiting + decreased LOC + pupil changes Late sign: Cushing’s triad * Increased BP/widened pulse pressure * Bradycardia * Irregular respirations Nursing: * Elevate head as ordered * Maintain neutral neck alignment * Avoid unnecessary stimulation * Monitor neurological status * Prevent hypoxia/hypercapnia ⸻ Parkinson’s Disease Classic: TRAP T – Tremor R – Rigidity A – Akinesia/bradykinesia P – Postural instability Nursing: * Fall prevention * Mobility support * Medication timing * Swallowing assessment * Nutrition ⸻ Spinal Cord Injury Priority: Airway + breathing + immobilization + neurological assessment Possible complications: * Neurogenic shock * Autonomic dysreflexia * Respiratory compromise * Loss of bowel/bladder control * Pressure injuries Autonomic dysreflexia Usually associated with injuries at/above T6. Signs: * Sudden severe hypertension * Headache * Flushing/sweating above injury * Bradycardia Priority: Sit patient upright and identify/remove the trigger. ⸻ 👁️ 13. SENSORY Cataracts Clouding of lens. Symptoms: * Blurred vision * Glare * Reduced visual acuity Treatment: Surgical removal when significantly affecting vision. ⸻ Glaucoma Optic nerve damage often associated with increased intraocular pressure. Key distinction: Glaucoma → pressure/optic nerve Cataract → cloudy lens Acute angle-closure glaucoma: * Severe eye pain * Headache * Halos * Nausea/vomiting * Red eye Emergency. ⸻ Hearing Loss Conductive Problem with sound transmission through outer/middle ear. Sensorineural Problem involving inner ear/auditory nerve. Communication: * Face patient * Speak clearly * Don’t shout * Reduce background noise * Verify understanding ⸻ 🔥 14. BURNS Think: Airway → Breathing → Circulation Inhalation injury Red flags: * Facial burns * Soot * Singed nasal hairs * Hoarseness * Stridor * Carbonaceous sputum Airway edema can worsen rapidly. ⸻ Burn priorities * Airway * Breathing * Circulation * Fluid resuscitation for significant burns * Pain management * Infection prevention * Temperature control * Nutrition * Wound care ⸻ 15. WOMEN’S & MEN’S HEALTH Menopause Decrease in estrogen. Common: * Hot flashes * Night sweats * Sleep problems * Vaginal dryness * Mood changes Long-term: * Bone loss * Cardiovascular considerations ⸻ Birth Control Know: * Effectiveness * How it is used * Contraindications * STI protection Most hormonal birth control does NOT protect against STIs. Condoms help reduce STI transmission. ⸻ STIs Examples: * Chlamydia * Gonorrhea * Syphilis * HPV * Herpes * HIV Nursing: * Testing * Treatment adherence * Partner notification/treatment when appropriate * Safer sex education * Prevention ⸻ Breast Cancer Warning signs: * New breast lump * Skin changes * Nipple changes/discharge * Axillary lymph node changes Know current screening recommendations and individual risk factors. ⸻ Prostate Cancer Possible: * Urinary hesitancy * Weak stream * Frequency * Hematuria Important: Early prostate cancer may have no symptoms. ⸻ 🚨 16. EMERGENCY NURSING Shock Basic concept: Tissues aren’t receiving enough oxygen/perfusion. Signs: * Tachycardia * Hypotension * Altered LOC * Cool/clammy skin in many shock states * Decreased urine output * Tachypnea Major types Hypovolemic → blood/fluid loss Cardiogenic → pump failure Distributive → vasodilation (e.g., septic/anaphylactic) Obstructive → obstruction to circulation Priority: ABCs + identify/treat cause + restore perfusion. ⸻ Hemorrhage Look for: * Tachycardia * Hypotension * Pallor * Weakness * Decreased LOC * Decreased urine output Priority: Control bleeding + support circulation + escalate. ⸻ Anaphylaxis Severe allergic reaction. Signs: * Airway swelling * Wheezing * Dyspnea * Hypotension * Hives * GI symptoms FIRST-LINE MEDICATION: IM epinephrine Do not delay epinephrine while waiting for other treatments. ⸻ 💧 17. FLUID & ELECTROLYTES Dehydration Signs: * Thirst * Dry mucous membranes * Tachycardia * Hypotension * Poor skin turgor * Decreased urine output * Weight loss ⸻ Fluid overload Signs: * Edema * Crackles * Dyspnea * Weight gain * JVD * Hypertension ⸻ Potassium Hypokalemia Think: Weak + irregular heart Causes: * Diuretics * GI losses Hyperkalemia Think: Dangerous heart rhythm Causes: * Renal failure * Tissue breakdown * Certain medications ⸻ Acid-Base Use: ROME Respiratory = Opposite Metabolic = Equal Examples: Respiratory acidosis CO₂ ↑ → pH ↓ Respiratory alkalosis CO₂ ↓ → pH ↑ Metabolic acidosis HCO₃ ↓ → pH ↓ Metabolic alkalosis HCO₃ ↑ → pH ↑ ⸻ 👶 MATERNAL-CHILD NURSING Prenatal Care Monitor: * Maternal vital signs * Weight * Blood pressure * Urine * Fetal growth * Fetal heart rate * Laboratory screening * Risk factors Important warning signs: * Vaginal bleeding * Severe headache * Visual changes * Severe