NR 507 Final Exam Study Guide

NR 507 Final Exam Study Guide Endometrial Cycle - ✅Three Phases: Proliferative Phase, Secretory Phase, Ischemic Phase, Ovulation occurs between the follicular/proliferative and the luteal/secretory phase uterine prolapse - ✅the decent of the cervix or entire uterus into the vaginal canal ** can be severe protruding completely through vagina and protrude from introitus PCOS - ✅Oligo-ovulation or anolvulation elevated androgen levels and polycystic ovaries testicular cancer - ✅highly treatable cancer develops in young middle aged men cure rate 90% often manifests as painless enlargement that is gradual sensation of heaviness with dull ache Risk factors for testicular cancer - ✅cryptorchidism, abnormal testicular development, hiv, aids, Klinefelter syndrome, Hx of testicular CA. Eval for breast Ca - ✅Painless lump in the breast palpable nodes in the axilla retraction of the tissue or dimpling of the skin bone pain caused by metastasis to vertebrae.

Premenstrual dysphoric disorder - ✅cycle in recurrence (occurs in the luteal phase) distressing physical psychological or behavioral changes that impair relationship or interfere with usual activity. dysfunctional uterine bleeding - ✅heavy menstrual bleeding which does not appear to have any anatomical cause other causes have been ruled out accounts for 70% of hysterectomies and ablations. prostate cancer - ✅cancer of the prostate gland, usually occurring in men middle-aged and older chronic exposure to arsenic as well as estrogen is a risk factor HPV and Cervical Cancer - ✅- HPV found in 95% of cervical cancer - 80-90% transient, gone 1-2 years (which is why we test q 3 years) - 10-20% persist (of these, 2% progress to cervical cancer) Human papillomavirus linked to development of precancerous cells known as dysplasisa high hormone levels - ✅causes negative feed back decreasing secretion of the tropic hormone.

Cushing's syndrome - ✅a condition caused by prolonged exposure to high levels of cortisol moon face , trunk obesity, buffalo hump Cause of hypoparathyroidism - ✅Thyroid or parathyroid surgery, autoimmune, congenital associated with DiGeorge syndrome low calcium levels chronic alcoholism malnutrition aminoglycoside antibiotics chemo-agents parenteral nutritional therapy Parathyroid syndrome - ✅hypocalcemia dry skin loss of body hair ridges on nails labs for primary hypothyroidism - ✅documentation of clinical symptoms of hypothyroidism and measurement of increased levels of TSH and Decreased TH Thyroid storm - ✅death can occur within 48 hrs w/o treatment can develop spontaneously in those with un-diagnosed or partially treated or severe hyperthyroidism Cause of Thyroid storm - ✅infection pulmonary disorder cardiovascular disorder trauma burn seizure surgery OB complication emotional stress Dialysis Thyriodtoxicosis symptoms - ✅Hyperthermia tachycardia high-out put heart failure agitation delirium N&V Diarrhea Shock dermatome - ✅area of skin innervated by a spinal nerve

spondylosis - ✅a degenerative disorder that can cause the loss of normal spinal structure and function involves the lamina and neural arch of vertebra cerebral cortex - ✅controls motor function and sensory function in the brain cerebral infarction - ✅due to either embolism or thrombosis of the intra or extracranial arteries Agnosia - ✅the inability to recognize familiar objects. accumulation of blood in the subarachnoid hemorrhage - ✅when leaking blood ozzes when a tear occurs blood under pressure is pumped into the subarachnoid space ICP increases irritation of meninges and tissues impaired CSF Meningitis - ✅inflammation of the meninges of the brain and spinal cord caused by bacteria viruses fungi parasites or toxins diet prevention of prostate cancer - ✅high intake of animal products (protein) to fruits and vegetables will slow the progression of the indolent to the aggressive forms of prostate cancer.

BPH - ✅prostate enlarges as nodules form and grow usually can cause urinary symptoms such as bladder out flow obstruction urge to urinate often delay in start and decreased force.

DNA and genetics - ✅You must have this to be alive. It is the way we pass on our traits down to the next generation. provides the code for all the body proteins.

