Module 2 NUR 529

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Questions and Answers

What is chronic activation of the stress response linked to?

Only neurological diseases

Only cardiovascular diseases

A myriad of health disorders (correct)

Only gastrointestinal diseases

What does allostatic load describe?

The effects of chronic stress on the brain

The effects of stress on the skin

The cumulative effects of chronic stress on one’s health (correct)

The effects of acute stress on the heart

What is edema defined as?

Painful swelling produced by expansion of the interstitial fluid volume

Palpable swelling produced by expansion of the interstitial fluid volume (correct)

Visible swelling produced by expansion of the interstitial fluid volume

Tingling sensation produced by expansion of the interstitial fluid volume

How is edema assessed?

Through daily weight, visual assessment, measurement of the affected part, and application of finger pressure to assess for pitting edema Signup and view all the answers

What is the goal of treatment for edema involving vital structures?

To maintain life Signup and view all the answers

How does albumin administration help in edema treatment?

By increasing the plasma colloidal osmotic pressure Signup and view all the answers

What is the effect of elastic support stockings and sleeves on interstitial fluid?

It increases interstitial fluid pressure and resistance to outward movement of fluid Signup and view all the answers

What is a common treatment for an increase in ECF volume?

Diuretic therapy Signup and view all the answers

What is the primary target site of antifungal agents?

Cytoplasmic membranes of yeasts or molds Signup and view all the answers

What is the purpose of surgical intervention in treating infectious diseases?

To remove infected tissues, organs, or limbs Signup and view all the answers

What type of agents inhibit an HIV-specific enzyme necessary for late maturation events in the virus life cycle?

Protease inhibitors Signup and view all the answers

What is the purpose of immunotherapy?

To stimulate the host's immune response Signup and view all the answers

Why do antiviral agents often have side effects on the host?

Because they interfere with host cell production Signup and view all the answers

What is the main function of the intact skin as a physical barrier?

To prevent infection Signup and view all the answers

What is the characteristic of a bactericidal agent?

It causes irreversible and lethal damage to the bacterial pathogen Signup and view all the answers

What is a characteristic of a Grade I anaphylaxis reaction?

Erythema and urticaria, with or without angioedema Signup and view all the answers

What is the goal of treatment of parasitic illness?

To exploit essential components of the parasite's metabolism or cellular anatomy Signup and view all the answers

What is a critical step in the initial management of anaphylaxis?

Withdrawal of the offending allergen Signup and view all the answers

What is a hallmark feature of anaphylaxis?

Systemic IgE-mediated hypersensitivity reaction Signup and view all the answers

What is a potential complication of Grade IV anaphylaxis?

Cardiac arrest Signup and view all the answers

What is the primary goal of preventing exposure to potential triggers in anaphylaxis?

Preventing anaphylaxis from occurring Signup and view all the answers

What is a key component of innate immunity that helps protect humans against pulmonary infections?

Innate immunity barriers Signup and view all the answers

What is the primary function of the lungs in acid-base regulation?

To control extracellular CO2 levels Signup and view all the answers

What is the timeframe for the respiratory system to respond to acid-base disturbances?

Minutes to hours Signup and view all the answers

What is the primary role of the kidneys in acid-base regulation?

To excrete H+ ions from the body Signup and view all the answers

What is the purpose of a culture in diagnosing infectious diseases?

To recover a probable pathogen from the infected site Signup and view all the answers

What is the basis for identifying a bacterial pathogen in a culture?

All of the above Signup and view all the answers

How do fungi differ from bacteria in terms of culture?

Fungi are identified based on microscopic and colonial morphology Signup and view all the answers

What is the timeframe for identifying some fungi through culture?

Weeks to months Signup and view all the answers

What are the two criteria required for the diagnosis of an infectious disease?

Recovery of a probable pathogen and clinical signs and symptoms Signup and view all the answers

What is the traumatic stress response?

A change in the biochemical stress response system due to childhood mistreatment Signup and view all the answers

What is a consequence of caregiver burnout?

Decreased patient satisfaction and increased safety risks Signup and view all the answers

What was a finding in a study of caregivers of a spouse or family member during the COVID-19 pandemic?

Caregivers reported higher levels of caregiver stress and poorer self-perceived global health ratings Signup and view all the answers

What is the importance of educating caregivers about available resources and support systems?

To reduce caregiver stress and prevent abuse of older adults Signup and view all the answers

According to the American Institute of Stress, what is the difference in the prevalence of stress between two age groups?

Stress is twice as common in people aged 50 to 65 than those aged 65 to 80 years Signup and view all the answers

What is a consideration when working with bilingual older adults who are stressed?

An interpreter may be helpful when bilingual people use their home language when stressed Signup and view all the answers

What is the effect of early intervention on people who have experienced childhood mistreatment?

