NUR 235 Exam 2 Review Fall 2024 PDF

# NUR 235 Fall 2024 Exam 2 Review ## Exam 2 will cover textbook chapters 8, 9, 15, 16. **(Textbook: Applied Pathophysiology, Nath, Fourth edition.)** ### Ch 8: Altered Fluid and Electrolyte Balance * Expected (normal) values of extracellular electrolytes (Figure 8.1) * What functions do those...

# NUR 235 Fall 2024 Exam 2 Review ## Exam 2 will cover textbook chapters 8, 9, 15, 16. **(Textbook: Applied Pathophysiology, Nath, Fourth edition.)** ### Ch 8: Altered Fluid and Electrolyte Balance * Expected (normal) values of extracellular electrolytes (Figure 8.1) * What functions do those electrolytes have in our bodies? What happens if they become imbalanced (see Manifestations of Electrolyte Imbalance: Table 8.1)? How do they become imbalanced? (See the description of each electrolyte imbalance in Ch 8 – for example we can lose sodium through vomiting, diarrhea, and sweating. We can lose potassium through diuretic use, severe vomiting, or diarrhea. Renal failure can lead to hyperkalemia. Thyroid disorders, severe burns, kidney failure, vitamin D deficiency, and sepsis may lead to hypocalcemia. And so on.) * Where do our bodies hold fluids? How do the fluids move in and out of cells and tissues? How do fluids move in and out of circulation (vessels, nephrons)? * How do our bodies regulate fluid intake and excretion? * Tonicity, including isotonic, hypertonic, and hypotonic fluids * Altered fluid balance: hypovolemia, hemorrhage, dehydration, water intoxication, hypervolemia, edema * **Models:** cirrhosis and dehydration ### Ch 9: Altered Acid-Base Balance * Physiologic pH * Why must we maintain the physiologic pH? What happens to cells and tissues when the pH goes out of range? * What are the 3 buffer systems that our bodies use to keep the pH in check? How do they work? * **Model:** metabolic acidosis ### Ch 15: Altered Ventilation and Diffusion * How does ventilation work? How does diffusion work? * Inspiration, expiration, partial pressures, O2 and CO2 transport * What happens when ventilation and diffusion are impaired? * Impaired ventilation-perfusion matching * Impaired diffusion * Effects: hypoxemia, hypoxia, hypercapnia * General manifestations of impaired ventilation and diffusion * How to measure impaired ventilation and diffusion * How to treat impaired ventilation and diffusion * **Models:** COPD: Emphysema, chronic bronchitis; asthma, cystic fibrosis ### Ch 16: Altered Perfusion * Perfusion * Path from ventilation to perfusion * Circulatory system: pathway, pulmonary, systemic, cardiac * Function of the heart * Cardiac cycle * Electrical impulses * Cardiac output * Neural control of heart and blood pressure * Altered perfusion * Ventilation-perfusion mismatch * Impaired circulation * Altered cardiac output * Changes in perfusion demands * Altered perfusion: manifestations, lab and diagnostics, treatments * **Clinical models:** hypertension, shock, myocardial infarction, heart failure, stroke ### List of all Exam 2 diagnoses (clinical models): * COPD: Emphysema and chronic bronchitis * Asthma * Cystic fibrosis * Hypertension * Stroke * Shock * Heart failure * Myocardial infarction * Cirrhosis * Dehydration * Metabolic acidosis ## General studying advice: * How should you study? Use a variety of sources: the textbook, your notes from pre-lecture preparation and class discussion, your pre-lecture study guides. If you like videos, use the resources posted on Brightspace. There are some videos embedded in the powerpoints that I find helpful. Use other videos you have found helpful. If writing helps you, make a concept map. * Some people like to study in groups. If that works for you, great. But make your own judgment – if you think your study group is focusing on material that you don't remember us reviewing, or they've skipped an important concept, take initiative to alter your own approach. Confirm materials with the textbook or what we've learned in class. * **What content should you focus on?** For most chapters, remember we learned about how the body is supposed to work first. This should be a review of anatomy and physiology - you should know the expected functions of the body. We also learned what happens when the body functions are altered – aka pathophysiology. What happens when things go wrong? * **Remember what we stressed in class.** Use your notes from pre-lecture reading or class. **DO NOT RELY SOLELY ON POWERPOINTS.** We added a lot of information to those in class. If you must use powerpoints to study, please supplement the slides with your readings and class discussions. ## Main topics and some advice on how to approach a test question: 1. Make sure you are familiar with the foundational concepts that we studied - how cells respond to stress, process of inflammation, how we repair our tissues, the immune response, and how the body gets infected and responds to infection. The book can get very complicated and technical but don't get bogged down in the granular details. Think about how we discussed the basic concepts in class. Use your notes from class, the textbook, and your pre-lecture study guides to help you organize your review. 2. At the end of each chapter, we used real diagnoses as examples of each concept we studied. Remember, in class I gave you the **pathophysiology** of each diagnosis and then we talked through the **signs and symptoms, tests, and treatment**. We could do this ourselves because we already learned the core concepts! Remember how we did that and use that knowledge to answer questions about the diagnoses. 3. Please avoid the temptation to simply memorize the material. I get it, some things we have to memorize, but when possible, please try to understand the concepts. I STRONGLY advise that you understand **WHY** diseases happen, **WHY** signs and symptoms occur, **WHY** we use the tests, and **WHY** we use certain treatments. This will help you in the future when the material gets more complicated. 4. Remember, in the first week we talked about expecting your exam questions to ask you to apply critical thinking. You'll see examples of this in post-lecture quizzes. You might get a short scenario that starts “The nurse is taking care of a patient with...” and then asks you to interpret the scenario based on your knowledge. Don't let the question confuse you. Think: what is this really asking? 5. The test will be administered through ATI. Please refer to the syllabus in regard to testing policies, LockDown software, and academic integrity. I will ask you to spread out and place your belongings (including all phones and watches) in front of the room before we begin. 6. I will ask you to rearrange the room to make sure the desks/tables are spread out and that I can walk between rows. We will not begin until the room is rearranged appropriately. **You cannot be sure you will be seated near an outlet, there are not enough. Make sure your computers are charged.** 7. **We will not begin the test until everyone is ready.** Please remain patient if there are delays - I cannot officially start until you have ALL completed the pre-test procedures. Please be kind to those experiencing technical difficulties - it happens to all of us. To avoid delays, everyone make sure their software is updated before test day. 8. The test will be approx. 40 questions, and you will have 1 hour (unless you have accommodations and you have already sent me LIU-approved documentation). If you finish early, please QUIETLY sit and occupy yourself or QUIETLY excuse yourself from the room. You will not be able to re-enter the room once you leave after the exam until everyone has finished. 9. **DO NOT CONGREGATE IN THE HALLWAY** near our room after the test. This can be disruptive to the students still testing and the other classrooms. If you want to make noise, go downstairs or outside. 10. We will not discuss the test immediately afterward. Once everyone has taken the test (including makeups) I will do testing analysis and release the final grades. I will not discuss individual questions but I will present a breakdown of class strengths and opportunities for improvement so you know how to reinforce your knowledge. 11. **Reminder: discussing test questions outside of the test, especially with students who have not yet taken the test, is a violation of the academic integrity policy.** 12. Don't overthink your studying, don't overthink the questions. Remember, the goal of the exam is to evaluate your understanding, NOT to trick anyone. You can do it.