Pathophysiology Exam 1

Nursing 1 with Anom at Goldfarb School of Nursing

About this deck

By: R. Robinson
Textbook:

Calculate with Confidence

Pathophysiology: The Biologic Basis for Disease in Adults and Children (Pathophysiology the Biologic Basis)

Pharmacology for Nursing Care, 7th Edition (Book & CD-ROM)

Professional Nursing: Concepts & Challenges (Chitty, Professional Nursing; Concepts and Challenges)
Created: 2011-05-30
Size: 55 flashcards
Views: 384

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Vitamin

if you (the body) can't produce it
must come from external source (food, sunlight, etc)

Fat Soluble Vitamins

must have fat in your diet to absorb these
stored in adipose tissue and fat cells
more potential to become toxic if stored in large amount

primarily children die from fat soluble overdoses/toxicity

Water Soluble Vitamins

All others

Vitamin A

*night blindness

-- Rhodopsin renewed by intake of vit A

- correlations w/ vitamin A and particular types of cancer

-VERY toxic to pregnant women, large doses can induce labor

Vitamin D

Necessary for the absorption of Ca+
been discussed as to rename a hormone for quite some time (we make)
skn exposed to UV light, we make an inactive form of vit D

2 step process in kidney activates vit D

Vit D and sunscreen

need UV light to activate

estimated 40-60% of females over age of 19 have osteoporosis b/c defficient
No Tums as a source of Ca+

African Americans higher endogenous cholesterol correlated w/ heart disease---less UV light able to come through darker skin

Vitamin K

COAGULATION

cascading or waterfall effect

to acivate 3 coagulatin facors you must have Vit K1`

Vitamin C

Scurvy

lime(y)'s disease

wash your hands
antioxidant
Sx: bloody gums, poor wound healing, collegen...etc

VItamin E

antioxidant
must have broken skin for it to be beneficial (otherwise topically no use)
Studies of Vit E and cardiovascular disease/ cancer

inconclusive

Used to give to premature infants before we had a synthetic surfactant

cont. towards blindness (free O2 gloasting, neurological damage)

Inflammation

Adjunct tissue response designed to deliver fluid and cellular components to injured for necrotic tissue

beneficial
desirable

necessary response for repair process

Cell Damage Theory first 2 Components

Rubor: (Red)

from vasodialation, increased blood supply (possible red, bluish)

Calor: (Heat) Calorie

heat results from vasodialation and increased blood supply
Tumor: (Swelling) 2 possible reasons
Dolor: (Pain): results from swelling

Cell Damage Repair Re: Fluids & Interstitial Space

usually not much fluid in vascular system and in intersitial space
permiability of bl vessels changes when damaged sending out an instantaneous message to send proteins to repair the damaged tissue

Example of the Blister

when protein is done regenerating it deposits water instead of protein

PERMEABILITY changes SELECTIVELY depending on stage of repair

protein

water, etc...

Chemotaxis

Migration of WBC's to affected area
Originate from affected tissue
damaged cells leak messenger chemical

picked up in vascular system
WBC follow chemicals to affected site

Histamine

causes vasodialation: makes vessels bigger in diameter
damaged cells release chemical messenger to bring WC's that produce HISTAMINE
can be systemic or local reaction
activate the Hageman Factor XII

Hageman XII

Coagulatin Factor 12

creates a meshlike structure around area of inflammation (hair net)
holding in place

if scab is still red around the edges it's not healed
the white strings you see when you pull of is the Hageman Factor

Plasma Factors

anti coagulating factors

Serum: no anti coagulating factors, already used up clotting factor

Exudates

Fluids that migrate to the affected area

5 Types of Exudates

Serous

Transudate

Fibrinous

Neutrophilic

Mixed: firbropurulent

Serous Exudate

Serum

water & protein

*more protein than water

Transudate

*less protein more water

not generally associated with inflammation

interstitial fluid

Fibrinous Exudate

fluid containing

* fibrinogen strands

2 classics cases of patho fibrinous exudate

- Pleural Space

- Pericardial Sac

*** known as FRICTION RUB due to noise it makes

Neutrophilic Exudate

Puss

Purulent exudate

**white blood cells (WBC's)

Mixed Exudate

Example:

