Health-Illness Concepts Across Lifespan I Exam 1

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Questions and Answers

Which of the following conditions is NOT associated with hypovolemia?

  • Excess sweating
  • CHF (correct)
  • Diarrhea
  • Addison's disease

Which of the following laboratory tests is typically included in a CMP (Complete Metabolic Panel)?

  • ALP (correct)
  • PaCO2
  • PoO2
  • BUN

Which of the following is a sign or symptom of hypervolemia?

  • Decreased urine output (U/O)
  • Dry mucous membranes
  • Weak, thready pulse
  • Bounding peripheral pulses (correct)

Which of the following conditions is associated with fluid volume deficit (hypovolemia)?

<p>Excess sweating (C), Hemorrhage (D)</p> Signup and view all the answers

What is the normal range for arterial oxygen tension (PoO2)?

<p>80 - 100 mmHg (C)</p> Signup and view all the answers

Which condition requires defibrillation as a treatment?

<p>Ventricular Fibrillation (C)</p> Signup and view all the answers

What is the best indicator of fluid balance in a patient?

<p>Daily Weights (C)</p> Signup and view all the answers

What are cardiovascular changes an indicator of?

<p>Dehydration Status (D)</p> Signup and view all the answers

Which condition can lead to asystole?

<p>Acute Myocardial Infarction (D)</p> Signup and view all the answers

What is the minimum obligatory urine output for maintaining adequate hydration?

<p>30 mL/hour (A)</p> Signup and view all the answers

What does movement of water across a semi-permeable membrane refer to?

<p>Osmosis (C)</p> Signup and view all the answers

What can result from electrolyte imbalances, particularly hypokalemia?

<p>Asystole (B)</p> Signup and view all the answers

What is a critical requirement to prevent death related to fluid balance?

<p>Ensure adequate perfusion and oxygenation (C)</p> Signup and view all the answers

What is the primary function of aldosterone in fluid balance?

<p>Stimulates water reabsorption by the kidneys (C)</p> Signup and view all the answers

Which of the following is NOT a sign of dehydration?

<p>Increased blood pressure (A)</p> Signup and view all the answers

Which IV fluid type would be most appropriate for immediate volume expansion in a patient with severe blood loss?

<p>Colloids (D)</p> Signup and view all the answers

What is the main mechanism of action of Antidiuretic Hormone (ADH) on fluid balance?

<p>Stimulates the production of water channels in the kidney tubules (D)</p> Signup and view all the answers

What is the primary function of natriuretic peptides in fluid balance?

<p>Decreases blood pressure by increasing water excretion (A)</p> Signup and view all the answers

A patient presents with a sudden loss of consciousness and is found to have no pulse with no discernable heart rhythm displayed on the cardiac monitor. According to the content, which of the following is the MOST likely intervention?

<p>Immediate defibrillation (A)</p> Signup and view all the answers

A patient's weight has increased by 4.4 lbs over the past 2 days. According to the content this corresponds to a fluid retention of approximately:

<p>2 liters (A)</p> Signup and view all the answers

Which of the following best describes the primary function of cortisol in the context of stress response?

<p>To suppress the immune system and increase blood pressure. (D)</p> Signup and view all the answers

A patient experiencing significant cardiovascular changes, including rapid heart rate and decreased blood pressure, combined with a reported 3 kilogram weight loss over 3 days might MOST likely be showing symptoms of:

<p>Hypovolemia (D)</p> Signup and view all the answers

According to the General Adaptation Syndrome (GAS), what does the body experience as a direct result of being exposed to stress?

<p>A physical response characterized by hormonal changes and immune suppression. (B)</p> Signup and view all the answers

Which of the following is NOT a potential causative factor listed in the content for asystole?

<p>Untreated ventricular tachycardia (D)</p> Signup and view all the answers

A person interprets a normally non-threatening event as a significant challenge. Which term best describes this appraisal?

<p>Eustress (A)</p> Signup and view all the answers

Which coping strategy is most likely to hinder a person's healthy growth and development when applied long term?