It assists them in developing new and effective coping mechanisms to better manage stress Signup and view all the answers

What is a long-term consequence of chronicity and excessive activation of the stress response?

Development of long-term health problems Signup and view all the answers

Which of the following is NOT a potential health problem associated with chronic stress?

Improved bone density Signup and view all the answers

What is the term for the cumulative effects of chronic stress on one’s health?

Allostatic load Signup and view all the answers

What is a common treatment for edema resulting from an increase in ECF volume?

Diuretic therapy Signup and view all the answers

What is the purpose of administering albumin in the treatment of edema?

To raise the plasma colloidal osmotic pressure Signup and view all the answers

What is the effect of elastic support stockings and sleeves on interstitial fluid?

They increase interstitial fluid pressure and resistance to outward movement of fluid Signup and view all the answers

What is seen because of the increased allostatic load in marginalized communities?

Health disparities Signup and view all the answers

What is the primary goal of edema treatment when it involves vital structures?

To maintain life Signup and view all the answers

What is the primary goal of the respiratory system in acid-base regulation?

To regulate extracellular CO2 levels Signup and view all the answers

What is the timeframe for the kidneys to respond to acid-base disturbances?

12 to 24 hours Signup and view all the answers

What is the primary role of the kidneys in acid-base regulation?

All of the above Signup and view all the answers

What are the two criteria required for the diagnosis of an infectious disease?

Recovery of a probable pathogen and clinical signs and symptoms Signup and view all the answers

What is the basis for identifying a bacterial pathogen in a culture?

Biochemical reactions and microscopic appearance Signup and view all the answers

How do fungi differ from bacteria in terms of culture?

Fungi take longer to grow and require more reliance on microscopic morphology Signup and view all the answers

What is the timeframe for identifying some fungi through culture?

Weeks to months Signup and view all the answers

What is the purpose of a culture in diagnosing infectious diseases?

To identify the pathogen and its characteristics Signup and view all the answers

What is the primary mechanism by which antiparasitic agents target parasites?

By exploiting essential components of the parasite's metabolism or cellular anatomy Signup and view all the answers

What is the main difference between bactericidal and bacteriostatic agents?

Bactericidal agents cause irreversible damage to bacteria, while bacteriostatic agents inhibit bacterial growth Signup and view all the answers

Why do antiviral agents often have side effects on the host?

Because they inhibit viral replication, which also affects host cell production Signup and view all the answers

What is the primary purpose of immunotherapy?

To supplement or stimulate the host's immune response Signup and view all the answers

What is the primary target site of antifungal agents?

The cytoplasmic membranes of fungi Signup and view all the answers

What is the primary goal of surgical intervention in treating infectious diseases?

To remove infected tissues or organs Signup and view all the answers

What is the primary mechanism by which protease inhibitors work?

By inhibiting an HIV-specific enzyme necessary for late maturation events in the virus life cycle Signup and view all the answers

What is the primary function of the intact skin as a physical barrier?

To prevent infection by blocking the entry of pathogens Signup and view all the answers

What percentage of people presenting with sepsis cannot be identified by culture? The causative organism cannot be identified by culture in up to 33% of people presenting with sepsis.

33% Signup and view all the answers

What type of antibodies generally rise and fall during the acute phase of the disease?

IgM Signup and view all the answers

What is the primary mechanism of antigen detection in infectious diseases?

Purified antibodies detecting antigens Signup and view all the answers

What is the primary source of most antibiotics?

Bacteria and fungi Signup and view all the answers

What is the primary advantage of antigen detection over culture?

Reduced time required for diagnosis Signup and view all the answers

What is the primary function of serology in diagnosing infectious diseases?

Indirect detection of pathogens through antibody measurement Signup and view all the answers

What is the significance of IgM antibodies in neonates?

They do not cross the placenta Signup and view all the answers

What is the primary mechanism underlying anaphylaxis?

IgE-mediated hypersensitivity reaction Signup and view all the answers

What is the characteristic of a Grade III anaphylaxis reaction?

Life-threatening due to the development of bronchospasm, cardiac dysrhythmias, and cardiac collapse Signup and view all the answers

What is the critical step in the initial management of anaphylaxis?

Withdrawal of the offending allergen and maintenance of a patent airway Signup and view all the answers

What is the purpose of preventing exposure to potential triggers in anaphylaxis?

To prevent the reaction from occurring Signup and view all the answers

What is the hallmark feature of anaphylaxis?

Systemic, life-threatening IgE-mediated hypersensitivity reaction Signup and view all the answers

What is the function of lysozyme in the human body?

To break down bacterial cell membranes Signup and view all the answers

What is the role of the complement system in the immune response?

To facilitate the phagocytic activity of immune cells Signup and view all the answers

What is the function of defensins in the stomach and intestines?