abdominal pain * Fluid leakage * Decreased fetal movement * Sudden swelling/other signs of hypertensive disorders ⸻ Fetal Development High-yield concept: First trimester → organ formation Second trimester → growth and development Third trimester → maturation and preparation for birth ⸻ Labour Stage 1 Onset of true labour → complete cervical dilation. Stage 2 Complete dilation → birth of baby. Stage 3 Birth of baby → delivery of placenta. Stage 4 Immediate postpartum recovery. ⸻ Apgar At approximately 1 and 5 minutes. A P G A R A – Appearance P – Pulse G – Grimace A – Activity R – Respiration Each scored 0–2. Apgar helps assess newborn adaptation; it does not by itself diagnose asphyxia or determine long-term prognosis. ⸻ Newborn Assessment Assess: * Respiratory effort * Heart rate * Temperature * Colour * Tone * Feeding * Reflexes * Weight * Head circumference * Urine/stool ⸻ Breastfeeding Benefits: * Nutrition * Immune protection * Bonding Signs of effective feeding: * Good latch * Audible swallowing * Appropriate wet/dirty diapers * Expected weight pattern ⸻ 👶 PEDIATRIC NURSING Development General progression: Head → toe Simple → complex Large muscles → fine motor Always consider developmental stage when communicating with children. ⸻ Pediatric Safety Big priorities: * Falls * Choking * Burns * Poisoning * Drowning * Car-seat safety * Medication dosing * Safe sleep Medication principle Pediatric medications are often based on: weight (kg) Always verify calculations and concentrations. ⸻ Pediatric Asthma Same basic principles as adults: * Bronchodilator for acute symptoms * Controller medications for long-term control * Trigger avoidance * Asthma action plan ⸻ RSV Common in infants/young children. Signs: * Rhinorrhea * Cough * Wheezing * Increased work of breathing * Poor feeding Priority: Respiratory assessment and hydration. ⸻ Croup Classic: Barking cough + stridor Often worse at night. Severe respiratory distress requires urgent intervention. ⸻ Cystic Fibrosis Thick secretions affect lungs and GI system. Think: “Thick mucus + lung infections + malabsorption.” Nursing: * Airway clearance * Nutrition * Pancreatic enzymes when prescribed * High-calorie/high-protein nutrition * Infection prevention ⸻ Gastroenteritis Major concern: Dehydration. Assess: * Wet diapers/urine * Mucous membranes * Tears * Capillary refill * Weight * Activity/LOC ⸻ Pyloric Stenosis Classic: Projectile, non-bilious vomiting Often occurs in young infants. Possible: * Hunger after vomiting * Dehydration * Weight loss ⸻ ASD vs VSD ASD Hole between atria. VSD Hole between ventricles. VSD can produce: A significant murmur and increased pulmonary blood flow. ⸻ Sickle Cell Disease Problem: Abnormal hemoglobin → sickled RBCs → vaso-occlusion and hemolysis. Crisis triggers: * Dehydration * Infection * Hypoxia * Stress Management: * Hydration * Oxygen if hypoxemic * Pain management * Treat infection * Rest * Disease-specific therapies ⸻ Meningitis Think: Fever + headache + stiff neck + altered mental status May also have: * Photophobia * Vomiting * Seizures Emergency. Use appropriate isolation precautions according to suspected organism and institutional policy. ⸻ Hydrocephalus Excess CSF. Infants may have: * Increasing head circumference * Bulging fontanelle * Irritability * Poor feeding * “Sunsetting” eyes Older children: * Headache * Vomiting * Visual changes * Altered LOC ⸻ 🧠 MENTAL HEALTH NURSING Therapeutic Communication DO: * Use open-ended questions * Listen * Reflect * Clarify * Validate feelings * Maintain appropriate boundaries DON’T: * Give false reassurance * Judge * Argue * Give excessive advice * Say “everything will be fine” ⸻ Depression Symptoms: * Persistent sadness * Anhedonia * Sleep changes * Appetite changes * Fatigue * Poor concentration * Feelings of worthlessness * Suicidal thoughts Nursing priority: Assess suicide risk directly. ⸻ Bipolar Disorder Mania * Elevated/irritable mood * Increased energy * Decreased need for sleep * Rapid speech * Impulsivity * Grandiosity Nursing: * Reduce stimulation * Maintain safety * Set clear limits * Encourage nutrition/hydration * Administer medications as prescribed ⸻ Schizophrenia Positive symptoms: * Hallucinations * Delusions * Disorganized speech/behaviour Negative symptoms: * Flat affect * Social withdrawal * Reduced motivation Communication Don’t argue with delusions. Instead: Acknowledge the patient’s feelings while presenting reality. ⸻ OCD Obsessions: Intrusive thoughts Compulsions: Repetitive behaviours/mental acts ⸻ Eating Disorders Watch: * Electrolytes * Cardiac rhythm * Nutrition * Weight * Refeeding complications * Psychological safety ⸻ Substance Use Priorities: * Airway/breathing/circulation * Overdose recognition * Withdrawal * Safety * Nonjudgmental communication ⸻ 🧪 HIGH-YIELD DIAGNOSTIC TEST THINKING When you see a test question, ask: “Why are they ordering this?” Examples: CT head after sudden neurological deficit → looking for bleeding/structural abnormalities. MRI → detailed soft tissue/neurological/musculoskeletal imaging. ECG → electrical activity/ischemia/dysrhythmia. Troponin → myocardial injury. HbA1c → long-term glucose control. Creatinine/GFR → kidney function. INR → warfarin effect. Culture and sensitivity → organism + effective antimicrobial. Pulmonary function test → lung function/obstruction/restriction. ⸻ 💊 PHARMACOLOGY MASTER MEMORY MAP Instead of memorizing 100 medications individually, memorize the danger associated with each class: Drug/Class Think Insulin Hypoglycemia Opioids Respiratory depression Warfarin Bleeding + INR Heparin Bleeding + HIT Furosemide Fluid/electrolyte loss Digoxin Bradycardia/toxicity ACE inhibitors Hyperkalemia + cough/angioedema Beta blockers Bradycardia/hypotension Steroids Hyperglycemia + infection NSAIDs GI bleeding + kidney injury Statins Muscle/liver effects Bronchodilators Tachycardia/tremor Inhaled steroids Oral candidiasis Antibiotics Allergy + C. diff ⸻ 🚨 THE “PRIORITY QUESTION” METHOD When you’re stuck on an exam question, ask: 1. Is the airway threatened? If yes → AIRWAY 2. Is breathing compromised? If yes → BREATHING 3. Is circulation/perfusion compromised? If yes → CIRCULATION 4. Is there an acute neurological deterioration? Think neurological emergency. 5. Is there a safety risk? Falls, suicide, aspiration, seizures, etc. 6. Which patient is deteriorating? Unstable beats stable. ⸻ ⭐ TOP THINGS I WOULD MEMORIZE FIRST If you have limited study time, prioritize these: 🚨 Emergencies * Anaphylaxis → IM epinephrine * Stroke → BE FAST + last known well * MI → ECG + rapid intervention * Sepsis → early recognition + rapid treatment * Tension pneumothorax → emergency * Severe hypoglycemia → rapid glucose treatment * Status epilepticus → emergency * Increased ICP → neurological deterioration * Hemorrhage → control bleeding + perfusion * Severe burns → ABCs 💊 Medications * Insulin → hypoglycemia * Morphine → respiratory depression * Warfarin → INR/bleeding * Heparin → bleeding/HIT * Digoxin → pulse/potassium/toxicity * Furosemide → fluid/electrolytes * Nitroglycerin → hypotension + PDE-5 interaction * Steroids → infection/hyperglycemia * Antibiotics → allergy/C. diff * Inhaled steroids → rinse mouth 🧪 Labs * Hb → oxygen carrying * WBC → infection/immune response * Platelets → bleeding/clotting * INR → warfarin * Glucose → current sugar * HbA1c → long-term glucose * Creatinine/GFR → kidney * K⁺ → heart rhythm * Na⁺ → neurological/fluid balance * Culture → organism * Sensitivity → antibiotic choice 🩺 Nursing skills * Infection control * Medication administration * IVs * Oxygen * Suction * Tracheostomy * Chest tubes * Urinary catheter * Wound care * Ostomy care * Vital signs * Neurovascular assessment * Respiratory assessment ⸻ 📚 How I’d recommend studying this huge syllabus Don’t try to study all of these diseases in one sitting. Use system blocks: Day 1: Diabetes + cardiovascular Day 2: Respiratory + renal Day 3: GI + liver Day 4: Hematology + immune/infection Day 5: Neuro + musculoskeletal Day 6: Maternal/newborn Day 7: Pediatrics Day 8: Mental health Day 9: Pharmacology Day 10: Labs + diagnostics + clinical skills Day 11: Emergency/priority questions Day 12: Full mixed practice exam + review weak areas For each condition, make yourself answer only 5 questions: 1. What is happening? 2. What will I assess? 3. What is the biggest complication? 4. What will I do first? 5. What do I teach the patient? That approach will help you think like a nurse rather than memorize isolated facts, which matches the study framework you were given.

Half Lives

Part 4 - Second half

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de Leon, Camden, Period 8

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Semana 19 - Cap 85: Fisiología del Deporte - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 19 - Capítulo 42: Regulación de la Respiración - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 23 - Cap 65: Funciones Secretoras del Tubo Digestivo - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 22 - Cap 27: Filtración Glomerular, Flujo Sanguíneo Renal y su Control - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 21 - Capítula 64: Propulsión y Mezcla de los Alimentos en el Tubo Digestivo - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet

Semana 20 - Cap 26: Sistema Urinario Anatomía Funcional y Formación de Orina en los Riñones - Tratado de Fisiología Medica de Guyton y Hall 14va. Edición | Quizlet