<p>Using defense mechanisms to minimize stress. (A)</p> Signup and view all the answers

A nurse notices a patient's skin turgor is poor. Based on this finding alone, which is the most likely imbalance the patient is experiencing?

<p>Fluid volume deficit (B)</p> Signup and view all the answers

How would the body’s response to a physiological stress be best characterized?

<p>A potentially harmful reaction to stimulus. (B)</p> Signup and view all the answers

A patient's lab values are showing changes in hematocrit and electrolytes in combination with a history of kidney disease. Based on the provided information, which of these is MOST relevant to monitor most closely?

<p>Cardiovascular status &amp; perfusion (B)</p> Signup and view all the answers

Besides weight, what other assessment is MOST relevant to monitor when assessing fluid balance in a patient?

<p>Fluid intake and output (B)</p> Signup and view all the answers

According to the content which of these is MOST important to maintain at sufficient levels to avoid death related to fluid imbalance?

<p>Blood pressure (B)</p> Signup and view all the answers

In a patient with hypervolemia due to chronic heart failure, which laboratory finding would be LEAST expected?

<p>Decreased serum albumin (C)</p> Signup and view all the answers

A patient with uncontrolled vomiting presents with confusion, decreased skin turgor, and a weak thready pulse. Which of the following electrolyte and fluid balance imbalances is MOST consistent with these findings?

<p>Hyponatremia and hypovolemia (A)</p> Signup and view all the answers

Which set of clinical manifestations would be MOST consistent with a patient experiencing fluid volume excess (hypervolemia)?

<p>Bounding peripheral pulses, edema, and increased blood pressure (D)</p> Signup and view all the answers

A patient with chronic renal failure develops hypervolemia. Which of the following laboratory results would be most likely?

<p>Increased BUN and increased creatinine (A)</p> Signup and view all the answers

A patient presents with a PaCO2 of 30 mmHg and a pH of 7.50, which of the following is the appropriate acid-base imbalance?

<p>Respiratory alkalosis (B)</p> Signup and view all the answers

Which of the following arterial blood gas values would be most indicative of respiratory acidosis?

<p>pH 7.30, PaCO2 50 mmHg (B)</p> Signup and view all the answers

Which of the following would be the LEAST expected finding in a patient with severe dehydration due to diarrhea?

<p>Increased blood pressure (B)</p> Signup and view all the answers

A patient with severe burns is at high risk for hypovolemia. Which of the following assessment findings would be MOST indicative of this developing complication?

<p>Tachycardia and orthostatic hypotension (D)</p> Signup and view all the answers

Which of the following clinical findings would be MOST consistent with a patient who has developed syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

<p>Hyponatremia, increased urine osmolality and decreased urine output (C)</p> Signup and view all the answers

What is the primary mechanism by which antidiuretic hormone (ADH) reduces plasma osmolarity?

<p>By promoting the reabsorption of solute-free water in the kidneys. (B)</p> Signup and view all the answers

A patient is experiencing a significant drop in blood pressure due to severe blood loss. Which type of intravenous (IV) solution would be most appropriate for initial volume expansion?

<p>A crystalloid solution, such as normal saline. (A)</p> Signup and view all the answers

A patient with Addison's disease is likely to exhibit which set of clinical findings due to the hormonal deficiency?

<p>Hypovolemia, hypotension and hyponatremia (D)</p> Signup and view all the answers

Which of the following most accurately describes the action of natriuretic peptides (NP) in fluid balance?

<p>They help reduce expanded extracellular fluid volume by increasing renal sodium excretion. (C)</p> Signup and view all the answers

A patient has been experiencing severe diarrhea and has become significantly dehydrated. Which of the following would represent the most likely urine output?

<p>Significantly less than 30mL/hr. (A)</p> Signup and view all the answers

What is the primary purpose of administering Dextran in emergency situations?

<p>To expand the patient’s blood volume rapidly when blood is unavailable. (D)</p> Signup and view all the answers

A patient is demonstrating rapid, erratic heart activity on an ECG, but also has a very slow heart rate and no P waves. What is the MOST concerning finding?

<p>The presenting data suggest a lethal dysrhythmia, necessitating immediate assessment of ABCs and LOC. (A)</p> Signup and view all the answers

Which of the following best exemplifies the affective learning domain in a patient care scenario?

