WGU D236 PATHO STUDY GUIDE WITH THE FULL UPDATE

WGU D236 PATHO STUDY GUIDE WITH THE FULL UPDATE




Pressurecthatciscduectocalbumincincthecbloodstream?c-ccorrectcanswer-Oncotic

Oncoticc-ccorrectcanswer-acformcofcosmoticcpressurecexertedcbycproteins

Incthecblood,c_____ciscthecmostccommoncplasmacproteincandcis,ctherefore,cacprimarycdet
erminantcofconcoticcpressurec-ccorrectcanswer-albumin

_____ccontrolscosmoticcpressurecincvascularcsystem,cbuildscvolumec-ccorrectcanswer-
Albumin

Onecquestioncwascaboutcthecdifferencecincchildrencandcadultcimmunityc-ccorrectcanswer-
Possiblecanswer:cnaivecTccells

Learningccheckcquestion:cWhichcdifferencescincimmunitycmakecchildrencandcoldercadultc
patientscmorecsusceptiblectocinfections?cChoosec2canswers

Youngercpatientschavecfewercmemoryccellsctoccombatcinfection

OldercadultcpatientschavecacdwindlingcpopulationcofcnaivecTccells

Oldercadultcpatientschavecmorecmemoryccellsctoccombatcinfection

YoungercpatientschavecaclargecpopulationcofcnaivecTccells

OldercadultcpatientschavecaclargecpopulationcofcnaivecTccellsc-ccorrectcanswer-
Youngercpatientschavecfewercmemoryccellsctoccombatcinfection

OldercadultcpatientschavecacdwindlingcpopulationcofcnaivecTccells

Rationale:cyoungercpatientschavecnotcbeencexposedctocmanycpathogens,cwhichcmeansc
thatctheychavecfewercmemoryccellscthancadults.cThecprimarycimmunecresponseciscrelativ
elycweakccomparedctocacsecondarycresponsecmediatedcbycmemoryccells.

,OldercadultcpatientscdocnotchavecascmanycTccellsccomparedctocyoungercpatients.cWhenct
hesecpatientscencountercnovelcpathogens,cthecreducedcnumbercofcnaivecTccellscgivesccl
onalcselectioncfewercopportunitiesctoc"find"cTccellscthatcwillcbeceffective.

Fluidcandcelectrolyteclevelscarecregulatedcbyc_______,cwhichcregulatescactionscsuchcasc
thirst,cADH,ctheckidneys,candcRAAS.c-ccorrectcanswer-osmoreceptors

Fluidcdeficitccausesc-ccorrectcanswer--Excessivecloss
-Inadequatecintake
-Orccombinationcofcboth

Fluidcdeficitcriskcfactorsc-ccorrectcanswer--Vomiting/diarrhea
-Excessivecsweating
-Insufficientcwatercintake

Fluidcdeficitcmanifestationsc-ccorrectcanswer--drycmucouscmembranes
-decreasedcskincturgor
-decreasedcurinecoutput
-lowcbloodcpressure
-tachycardia
-confusion

ROMEcforcABGsc-ccorrectcanswer-RespiratorycOppositecMetaboliccEqual

IfcpHcandcpCO2carecmovingcincoppositecdirections,cthencitciscpCO2clevelscthatcareccausin
gcthecimbalancecandcitciscrespiratorycincnature
Ifctheycarecmovingcthecsamecdirectioncthencitciscmetaboliccincnature

Buffers,crenalccompensation,candcrespiratoryccompensationchelpctocmaintaincacbloodcp
Hcofc_______c-ccorrectcanswer-7.35-7.45

AcpatientcwithcacviralcillnesscandcseverecvomitingchascancelevatedcCO2clevelcandcacbloo
dcpHcofc7.53.cSheciscbreathingcslowly.cWhatcconditioncdoescthecpatientchave?c

Metaboliccalkalosisc
Metaboliccacidosisc
Respiratorycalkalosis
Respiratorycacidosisc-ccorrectcanswer-Metaboliccalkalosis

Thecpatient'scpHcandcCO2clevelcarecbothcelevatingc(movingcincthecsamecdirection).cThisc
indicatescmetaboliccalkalosis.cThecCO2clevelcischighcbecausechercrespiratorycsystemcisc
attemptingctoccompensatecforcthechighcpHcbycexhalingclesscandcretainingcmorecCO2

TocpreventcchangescincpH,cthecbodycemployscbuffercsystems.cThecbodycutilizesc3cbuffer
csystems:c-ccorrectcanswer-proteins,cphosphates,candctheccarboniccacid-

bicarbonatecsystem

Carboniccacid-
bicarbonatecsystemcfirstclinecofcdefensecisc_____,csecondclinecofcdefensecisc_____c-
ccorrectcanswer-respirations;ckidneys

,Carboniccacid-bicarbonatecsystemcequationc-ccorrectcanswer-
Thecequationcmovescincbothcdirections