To kill microorganisms by disrupting their membranes Signup and view all the answers

What is the role of the complement system in bridging the innate-adaptive immune responses?

Through the release of C3 complement protein Signup and view all the answers

What is the combined effect of digestive enzymes, acidic conditions, and defensins in the stomach and intestines?

Death of microorganisms Signup and view all the answers

What is the function of lysozyme in the innate immune response?

To break down bacterial cell walls Signup and view all the answers

What is the primary function of the complement system?

To facilitate the activity of phagocytic immune cells Signup and view all the answers

What is the role of defensins in the innate immune response?

To kill microorganisms by disrupting their membranes Signup and view all the answers

What is the result of the action of digestive enzymes, acidic conditions, and defensins in the stomach and intestines?

The death of microbes Signup and view all the answers

What is the primary function of hemostasis?

To stop blood flow Signup and view all the answers

During stage 1 of hemostasis, what occurs?

Vessel vasoconstriction Signup and view all the answers

What is the role of Von Willebrand factor (vWF) in hemostasis?

To bind platelet receptors and cause adhesion to collagen fibers Signup and view all the answers

What is released from platelets during stage 2 of hemostasis?

ADP and TXA2 Signup and view all the answers

What is the result of platelet adhesion to collagen fibers during stage 2 of hemostasis?

Platelet activation and release of ADP and TXA2 Signup and view all the answers

What is the overall goal of the three stages of hemostasis?

To stop blood flow and promote healing Signup and view all the answers

What is the most common cause of iron deficiency anemia in adult men and postmenopausal women?

Chronic blood loss from peptic ulcer Signup and view all the answers

Why is iron demand increased in child-bearing age women?

Due to loss of RBCs through menstrual cycle Signup and view all the answers

What is a characteristic of anemia manifestation?

All of the above Signup and view all the answers

What is a common cause of iron deficiency in infants?

All of the above Signup and view all the answers

What is a diagnostic criterion for anemia?

Decreased MCHC and MCV Signup and view all the answers

What is a cause of iron deficiency anemia in children?

Increased iron demand due to growth Signup and view all the answers

What is a manifestation of anemia?

All of the above Signup and view all the answers

What is a consequence of iron deficiency anemia?

Decreased RBC production and shortened RBC lifespan Signup and view all the answers

What is the primary function of thrombin in the coagulation process?

To convert fibrinogen to insoluble fibrin threads Signup and view all the answers

What is the main difference between the intrinsic and extrinsic pathways of coagulation?

The intrinsic pathway is activated by factor XII, while the extrinsic pathway is initiated by tissue factor Signup and view all the answers

What is the characteristic of petechiae in bleeding disorders?

It is a sign of platelet deficiency Signup and view all the answers

What is the normal range for platelet count in the blood?

> 150,000/uL Signup and view all the answers

What is the effect of sickle cell disease on red blood cells?

It increases red cell adhesiveness and adherence to vessel walls Signup and view all the answers

What is the primary function of plasmin in the coagulation process?

To dissolve the clot and allow blood flow to be reestablished Signup and view all the answers

What is the result of a decrease in platelet production, increased destruction, or impaired function?

Bleeding disorders Signup and view all the answers

What is the characteristic of thrombocytopenia?

A decrease in platelet count Signup and view all the answers

How many stages is hemostasis divided into?

Four Signup and view all the answers

What is the final stage of hemostasis where a fibrin clot is formed?

Formation of the fibrin plug Signup and view all the answers

Hemostasis involves the interaction of substrates, enzymes, protein cofactors, and calcium ions that circulate in the blood or are released from platelets and cells. The process is an orderly, stepwise process for stopping bleeding that involves vasospasm, formation of a platelet plug, triggering of the coagulation cascade, and the development of a ______.

fibrin clot Signup and view all the answers

Clot retraction and clot dissolution are not significant processes in hemostasis.

False Signup and view all the answers

The central nervous system consists of the brain and the ______.

spinal cord Signup and view all the answers

The ______ is located between the thorax and the lower limbs.

pelvis Signup and view all the answers

The area between the chest and the pelvis is known as the ______.

abdomen Signup and view all the answers

The protective bony structure known as the ______ encases vital organs such as the heart and lungs.

chest Signup and view all the answers

The ______ is responsible for processing sensory information and coordinating motor functions.

brain Signup and view all the answers

Study Notes

Stress and Adaptation

The traumatic stress response is a change in the biochemical stress response system that occurs in people who have experienced mistreatment as a child, making it difficult for them to respond effectively to stressors in the future.
Early intervention can help individuals develop new and effective coping mechanisms to manage stress.
Caregiver stress can contribute to burnout, leading to decreased patient satisfaction and increased safety risks.
A study conducted during the COVID-19 pandemic showed that caregivers reported higher levels of caregiver stress and had poorer self-perceived global health ratings due to reduced home and community resources and limited contact with friends and family.