<p>A patient expresses a willingness to engage in regular physical therapy sessions, demonstrating a commitment to improving function. (D)</p> Signup and view all the answers

What best describes the role of plasma proteins in managing osmotic pressure?

<p>They control the osmotic pressure in the intravascular space. (D)</p> Signup and view all the answers

A nurse is caring for a patient from a different cultural background who demonstrates a dual pattern of identification. What term best describes this patient's situation?

<p>Biculturalism (D)</p> Signup and view all the answers

If a patient's insensible water loss is estimated to be 1200 mL/day, what might be a potential cause needing immediate attention?

<p>The measurement is greater than normal loss, indicating excessive water loss. (C)</p> Signup and view all the answers

Which situation MOST accurately illustrates 'rule of descent' related to race?

<p>A person’s racial category is assigned based on societal dictates that associate social identity with a person's ancestry. (B)</p> Signup and view all the answers

A patient is experiencing increased insensible water loss. What is a critical nursing intervention that should be implemented?

<p>Assess the patient's respiratory rate and effort closely. (B)</p> Signup and view all the answers

What is the expected physiological response to decreased blood pressure, with regards to fluid balance hormones?

<p>Increased aldosterone and ADH release and decreased natriuretic peptide release. (A)</p> Signup and view all the answers

What BEST describes the physiological process of an ECG capturing a waveform?

<p>It detects the movement of electrical current during the process of depolarization and repolarization in the heart. (B)</p> Signup and view all the answers

In terms of cultural dynamics, what process is occurring when new immigrants slowly begin to adopt the customs, behaviors and attitudes of the new country?

<p>Acculturation (D)</p> Signup and view all the answers

A patient presents with a suspected alteration in fluid balance. If the problem is not corrected what could occur?

<p>Significant fluid and electrolyte imbalances can occur leading to severe dehydration. (A)</p> Signup and view all the answers

A patient in the emergency department has an elevated heart rate of 120 bpm, coupled with signs of dehydration and reports high levels of anxiety . Which term BEST describes this patient's ECG presentation?

<p>Sinus Tachycardia (B)</p> Signup and view all the answers

A nurse is about to teach a patient how to use a new piece of medical equipment. Which learning domain is MOST important for the nurse to focus upon?

<p>Psychomotor (C)</p> Signup and view all the answers

A healthcare provider holds a preconceived, negative attitude about a particular population attributing negative characteristics to all individuals. Which term accurately describes this scenario?

<p>Prejudice (B)</p> Signup and view all the answers

The belief by an individual that their particular race is superior to another race and that their own character is more developed, best describes what term?

<p>Racism (B)</p> Signup and view all the answers

Flashcards

Hypovolemia

A decrease in the volume of plasma in the blood.

Hypervolemia

An increase in the volume of plasma in the blood.

CMP (Comprehensive Metabolic Panel)

A type of blood test that measures the levels of various components in the blood, including electrolytes, proteins, and enzymes.

BMP (Basic Metabolic Panel)

A type of blood test that measures the levels of certain components in the blood, including blood urea nitrogen (BUN), creatinine, glucose, and electrolytes (calcium, sodium, potassium, and chloride).

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Fluid overload

A condition characterized by fluid overload and excess water in the body. It can lead to symptoms such as edema, weight gain, and shortness of breath.

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Ventricular Fibrillation (VFib)

A life-threatening irregular heartbeat where the heart's ventricles quiver instead of pumping blood effectively.

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Asystole

Complete absence of electrical activity in the heart, meaning there's no heartbeat.

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Osmosis

The movement of water across a semipermeable membrane from a region of high water concentration to a region of low water concentration.

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Obligatory Urine Output

The minimum amount of urine needed to eliminate waste products from the body.

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Cognition Changes

Changes in mental clarity, alertness, and awareness. Can signal problems with fluid balance.

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Weight Loss/Gain

Loss or gain in body weight, a reliable indicator of fluid balance, as 1 kg weight change is about 1 L of fluid.