CABScEquation:
WhencCO2clevelscarecelevated,cthecequationcmovesc________,cformingcmorecH+candc
HCO3-cionsc-ccorrectcanswer-towardcthecright

CABScEquation:
WhencH+cionscarecelevated,cthecequationcmovesc_____,cascH+cionscarecconvertedctocC
O2candcthecCO2ciscexhaled.c-ccorrectcanswer-towardcthecleft

CO2clevelsc-ccorrectcanswer-35-45

HCO3clevelsc-ccorrectcanswer-22-26

Michael'scpulmonarycedemacleadsctocrespiratorycacidosis.cHowcdoescpHcimpactcMicha
el'scbasalcmetaboliccpanel?cChoosec3canswers.c

HiscCO2clevelciscincreasedcbecausechisclungschavecdifficultycremovingcitcfromcthecblood
stream.c

HiscK+ciscelevatedcbecause,cascH+cmovescinsidecofccellscincancattemptctocgetcitcoutcofcthe
cbloodstream,cK+cmovescfromccellscintocthecbloodstream.c




Hiscsodiumclevelciscdecreasedcduectochypervolemia.c

HisccalciumclevelciscreducedcbecausecthecelevatedcconcentrationcofcH+cmakescitceasierc
forcCa+ctocbindctocalbumin.c

HiscCO2clevelciscdecreasedcbecausechisclungschavecdifficultycaddingcitcintocthecbloodstr
eamc-ccorrectcanswer-
HiscCO2clevelciscincreasedcbecausechisclungschavecdifficultycremovingcitcfromcthecblood
stream.c

HiscK+ciscelevatedcbecause,cascH+cmovescinsidecofccellscincancattemptctocgetcitcoutcofcthe
cbloodstream,cK+cmovescfromccellscintocthecbloodstream.c




Hiscsodiumclevelciscdecreasedcduectochypervolemia.

Thereciscacquestioncaboutchypoventilationcorchyperventilationc-ccorrectcanswer-
MetaboliccacidosiscpHc<7.35c=crespirationscincreasecincdepthcandcratectocblowcoffcCO2

MetaboliccalkalosiscpHc>7.45c=crespirationscslowcdownctocincreasecCO2cretention

Respiratorycacidosisc=cexcesscCO2chascaccumulatedcwhichciscgeneratingcH+

Respiratorycalkalosisc=clungscblowcoffctoocmuchcCO2,ccreatingclesscH+cincblood

, Whatciscexcretedcincresponsectocfluidcvolumecoverload?c-ccorrectcanswer-
Natriureticcpeptides

Natriureticcpeptidesc-ccorrectcanswer-
hormonalcsignalscreleasedcbycthecbraincandcheartcincresponsectocexcesscfluidcincthecbod
y

Natriureticcpeptidescsignalsc_____curinecoutputcandc____cfluidcvolumec-
ccorrectcanswer-increase;creduce




Achormonalcpanelcwascdoneconcacpatientcwithccongestivecheartcfailurecandcfluidcvolumec
overload.cWhichcelevatedchormoneconcthecpatient'scchartciscindicativecofcthecbody'scatte
mptctocreducecthecfluidcoverload?c-ccorrectcanswer-BNPc-
cit'screleasedcwhencfluidcvolumecexcessciscpresent




Comparecandccontrastchemodialysiscandcperitonealcdialysisc-ccorrectcanswer-
Hemodialysis:c
-machinecpumpscbloodcfromcthecbodycandcfilterscwaste
-3xcacweekcforchourscincacclinic
-acuteckidneycfailure

Peritoneal:c
-
nocmachine,cinjectioncintocabdominalccavitycandcwastecproductscdiffusecintoccavitycthenc
drained
-continuouscfiltrationcandclesscdisruptioncbutcrequirescsomectraining
-notcforcoverweightcorcsevereckidneycfailurecpatients

Hemodialysisctakescbloodcoutcofcthecbodycviacac_____,candcputscbloodcbackcintocbodycth
roughcac_____c-ccorrectcanswer-PIV;ccentralcline

*NOTE*ctherecarecseveralcquestionscaboutcsignscandcsymptomscofcdifferentcelectrolyteci
mbalancesc-ccorrectcanswer-

Sodiumclevelsc-ccorrectcanswer-135-145

Hyponatremiaccausesc-ccorrectcanswer-Vomiting
Diuretics
ExcessivecadministrationcofcdextrosecandcwatercIVs
Burns,cwoundcdrainage
Excessivecwatercintake
SIADH

Hyponatremiacmanifestationsc-ccorrectcanswer-
poorcskincturgor,cdrycmucosa,cheadache,cdecreasedcsalivation,cdecreasedcbloodcpress
ure,cnausea,cabdominalccramping,cneurologiccchanges,clethargy,cconfusion,cseizures

Hypernatremiaccausesc-ccorrectcanswer-
excesscwatercloss,cexcesscsodiumcadministration,cdiabetescinsipidus,cheatcstroke,chyp
ertoniccIVcsolutions