Geriatric Considerations

Using an interpreter can be helpful when bilingual people use their home language when stressed.
Caregiver stress contributes to abuse of older adults, highlighting the importance of educating about available resources and support systems.
Role fulfillment is key to stress management in the aging adult, and sharing the need to allow the person to perform roles within limitations is encouraged.
Stress is twice as common in people aged 50 to 65 than those aged 65 to 80 years.

Pediatric Considerations

Chronicity and excessive activation of the stress response can result from chronic illnesses and contribute to the development of long-term health problems.
Chronic activation of the stress response is an important public health issue from both a health and a cost perspective.
Stress is linked to various health disorders, including diseases of the cardiovascular, gastrointestinal, immune, and neurologic systems, as well as depression, substance use disorder, eating disorders, accidents, and suicide.
Allostatic load describes the cumulative effects of chronic stress on one's health, leading to negative effects on the immune, cardiovascular, and metabolic processes.

Hormonal Stress

Neuroendocrine responses and effects on the body are important aspects of hormonal stress.

Compartmental Distribution of Body Fluids

Edema can be defined as palpable swelling produced by expansion of the interstitial fluid volume.
Assessment of edema involves daily weight, visual assessment, measurement of the affected part, and application of finger pressure to assess for pitting edema.
Treatment of edema is directed towards maintaining life when the swelling involves vital structures, correcting or controlling the cause, and preventing tissue injury.
Edema of the lower extremities may respond to simple measures such as elevating the feet.

Mechanisms of Acid-Base Regulation

The lungs play a role in acid-base regulation through the control of extracellular CO2.
The kidneys are the third line of defense in acid-base disturbances and play three major roles: excretion of H+ from fixed acids, reabsorption of HCO3, and production of new HCO3.

Infectious Diseases

Diagnosis of an infectious disease requires the recovery of a probable pathogen or evidence of its presence from the infected sites of a diseased host, and accurate documentation of clinical signs and symptoms compatible with an infectious process.
Culture refers to the growth of a microorganism outside of the body, usually on or in artificial growth media.
Diagnosis types include culture, microscopy, and biochemical reactions.

Treatment of Infectious Diseases

Antimicrobial agents can be bactericidal or bacteriostatic, depending on whether they cause irreversible and lethal damage to the bacterial pathogen or inhibit bacterial growth.
Antiviral agents interrupt viral replication and can interfere with host cell production.
Antifungal agents target the cytoplasmic membranes of yeasts or molds.
Antiparasitic agents target essential components of the parasite's metabolism or cellular anatomy that are not shared by the host.
Immunotherapy involves supplementing or stimulating the host's immune response to limit or reverse the spread of a pathogen.
Surgical intervention may be necessary to remove infected tissues, organs, or limbs.

Innate and Adaptive Immunity

Epithelial barriers, such as intact skin, provide a physical barrier against infection.
Anaphylaxis is a catastrophic, systemic, life-threatening IgE-mediated hypersensitivity reaction that requires immediate management, including withdrawal of the offending allergen, maintenance of a patent airway, and administration of epinephrine.

Innate Immunity Barriers

Innate barriers, such as the respiratory tract, help protect humans against pulmonary infections.

Chronic Stress and Health

Chronic stress can lead to chronic illnesses and contribute to the development of long-term health problems.
Chronic activation of the stress response is a significant public health issue, affecting both health and economic costs.
Stress is linked to various health disorders, including cardiovascular, gastrointestinal, immune, and neurologic system diseases, as well as depression, substance use disorder, eating disorders, accidents, and suicide.
Allostatic load describes the cumulative effects of chronic stress on one's health, leading to negative effects on the immune, cardiovascular, and metabolic processes, resulting in inflammation, hypertension, hyperglycemia, and other health problems.
Increased allostatic load contributes to health disparities in marginalized communities.

Hormonal Stress

Neuroendocrine responses and effects on the body

Compartmental Distribution of Body Fluids

Edema is defined as palpable swelling produced by expansion of the interstitial fluid volume.
Assessment: daily weight, visual assessment, measurement of the affected part, and application of finger pressure to assess for pitting edema.
Treatment: directed towards maintaining life when the swelling involves vital structures, correcting or controlling the cause, and preventing tissue injury.
Edema of the lower extremities may respond to simple measures such as elevating the feet.
Diuretic therapy is commonly used for an increase in ECF volume.
Albumin may be administered to raise the plasma colloidal osmotic pressure when the cause of the edema is hypoalbuminemia.
Elastic support stockings and sleeves increase interstitial fluid pressure and resistance to outward movement of fluid from the capillary into the tissue spaces.