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Cardiovascular Changes

Changes in heart rate, blood pressure, and overall body temperature.

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Fluid Intake/Output

The amount of fluid taken in vs. the amount of fluid excreted. Monitoring this helps gauge fluid balance.

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Osmotic pressure

The pressure exerted by a solution across a semipermeable membrane to prevent the inward flow of water due to differences in solute concentrations.

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Tonicity

The ability of a solution to cause water to move across a semipermeable membrane.

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Aldosterone

A hormone released when blood pressure is low, causing the kidneys to reabsorb sodium and water, leading to increased blood volume.

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Antidiuretic hormone (ADH)

A hormone that stimulates water reabsorption in the kidneys, leading to concentrated urine and decreased plasma osmolarity.

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Crystalloids

IV solutions that contain electrolytes and other substances that are dissolved easily in water, used for dehydration, low blood pressure, and volume replacement.

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Why is fluid balance important?

Fluid balance is crucial for maintaining blood volume and pressure for adequate tissue perfusion and oxygenation. This is necessary for life.

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Weight change as a fluid balance indicator

Changes in weight can indicate fluid loss or gain, which can affect the body's fluid balance. For example, losing 2.2 lbs represents roughly 1 L of fluid loss.

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Intracellular fluid

Fluid inside the body that surrounds cells and plays a crucial role in maintaining cell function.

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Extracellular fluid

Fluid outside the cells in the body's compartments like blood and lymph.

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Isotonic Solution

A type of solution that has the same concentration of solutes as the cells inside the body. Water doesn't move in or out of cells.

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Hypertonic Solution

A type of solution that has a higher concentration of solutes than the cell's interior. Water moves out of the cell.

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Hypotonic Solution

A type of solution that has a lower concentration of solutes than the cell's interior. Water moves into the cell.

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Comprehensive Metabolic Panel (CMP)

A blood test that measures the levels of various components in the blood, including electrolytes, proteins, and enzymes.

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What is a stressor?

Any event or stimulus that disrupts a person's normal state, leading to stress.

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Define Eustress

A specific type of stress that has a positive impact, like a challenge or an exciting event.

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Explain the concept of stress appraisal.

The process through which an individual interprets a stressor, determining if it's a threat or a challenge.

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What is the General Adaptation Syndrome (GAS)?

A set of physiological responses to prolonged stress, divided into three stages: alarm, resistance, and exhaustion.

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What are the two main types of coping strategies?

Problem-focused coping strategies aim to directly address and change the stressful situation, while emotion-focused coping focuses on managing the emotional response to the stressor.

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Natriuretic peptide (NP)

A hormone that helps to control fluid balance by reducing extracellular volume through increased sodium excretion.

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Colloids

IV fluids that are difficult to dissolve, used for volume expansion in emergencies where blood is unavailable.

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Insensible water loss

Loss of fluids from the body through the skin and lungs, as well as in stool.

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Enculturation

The process of learning and acquiring the traditions, customs, and values of a particular culture.

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Acculturation

The process of adopting the customs, values, and behaviors of a new culture while retaining some aspects of your original culture.

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Assimilation

The process of fully integrating into a new culture and losing much of one's original cultural identity.

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Biculturalism

The ability to identify with and function in two or more cultures.

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Stereotype

A general belief held about a group of people, often negative and based on stereotypes.

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Prejudice

Having negative feelings or opinions about a group of people based on prejudice or stereotypes.

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Discrimination

Actions or policies that discriminate against a group of people based on their race, religion, gender, or other factors.

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Race

A social concept that groups people based on shared physical characteristics, ancestry, and cultural traditions.

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Racism

The belief that one racial group is superior to another and that racial differences determine a person's character and abilities.

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Rule of descent

The practice of assigning a person's racial identity based on societal rules that link social identity to one's ancestors.

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Study Notes

A7 Study Notes - Health-Illness Concepts Across the Lifespan I

  • Course: Health-Illness Concepts Across the Lifespan I
  • Institution: Florida State College at Jacksonville
  • Course Material: Study notes, likely exam content covering stress, coping mechanisms, defense mechanisms, and stress-related disorders.