Mutations - ✅inherited alterations of genetic material causes alteration in the amino acid sequence Transcription - ✅(genetics) the organic process whereby the DNA sequence in a gene is copied into mRNA Trisomy - ✅a condition in which an extra copy of a chromosome is present in the cell nuclei, causing developmental abnormalities.

Chromonsome 13, 18 or 21 result in live births all others are fetal demise.

Down Syndrome - ✅Trisomy 21, low nasal bridge epicanthalfold low set ears poor muscle tone

short statue congenital heart defects delay Klinefelter syndrome - ✅XXY, male usually sterile over half have gynecomastia, small testes sparse body hair, high pitch voice mental impairment increases with each extra x chromosome. multifactoral disease - ✅HTN, coronary artery heart disease, Stroke Diabetes Mellitus II and I some CA multifactorial inheritance - ✅a pattern of inheritance in which a trait is influenced by both genes and environmental factors Duchenne muscular dystrophy - ✅A human genetic disease caused by a sex-linked recessive allele; characterized by progressive weakening and a loss of muscle tissue.

Neurofibromatosis - ✅AD; pigmented neurofibromas; cafe au lait spots respiratory alkalosis - ✅Arise in blood pH due to hyperventilation (excessive breathing) and a resulting decrease in CO2.

Stable angina - ✅chest pain that occurs when a person is active or under severe stress orthostatic hypotension - ✅Decrease in blood pressure related to positional or postural changes from lying to sitting or standing positions Isolated systolic hypertension - ✅is very common in old age due to decrease in compliance of the aorta and its proxmal branches.

Natriuretic hormones affect the balance of: - ✅Sodium sympathetic nervous system - ✅the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations primary hypertension - ✅denotes high blood pressure from an unidentified cause; also called essential hypertension unstable plaque - ✅plaque formed in the artery wall that can break away and obstruct blood flow or form a clot Dyslipidemia - ✅abnormal blood lipid levels, including high total, low-density lipoprotein, and triglyceride levels as well as low high-density lipoprotein levels

Fatty streak formation - ✅one of the first pathological changes in cardiovascular disease Left sided heart failure symptoms - ✅-Left = lungs (and heart) -Crackles, increased HR, SOB, palpitations, dizzy, lightheaded, confused, restless, cough, dyspnea right sided heart failure - ✅1. Jungular Vein Distention 2. Ascending Dependent Edema 3. Weight Gain 4. Hepatomegaly (Liver Enlargement) infective endocarditis - ✅inflammation of endothelium that lines heart and cardiac valves. most commonly damages mitral valve, then aortic and tricuspid valves. commonly caused by bacteria that are normally present in the body. can also occur after an invasive medical or dental procedure. symptoms: valvular dysfunction, may affect organ systems, chest pain, CHF, clubbing, meningitis, low back pain, arthralgia, arthritis Contractures and obstructions - ✅Scar tissue is non-elastic Can restrict range of movement pressure ulcer - ✅any lesion caused by unrelieved pressure that results in damage to underlying tissue Pressure Ulcer Prevention - ✅Perform risk assessment, such as Braden Scale, to identify those at risk for developing pressure ulcers Positioning --Reposition a minimum of every 2 hours --Use transfer/draw sheets --Careful attention to heels, area between knees --Float heels Skin Care --Keep skin clean and dry --Use of moisture barrier creams Meet Nutritional needs --Adequate hydration (2,000mL-3,000mL/day) --Nutritional support if indicated DVT (deep vein thrombosis) - ✅formation of a blood clot in a deep vein of the body, occuring most commonly in the legs or thighs

Hypoxia - ✅Low oxygen saturation of the body, not enough oxygen in the blood Anemia - ✅A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume.