Mechanisms of Acid-Base Regulation

Respiratory: Control of extracellular CO2 by the lungs, which comes into play when chemical buffers do not minimize H+ changes.
The lungs respond rapidly, preventing large changes in pH from occurring while waiting for the kidneys to respond.
Kidneys: The third line of defense in acid-base disturbances, playing three major roles:
- Excretion of H+ from fixed acids that result from protein and lipid metabolism.
- Reabsorption of HCO3 that is filtered through the glomerulus, so it's not lost in the urine.
- Production of new HCO3 that is released back into the blood.

Infectious Diseases

Diagnosis and treatment of infectious diseases require the recovery of a probable pathogen or evidence of its presence from the infected sites of a diseased host, and accurate documentation of clinical signs and symptoms compatible with an infectious process.
Diagnosis types:
- Culture: Growth of a microorganism outside of the body, usually on or in artificial growth media.
- Serology: Indirect means of identifying infectious agents by measuring serum antibodies in the diseased host.
- Antigen detection: Incorporates features of culture and serology, reducing the time required for diagnosis.
- DNA and RNA sequencing: Methods such as DNA probe hybridization and polymerase chain reaction (PCR).
General intervention methods used in treatment of infectious diseases:
- Antimicrobial agents: Can be categorized according to mechanism of anti-infective activity, chemical structure, and target pathogen.
- Antimicrobial agents: Antibacterial agents, antiviral agents, antifungal agents, and antiparasitic agents.
- Immunotherapy: Involves supplementing or stimulating the host's immune response.
- Surgical intervention: Surgical removal of infected tissues, organs, or limbs, usually only needed when the infective agent is resistant to all treatments.

Innate and Adaptive Immunity

Epithelial barriers: The intact skin is a formidable physical barrier available to infection.
Anaphylaxis: A catastrophic, systemic, life-threatening IgE-mediated hypersensitivity reaction associated with the widespread release of histamine into the systemic circulation.
Clinical manifestations of anaphylaxis occur along a continuum in severity and can be graded on a scale of I to IV.
Prevention of anaphylaxis is essential, and initial management should focus on withdrawal of the offending allergen, maintenance of a patent airway, establishment of appropriate intravenous access, volume resuscitation, and administration of epinephrine.

Innate Immunity Barriers

Innate barriers that help protect humans against pulmonary infections:
- Epithelial barriers

Chemical Defenses

Mucus-trapped microorganisms are subjected to various chemical defenses throughout the body.
Lysozyme is a hydrolytic enzyme found in tears, saliva, and human milk that breaks down bacterial cell walls.
Lysozyme is capable of breaking down bacterial cell walls.

The Complement System

The complement system is found in the blood and is essential for the activity of antibodies.
The complement system is composed of 20 different enzyme precursors.
Activation of the complement system by antigen-antibody complexes causes bacteria to clump together.
Clumped bacteria are more susceptible to phagocytic immune cells.

Bridging Innate-Adaptive Immune Responses

The complement system plays a key role in bridging the innate-adaptive immune responses through the release of C3 complement protein.
Research by Thurman (2020) supports the role of complement in bridging innate-adaptive immune responses.

Defense Mechanisms in the Stomach and Intestines

Death of microbes in the stomach and intestines results from the action of digestive enzymes, acidic conditions, and the secretion of defensins.
Defensins are small, positively charged peptides that quickly kill both gram-positive and gram-negative microorganisms.
Defensins disrupt the microbial membrane, leading to the death of microorganisms.
Research by Lin et al. (2020) supports the role of defensins in killing microorganisms.

Chemical Defenses

Mucus-trapped microorganisms are subjected to various chemical defenses throughout the body.
Lysozyme is a hydrolytic enzyme found in tears, saliva, and human milk that breaks down bacterial cell walls.
Lysozyme is capable of breaking down bacterial cell walls.

The Complement System

The complement system is found in the blood and is essential for the activity of antibodies.
The complement system is composed of 20 different enzyme precursors.
Activation of the complement system by antigen-antibody complexes causes bacteria to clump together.
Clumped bacteria are more susceptible to phagocytic immune cells.

Bridging Innate-Adaptive Immune Responses

The complement system plays a key role in bridging the innate-adaptive immune responses through the release of C3 complement protein.
Research by Thurman (2020) supports the role of complement in bridging innate-adaptive immune responses.

Defense Mechanisms in the Stomach and Intestines

Death of microbes in the stomach and intestines results from the action of digestive enzymes, acidic conditions, and the secretion of defensins.
Defensins are small, positively charged peptides that quickly kill both gram-positive and gram-negative microorganisms.
Defensins disrupt the microbial membrane, leading to the death of microorganisms.
Research by Lin et al. (2020) supports the role of defensins in killing microorganisms.