Exam 1 (Modules 1 & 2)

  • Stress: A state of mental/emotional strain, tension causing a stress response. Heavily connected to coping.
  • Stressor: Event/stimulus disrupting normalcy.
  • Stress Appraisal: Process of interpreting a stressor as a threat or challenge.
  • Coping: Actions taken to minimize stress, categorized as problem-focused (long-term solutions) and emotion-focused (managing emotional response).
  • Distress: Negative stress
  • Eustress: Positive stress
  • Physiologic stress: The body's potential harmful reaction to a stimulus.
  • Psychological stress: Emotional and cognitive factors related to interpreting threats.
  • Sociocultural stress: Societal factors like racism, economic hardships, and political upheaval.
  • Cortisol: Main stress hormone. Functions include: decreased serotonin, suppressing the immune system, increasing blood sugar & blood pressure, heightening memory & attention and reducing sensitivity to pain.
  • General Adaptation Syndrome (GAS): Physical response to stress
  • Types of Coping: Problem-focused, emotion-focused, and meaning-focused.
  • Maladaptive Coping: Inaccurate assessment of stressor (denial or avoidance).
  • Defense Mechanisms: Unconscious responses to stress and anxiety (e.g., compensation, conversion, denial).
  • Stress-related disorders: Post-Traumatic Stress Disorder (PTSD), Major Depression, Compassion Fatigue. (Cardinal symptoms including: flashbacks, avoidance, altered cognition/mood, altered arousal/activity).

Assessments

  • Cultural competence: Essential in patient care.
  • Problem-solving ability: Assess patient's ability to solve problems.
  • Suicidal ideation/plan: Verbilization of suicidal thought or plan must be taken seriously; do not leave patient alone without supervision.
  • Physical signs of stress: Evaluate and monitor all systems for potential physical responses to stress; check for all systems.

Additional Topics (from pages 4 & 5)

  • Autonomic Nervous System (ANS): Fight-or-flight response, rest-and-digest response.
  • Panic Disorders: Panic attacks, symptoms.
  • Types of Phobias: Specific, social, and agoraphobia. General Anxiety Disorder (GAD).
  • Obsessive-Compulsive Disorder (OCD): Obsessions and compulsions.
  • Culture and Ethnicity: Culture, ethnicity, enculturation, acculturation, assimilation, biculturalism.
  • Stereotypes, Prejudice, and Discrimination: Defined.
  • Race, Racism, and Bias: Explained
  • Stigma: Defined.

Additional Topics (from pages 6-11)

  • Electrocardiograms (ECG): Understanding different rhythms (Sinus tachycardia, sinus bradycardia, atrial flutter, atrial fibrillation, ventricular tachycardia, ventricular fibrillation, asystole). Risk factors for ventricular arrhythmias.
    • Specific features and interpretation for each listed rhythm should be added.
  • Fluid and Electrolyte imbalances (hypovolemia, hypervolemia): Causes, symptoms, nursing interventions, and monitoring.
  • Sodium (Na+): Function, imbalances (hypo/hypernatremia), related issues, and treatment (infusing hypertonic solutions)
  • Potassium (K+): Function, imbalances (hypo/hyperkalemia), nursing interventions (avoid IV push, consider rate of infusion).
  • Calcium (Ca2+): Function, imbalances (hypo/hypercalcemia), nursing interventions; monitoring for ECG changes, seizure precautions, and fluid restriction.
  • Magnesium (Mg2+): Function, imbalances (hypo/hypermagnesemia), nursing interventions including monitoring for cardiac and respiratory functions.
  • Chloride (Cl-): Function, imbalances (hypo/hyperchloremia), nursing interventions; focus on electrolyte replacement and monitoring fluid balance.

Additional Topics (from pages 12-13)

  • Acid-base imbalances (Respiratory and metabolic acidosis and alkalosis): Causes, symptoms, nursing interventions, ABG values (pH, PaCO2, HCO3), Anion gap (4-12 mmol/L) explained for interpretation.
  • Nursing Considerations, priorities and vital patient assessments: Ongoing monitoring of vital signs, patient safety, including oxygen saturation and support.

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