Folate deficiency anemia - ✅lack of folate leading to premature RBC death... caused by dietary deficiency iron deficiency anemia - ✅anemia caused by inadequate iron intake sickle cell anemia - ✅hereditary disorder of abnormal hemoglobin producing sickleshaped erythrocytes and hemolysis Aplastic anemia causes - ✅Drugs (phenylbutazone), Infection (parvovirus), Benzene (also causes acute leukemia) Autoimmune hemolytic anemia - ✅anemia caused by antibodies produced by the patient's own immune system secondary polycythemia - ✅from dehydration, emphysema, high altitude, or physical conditioning Anemia of Chronic Renal Failure - ✅Failure of the renal endocrine function impairs erythropoietin production and bone marrow compensation causes of hypernatremia - ✅Decreased sodium excretion (corticosteroids, Cushing's Syndrome, Renal failure, Hyperaldosterone) Increased sodium intake (excessive oral soidium ingestion or administration of sodium containing IV fluids) Decreased water intake (NPO) Increased water loss (increased rate of metabolism, fever, hyperventilation, infection, excessive diaphoresis, watery diarrhea, diabetes insipidus) increased aldosterone - ✅Volume excess Na+ Retention Primary Hyperaldosteroneism dependent edema - ✅Swelling in the part of the body closest to the ground, caused by collection of fluid in the tissues; a possible sign of congestive heart failure.

Isotonic - ✅when the concentration of two solutions is the same capillary oncotic pressure - ✅osmotically attracts water from the interstitial space back into the capillary fluid compartments in body - ✅intracellular and extracellular tactile fremitus - ✅a tremulous vibration of the chest wall during speaking that is palpable on physical examination acute airway obstruction - ✅foreign body aspiration, laryngospasm, trauma, etc. chronic bronchitis - ✅inflammation of bronchi persisting over a long time; type of chronic obstructive pulmonary disease (COPD) pneumothorax - ✅air in the pleural cavity caused by a puncture of the lung or chest wall Surfactant - ✅chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing Cheyne-Stokes respiration - ✅pattern of breathing characterized by a gradual increase of depth and sometimes rate to a maximum level, followed by a decrease, resulting in apnea innate immunity - ✅Immunity that is present before exposure and effective from birth.

Responds to a broad range of pathogens. adaptive immunity - ✅the ability to recognize and remember specific antigens and mount an attack on them herd immunity - ✅The resistance of a group to an attack by a disease to which a large proportion of the members of the group are immune acquired immunity - ✅production of antibodies and lymphocytes after exposure to an antigen immunocompromised - ✅impaired immunologic defenses caused by an immunodeficiency disorder or by therapy with immunosuppressive agents desensitization therapy - ✅a conditioning technique designed to gradually reduce anxiety about a particular object or situation

shift to the left - ✅indicates an increased number of immature neutrophils or increased number of bands. This signals an acute infectious process.

C-reactive protein - ✅A nonspecific protein, produced in the liver, that becomes elevated during episodes of acute inflammation or infection. long bone growth - ✅epiphyseal plate cartilage. closes at 18 in females and 21 in males apendicular skeleton - ✅The appendicular skeleton is divided into six major regions: Pectoral girdles (4 bones) - Left and right clavicle (2) and scapula (2).

Arms and forearms (6 bones) - Left and right humerus (2) (arm), ulna (2) and radius (2) (forearm).

Hands (54 bones) - Left and right carpals (16) (wrist), metacarpals (10), proximal phalanges (10), intermediate phalanges (8) and distal phalanges (10).

Pelvis (2 bones) - Left and right hip bone (2).

Thighs and legs (8 bones) - Left and right femur (2) (thigh), patella (2) (knee), tibia (2) and fibula (2) (leg).

Feet and ankles (52 bones) - Left and right tarsals (14) (ankle), metatarsals (10), proximal phalanges (10), intermediate phalanges (8) and distal phalanges (10).

Function of normal flora - ✅Compete with potential pathogens The functions of the normal flora include digestion of substrates, production of vitamins, stimulation of cell maturation, stimulation of the immune system, aid in intestinal transit and colonization resistance Most common valvular disease - ✅aortic stenosis accounts for 70% of cases more common in women causes are infective endocarditis, severe calcification of the valve opening, tumors, systemic lupus erythematosus or cancer