explore the pathophysiology of common and complex diseases affecting different systems in the body, including cardiovascular, respiratory, renal, gastrointestinal, endocrine, and neurological systems.
NURSING 611 COMPREHENSIVE STUDY
GUIDE QUESTIONS AND ANSWERS
Pathophysiology associated with Type 1 & 2 DM - autoimmune loss of B cells in
the pancreatic islet
Development of insulin resistance in a characteristic of: - Type 2 DM
Lack of all anterior pituitary hormones is called? - panhypopituitarism
Clinical manifestations of hypothyroidism - low basal metabolic rate, cold
intolerance, lethargy, tiredness, and slightly lower basal body temperature
Characteristics of diabetes insipidus - an insufficiency of ADH, leading to polyuria
and polydipsia
Characteristics of diabetes mellitus - not a single disease but a group of clinical
heterogeneous disorders that have glucose intolerance in common
Characteristics of SIADH - by high levels of ADH in the absence of normal
physiologic stimuli for its release
Common symptom of DM, DI, and SIADH - thrist
What causes the microvascular complications of DM - results from capillary
basement membranes thickening and endothelial cell hyperplasia
,What is the cause of diabetes insipidus - inability of kidney to increase
permeability of water - resulting in large excretions of large volume of dilute urine
and increased plasma osmolality
Describe the pathophysiological changes associated with Addison's Disease -
results from hyposecretion of adrenal cortex hormones
Describe the pathophysiological changes associated with hypoparathyroidism -
damages caused during thyroid surgery-
What are the causes of ketoacidosis - develops when there is an absolute or relative
deficiency of insulin and an increase in insulin counterregulatory hormones.
What are the pathophysiological changes associated with ketoacidosis - dry mouth,
HA, polyuria, polylipsia, wt loss, N/V, fruity breath, kussmaul resp., lethargy, SOB,
abd pain
What is acromegaly - a term for adults who have been exposed to continuously
high levels of growth hormone.
What is gigantism - term for children and adolescents who have been exposed to
an increase amount of growth hormone
One of the cause's of __________ is a deficiency of endemic iodine -
hypothyroidism
Manifestations of hypothyroidism - lower levels of thyroid hormone w/o negative
feedback of TH in the pituitary, increase secretion of TSH that may lead to a goiter
,Microvascular complications related to chronic diabetes mellitus - retinopathy,
nephropathy, and neuropathy
Macrovascular complications related to chronic diabetes mellitus - CAD, CVA,
PVD, disease and infection
What happens during hypoglycemia? - hunger, lightheadedness, tachycardia,
pallor, HA, and confusion
What can often cause hypoglycemia? - lack of glucose resulting from exercise
What is metabolic syndrome AKA insulin resistance syndrome or syndrome X? -
Cluster of clinical traits occuring together that increase the risk for accelerated
cardiovascular disease and type 2 DM
Describe how DM causes peripheral neuropathy? - the distal portions of the
neurons are initially and eventually more severely affected by axonal degeneration
that preferentially involves sensory nerve fibers.
What fibers are involved in peripheral neuropathy? - smaller polymodal
unmyelinated peripheral C fibers and the larger myelinated A delta fibers
Trace the electrical activity of the heart - starts in the SA node and is transmitted
from the atrial to the ventricular myocardium to the AV node then to bundle of HIS
and then to the bundle branches to the purkinje fibers of the heart wall
Where is the SA node located - junction of the right atrium and the superior vena
cava above the tricuspid valve.
, Identify the location of the neurotransmitters in the heart -
Define adrenergic receptors - SNS stimulation of the myocardium and coronary
vessels depends on the presence of adrenergic receptors - bound to
neurotransmitters of the SNS
Discuss left-ventricular end diastolic pressure - expressed in Frank Starling law,
cardiac muscle - like other muscles - increases its strength of contraction when it is
stretched
Define Starling's law - the volume of blood in the heart at the end of diastote is
directly related to the force of contraction during the next systole
Discuss the effects of angiotensin II on the heart - powerful vasoconstrictor and
stimulates the secretion of aldosterone from the adrenal gland; growth promoter in
cardiovascular tissues resulting in monocyte and vascular hypertrophy and
progression of HTN; causes structural changes in blood vessels that contribute to
permanent increase in peripheral resistance and make vessels more vulnerable to
endothelial dysfunction and platelet aggregation
Discuss the neural effects of angiotensin II - stimulation of thirst, release of ADH,
and increases in sympathetic nervous system output.
Define pulsus paradoxus - is when the arterial blood pressure during expiration
exceeds arterial pressure during inspiration by >10 mmHg
What is pulsus paradoxus mean clinically - it reflects impairment of diastolic
filling of the left ventricle plus reduction of blood volume within all 4 cardiac
chambers
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