Hemostasis and Blood Clotting

Hemostasis is the stoppage of blood flow, consisting of three stages
Stage 1: Vessel vasoconstriction, where vascular smooth muscle contraction occurs and local nervous reflexes and humoral factors (TXA2) are released from platelets
Stage 2: Formation of the platelet plug, where vWF is released from the endothelium, binds to platelet receptors, and causes adhesion of platelets to exposed collagen fibers
Stage 3: Development of a blood clot as a result of the coagulation process, involving two coagulation pathways: intrinsic and extrinsic
Clot retraction pulls the edges of the injured vessel together
Clot dissolution/lysis allows blood flow to be reestablished and tissue healing to take place

Bleeding Disorders: Platelet Disorders

Disorders result from a decrease in the number of platelets due to decreased production, increased destruction, or impaired function
Spontaneous bleeding often involves small vessels of mucous membranes and skin (mouth, nose, GI tract, uterine cavity)
Cutaneous bleeding includes pinpoint hemorrhages (petechiae) and bruising (purpura)
Petechiae indicates platelet deficiency, not dysfunction
Thrombocytopenia is characterized by reduced platelets (< 150,000/μL), commonly caused by folic acid and vitamin B12 deficiencies
Sickle cell disease is characterized by abnormally shaped RBCs that increase red cell adhesiveness and adherence to vessel walls, leading to hemolysis, occlusion, and ischemia

Anemia: Anemias of Deficient Red Cell Production

Iron deficiency anemia (IDA) can be caused by four factors: loss of RBCs from bleeding, destruction of RBCs, defective RBC production, or inadequate RBC production
IDA in adults is commonly caused by chronic blood loss, GI bleeds, or iron deficiency during childbearing age
IDA in children is commonly caused by increased iron demand due to growth and low iron levels at birth
Anemia manifestations include fatigue, irritability, PICA, dyspnea, tachycardia, angina, and palpitations
Diagnosis of anemia involves decreased MCHC and MCV

Nonneoplastic Disorders of White Blood Cells: Infectious Mononucleosis

Clinical course, most common complications, and laboratory diagnostics are key aspects of infectious mononucleosis

Hemostasis: Stages and Process

Hemostasis refers to the stoppage of blood flow and involves four stages: vessel vasoconstriction, formation of the temporary platelet plug, activation of the coagulation cascade, and formation of the fibrin plug (final clot).

Stages of Hemostasis

Vessel vasoconstriction: the first stage of hemostasis, where blood vessels constrict to reduce blood flow.
Formation of the temporary platelet plug: the second stage, where platelets aggregate to form a temporary plug to stop bleeding.
Activation of the coagulation cascade: the third stage, where a series of biochemical reactions occur to form a blood clot.
Formation of the fibrin plug (final clot): the fourth and final stage, where a stable fibrin clot is formed to permanently stop bleeding.

Importance of Clot Retraction and Clot Dissolution

Clot retraction: a process that pulls the edges of the injured vessel together, promoting wound healing.
Clot dissolution: a process that involves the action of plasmin to dissolve the clot and allow blood flow to be reestablished and tissue healing to take place.

Factors Involved in Hemostasis

Platelets: produced in the bone marrow, necessary for blood clotting.
Von Willebrand factor (vWF): generated by the vessel endothelium, necessary for blood clotting.
Clotting factors: synthesized in the liver, using vitamin K, necessary for blood clotting.
Calcium ions: essential for blood coagulation.
Vitamin K: necessary for the synthesis of clotting factors in the liver.

Regulation of Blood Coagulation

Blood coagulation requires the stepwise activation of coagulation factors, carefully controlled by activators and inhibitors.

Immune System Defenses

Microorganisms trapped by mucus face chemical defenses like lysozymes and the complement system.
Lysozymes are hydrolytic enzymes that break down bacterial cell walls, found in tears, saliva, and human milk.
The complement system consists of 20 enzyme precursors that enhance antibody activity and lead to bacterial clumping for easier phagocytosis.
Recent research indicates the complement system bridges innate and adaptive immunity via the release of C3 complement protein.
In the gastrointestinal tract, digestive enzymes, acidic conditions, and defensins lead to microbial death, with defensins disrupting microbial membranes.

Hemostasis

Hemostasis is the process of blood flow stoppage, divided into four key stages:
- Vessel vasoconstriction involves smooth muscle contraction and local factors like TXA2 from platelets.
- Formation of a platelet plug occurs through the action of Von Willebrand factor (vWF) binding to platelets, leading to aggregation.
- Development of a blood clot through the coagulation cascade activates both the intrinsic and extrinsic pathways, culminating in fibrin formation.
- Clot retraction brings vessel edges together, and clot dissolution via plasmin allows blood flow restoration and tissue healing.