Fibropurulent exudate

*** fluid w/ white cells & fibrous tissue

Healing by 1st Intention

Wound is clean cut

take 2 pieces of tissue
place back together, w/ stitches or glue

TISSUES REPAIR W/ FIRST INFLAMMATORY RESPONSE

Healing by 2nd Intention

Wound is jagged

not clean and can't approx it 100%

MUST GO THROUGH 2 INFLAMMATORY RESPONSES TO HEAL

Healing by 3rd Intention

No way to match up the wound

3 RESPONSES

*scar tissue an issue if internal

Granulomatous Inflammation

The bodies attempt to continuously repair or handle foreign objects

Example:

leaving a gauze pad, or instrument inside body cavity

TB pts: have nodules of inflammatory response stuff left in tissue

--- must remove

Problem of scarring = ADHESIONS

- hence the advantage of laproscopic surgery

Antigen

What the body interprets to be a foreign agent

Ex: pollen, poison ivy, Jack Daniels

- if your body recognizes as foreign it's an ANTIGEN

Antibody (Immunoglobulin [IgG])

Proteins the body produces to inactivate antigens

Can check for antibody levels by doing a TITER

found in the plasma

Gammaglobulin protein (90 % house here)

Agammaglobulin Anemia

Produces antibodies, but lack the Gammaglobulin to store the antibodies

AIDS pt had housing structure of Gamma protein, but does not produce the antibodies

** BOTH IMMUNE COMPROMISED

Plasma

proteins and water

- anticoagulated blood

Serum

comes from clotted blood and does not have the coagulatin factors

IgG

80% of all antibodies

- involved in the FIRST LINE OF DEFENSE

-provides immunity to virus', bacteria

- found in serum and other locations

*if you can not produce IgG antibodies (genetically)

-- BIG PROBLEM

LOSE 80% OF ANTIBODIES AND FIRST LINE OF DEFENSE!!!

IgA

12-13 %

located in Gammaglobulin and also found in secretions of exocrine glands:

- nasal fluid

- tears

- breast milk

- gastic secretions

DSM

Diagnostic Statistical Manual (psychiatry)

Cellular Injury

Physical:

disrupted cell to cell relationship

Living agents

bacteria, parasites, fungi, viruses (once inside host cell)

Chemical

environmental toxins ex: carbonmonoxide

Decreased O2

Adaptive Response

Our bodies are very forging if you implement change slowly

example of barbituates

example of blood pressure

Sublethal Injury: Morphological Changes w/in a cell

degenerative

moving on the continuum

accumulate water in the cytoplasm
accumulate fat in the cytoplasm

liver, kidneys, heart

often associated with alcoholism: FATTY LIVER

Cellular Death

Point of no return

Necrotic: Dead Necrosis: 3 pathways to death

Coagulative: still has same structure/ architectual features but is dead

if infected GANGRENE

Liquefactive: common in the brain, tissue then stored in spinal fluid

Caseous: cavity formation

common in TB patients

What Bacteria is associated with Gangenous Gas

Clostridium Perferangis

anaerobic

Calcification

storage of Ca+ in tissue

2 types of Calcification and attributes

normal: teeth & bones

Dystrophic: damaged tissue, Ca+ deposits

kidney stones, gall stones

Somatic Death

complete death

cell dies, tissue dies, organ dies, system death

Post Mortum Changes

Rigor Mortis

Algor Mortis

Livor Mortis

Rigor Mortis

muscles freeze

2,8,10 hours post death

Algor Mortis

cooling of the body

core and body temp decrease

Livor Mortis

pooling of the blood to lowest point

gravity

Genetic 2 factors

Extrinsic:

chemicals, environmental exposure, out of control

Intrinsic:

age, sex, genetics

Chromosomal Abnormalities 2 kinds

Abnormal # No.

Abnormal structure

Genetic Disease

familial disease

congenital

Single Gene Disorders

1 gene, 1 chromosome

3 sex linked disorders

Turners: females

- X (missing second) underdeveloped sex organs

Trisomy X: females (XXX) superfemale

Kleinfelders: (XXY) lenky, long limbs, gender identity issues possible

Cellular Death (4)

Cells dependent upon O2, nutrients (glucose)