Anemia

Four main causes of anemia include blood loss, hemolysis, defective RBC production, and inadequate production due to nutritional deficiencies.
Iron Deficiency Anemia (IDA) causes differ in adults and children; adults commonly experience chronic blood loss from gastrointestinal sources, while children often face increased growth demands and dietary deficiencies.
Symptoms of anemia include fatigue, irritability, PICA, dyspnea, tachycardia, and angina, with diagnosis showing decreased mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV).

Stress and Health

Chronic activation of the stress response leads to significant health issues, affecting cardiovascular, gastrointestinal, and immune systems.
Allostatic load refers to the cumulative health effects of chronic stress, linking to higher risks of inflammation and metabolic disorders.
Caregiver stress and burnout are critical issues, particularly highlighted during the COVID-19 pandemic.

Edema

Edema is characterized by swelling due to increased interstitial fluid volume, assessed via weight changes, visual eval, and pitting tests.
Treatment may involve diuretics and elevating affected limbs; hypoalbuminemia may require albumin administration to restore plasma osmotic pressure.
Supportive measures include elastic support to enhance fluid pressure and limit outward fluid movement.

Infectious Diseases

Diagnosis of infectious diseases involves recovering probable pathogens or compatible clinical signs.
Culturing microorganisms involves growth on media; bacterial identification relies on morphology and biochemical characteristics.
Fungal cultures can take weeks, necessitating attention to their distinct growth characteristics compared to bacteria.

Anaphylaxis

Anaphylaxis is a life-threatening IgE-mediated hypersensitivity reaction marked by widespread histamine release, leading to vasodilation and hypotension.
Reactions can range from mild (Grade I) to critical (Grade IV), with symptoms progressing from skin manifestations to potential cardiac arrest.
Initial management involves allergen withdrawal, airway maintenance, volume resuscitation, and epinephrine administration.

Acid-Base Regulation

The lungs control extracellular CO2 levels as a rapid response to acid-base disturbances, while kidneys serve as a slower, third line of defense by excreting H+ and reabsorbing bicarbonate (HCO3).
This dual-action helps prevent drastic pH changes and ensures effective acid-base homeostasis.### Chronic Stress
Chronic illnesses can lead to excessive activation of the stress response, increasing risks for long-term health problems.
Chronic stress is a significant public health concern due to its health impacts and associated costs.
Stress correlates with a variety of health disorders, including cardiovascular, gastrointestinal, immune, and neurological diseases, as well as mental health issues like depression and substance use disorders.
Allostatic load is defined as the cumulative impact of chronic stress on health, leading to inflammation, hypertension, and hyperglycemia.
Stress hormones, particularly cortisol, negatively affect immune, cardiovascular, and metabolic processes.
Increased allostatic load contributes to health disparities, particularly in marginalized communities.

Edema

Edema is characterized by palpable swelling due to increased interstitial fluid volume.
Assessment methods include daily weight monitoring, visual examination, and measuring the affected area.
Treatment aims to maintain vital function, manage underlying causes, and prevent tissue damage.
Lower extremity edema can be treated with simple measures like elevating the legs.
Diuretics are commonly used to reduce excess extracellular fluid volume.
Albumin can be administered to increase plasma colloidal osmotic pressure when hypoalbuminemia is the cause.
Elastic support stockings help increase interstitial fluid pressure, minimizing fluid movement into tissues.

Infectious Disease Treatment

Antimicrobial agents are classified by their anti-infective mechanisms, chemical structure, and targeted pathogens.
Antibacterial agents are often derived from microorganisms and act by either killing bacteria (bactericidal) or inhibiting their growth (bacteriostatic).
Antiviral drugs interrupt viral replication but may also affect host cell production.
Protease inhibitors specifically target HIV by inhibiting a key enzyme in the virus's lifecycle.
Antifungal agents primarily affect the cytoplasmic membranes of fungi.
Antiparasitic treatments leverage differences in parasite metabolism or cellular structure to avoid harming the host.

Immunotherapy and Surgical Intervention

Immunotherapy enhances the host's immune response using elements like IVIG and cytokines to control pathogens.
Surgical options may be necessary for resistant infections or to expedite recovery through drainage or debridement of infected areas.

Innate and Adaptive Immunity

Intact skin serves as a major physical barrier against infections.
Cultures should be obtained before antibiotic treatment when sepsis is suspected.
In serology, the presence of IgM and IgG antibodies can help diagnose infections, especially when there's a rise in antibody titers during illness.
Antigen detection methods provide quicker diagnosis by identifying infectious agents directly in patient samples.
Techniques such as DNA probe hybridization and polymerase chain reaction (PCR) enhance pathogen detection accuracy.

Anaphylaxis

Anaphylaxis is a severe IgE-mediated hypersensitivity reaction, manifesting as systemic vasodilation, hypotension, and airway edema.
Reactions are graded from I to IV, with increases in severity and risk to life at higher grades.
Immediate management includes avoidance of allergens, airway maintenance, IV access, volume resuscitation, and epinephrine administration.

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This quiz covers topics from Chapter 7 of Psychology, focusing on stress and adaptation, including the traumatic stress response and treatment of stress disorders.

Module 2 NUR 529

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Questions and Answers

What is chronic activation of the stress response linked to?

What does allostatic load describe?

What is edema defined as?

How is edema assessed?

What is the goal of treatment for edema involving vital structures?

How does albumin administration help in edema treatment?

What is the effect of elastic support stockings and sleeves on interstitial fluid?

What is a common treatment for an increase in ECF volume?

What is the primary target site of antifungal agents?

What is the purpose of surgical intervention in treating infectious diseases?

What type of agents inhibit an HIV-specific enzyme necessary for late maturation events in the virus life cycle?

What is the purpose of immunotherapy?

Why do antiviral agents often have side effects on the host?

What is the main function of the intact skin as a physical barrier?

What is the characteristic of a bactericidal agent?

What is a characteristic of a Grade I anaphylaxis reaction?

What is the goal of treatment of parasitic illness?

What is a critical step in the initial management of anaphylaxis?

What is a hallmark feature of anaphylaxis?

What is a potential complication of Grade IV anaphylaxis?

What is the primary goal of preventing exposure to potential triggers in anaphylaxis?

What is a key component of innate immunity that helps protect humans against pulmonary infections?

What is the primary function of the lungs in acid-base regulation?

What is the timeframe for the respiratory system to respond to acid-base disturbances?

What is the primary role of the kidneys in acid-base regulation?

What is the purpose of a culture in diagnosing infectious diseases?

What is the basis for identifying a bacterial pathogen in a culture?

How do fungi differ from bacteria in terms of culture?

What is the timeframe for identifying some fungi through culture?

What are the two criteria required for the diagnosis of an infectious disease?

What is the traumatic stress response?

What is a consequence of caregiver burnout?

What was a finding in a study of caregivers of a spouse or family member during the COVID-19 pandemic?

What is the importance of educating caregivers about available resources and support systems?

According to the American Institute of Stress, what is the difference in the prevalence of stress between two age groups?

What is a consideration when working with bilingual older adults who are stressed?

What is the effect of early intervention on people who have experienced childhood mistreatment?

What is a long-term consequence of chronicity and excessive activation of the stress response?

Which of the following is NOT a potential health problem associated with chronic stress?

What is the term for the cumulative effects of chronic stress on one’s health?

What is a common treatment for edema resulting from an increase in ECF volume?

What is the purpose of administering albumin in the treatment of edema?

What is the effect of elastic support stockings and sleeves on interstitial fluid?

What is seen because of the increased allostatic load in marginalized communities?

What is the primary goal of edema treatment when it involves vital structures?

What is the primary goal of the respiratory system in acid-base regulation?

What is the timeframe for the kidneys to respond to acid-base disturbances?

What is the primary role of the kidneys in acid-base regulation?

What are the two criteria required for the diagnosis of an infectious disease?

What is the basis for identifying a bacterial pathogen in a culture?

How do fungi differ from bacteria in terms of culture?

What is the timeframe for identifying some fungi through culture?

What is the purpose of a culture in diagnosing infectious diseases?

What is the primary mechanism by which antiparasitic agents target parasites?

What is the main difference between bactericidal and bacteriostatic agents?

Why do antiviral agents often have side effects on the host?

What is the primary purpose of immunotherapy?

What is the primary target site of antifungal agents?

What is the primary goal of surgical intervention in treating infectious diseases?

What is the primary mechanism by which protease inhibitors work?

What is the primary function of the intact skin as a physical barrier?

What percentage of people presenting with sepsis cannot be identified by culture? The causative organism cannot be identified by culture in up to 33% of people presenting with sepsis.

What type of antibodies generally rise and fall during the acute phase of the disease?

What is the primary mechanism of antigen detection in infectious diseases?

What is the primary source of most antibiotics?

What is the primary advantage of antigen detection over culture?

What is the primary function of serology in diagnosing infectious diseases?

What is the significance of IgM antibodies in neonates?

What is the primary mechanism underlying anaphylaxis?

What is the characteristic of a Grade III anaphylaxis reaction?

What is the critical step in the initial management of anaphylaxis?

What is the purpose of preventing exposure to potential triggers in anaphylaxis?

What is the hallmark feature of anaphylaxis?

What is the function of lysozyme in the human body?

What is the role of the complement system in the immune response?

What is the function of defensins in the stomach and intestines?