NURS 276 MIDTERM EXAM WITH
COMPLETE SOLUTION
What are the risk factors for renal failure? - ANSWER Trauma or surgery,
infection, hemorrhage, severe heart failure, severe liver disease, and lower
urinary tract obstruction, hypertension, diabetes
What lab values are indicative of renal failure? How do you know the patient
is getting better? - ANSWER Urine analysis: 1.005-1.025 (normal)
- Proteinuria (excess proteins) if glomerular damage is the cause
- Decreased presence of RBC's (glomerular dysfunction)
- Creatinine and BUN: Elevated
- Serum electrolytes: Monitor fluid and electrolytes status.
- Potassium is elevated in renal failure
- ABG: Show metabolic acidosis (low bicarbonate)
- CBC: Show reduced RBCs, moderate anemia, and low hematocrit
- ARF decreases erythropoietin secretion and RBC production.=Anemia
What is erythropoietin for? - ANSWER a hormone secreted by the kidneys
that increases the rate of production of red blood cells in response to falling
levels of oxygen in the tissues
What are the risk factors for cancer? Modifiable and non-modifiable -
ANSWER Six major topic areas associated with reducing cancer risk are found
within Healthy People 2020, including Cancer History, Tobacco Use,
,Nutrition, Weight Status, Oral Health, and Genomics
- Heredity
- One of the greatest risk factors for cancer is advanced age
- Gender: Risk for a certain type of cancers such as breast cancer
- Poverty/Racial and Economic Disparities: Inadequate access to health care,
preventative screenings
- Stress: unhealthy coping mechanisms such as overeating, drinking, smoking
- Diet: Some foods are considered genotoxic, such as nitrosamines and
nitrous indoles found in preserved meats and salted foods.
- Occupation: Considered controllable and uncontrollable. Working outside,
exposure to solar radiation.
- Infection: some viruses have been linked to cancer. Other like genital
herpes, HPV, or genital warts can be avoided by practicing safe sex.
- Smoking increases the risk of developing lung cancer and many other
cancers, including those involving the nasopharynx, nasal cavity, lip, oral
cavity, pharynx, esophagus, pancreas, ovary, kidney, and bladder as well as
colorectal cancers and some leukemias. Smoking is also a major risk factor
for cardiovascular disease and death
- Alcohol use: alcohol enhances contact with carcinogens, such as those in
cigarettes.
- Recreational drug use: promotes an unhealthy life style
- Obesity: excessive fat may be linked to hormone-dependent cancers. Poor
nutrition and a sedentary lifestyle—along with excessive weight—represent
,significant risk factors. Being overweight or obese is associated with
increased risk for developing cancers and cancer recurrence
- Sun exposure: as the ozone lay thins, more ultraviolet light reaches the
earth.
-Carcinogen exposure: sun exposure; environmental pollutants in the air,
water, soil, or food (such as radon or asbestos); or a
Name the hemoglobin found in patients with SCD. How is SCD inherited? -
ANSWER - Manifestations include: Pain, pallor, irritability, fatigue, and
jaundice
- Hemoglobin is replaced with hemoglobin S in RBCs
-autosomal recessive genetic defect. If both parents have the trait, then with
each pregnancy the risk of having a child with the disease is 25%.
- If child inherits sickle cell from only one parent, they are a carrier and have
no symptoms. If they inherit from both parent's, they are subject to sickle
cell crisis.
-most commonly affects people of African descent
Sickle Cell Crisis is the term used to describe painful periods resulting from
ischemia due to vascular occlusion. Any condition that increases the body's
need for oxygen or alters the transport of oxygen, such as infection or
trauma, may result in sickle cell crisis. Although potential causes include
those known to trigger sickling, in more than 50% of cases, the exact cause
of sickle cell crisis is not identifiable. Dehydration increases blood viscosity,
which can predispose an individual to sickle cell crisis.
What are the purposes of radiation? - ANSWER a. application of high-energy
, x-rays or particles for the purpose of damaging or killing cancer cells
b. localized treatment intended to affect only one body region
c. goal- tumor shrinkage prior to surgery, prevention of postoperative tumor
recurrence, and eradication of cancer cells in other parts of the body
Know cancer staging, T, N, M: What is bad and what is worst
A consistent mechanism used for clinical staging for most cancers is the TNM
Classification System.14 The staging is based on three factors:
1. TUMOR size and invasiveness
2. presence or absence of regional spread to lymph NODES
3. METASTASIS to distant organs. Although the TNM Classification System is
used for the majority of cancers, not all cancers can be staged in this way
because of variability in the growth and distribution of malignant cells.
Examples include leukemias and brain cancers. - ANSWER T:
relative tumor size, depth of invasion, and surface spread
-TX (Tumor cannot be measured)
-TO (No evidence of primary tumor, tumor cannot be found)
-Tis (Tumor in situ, meaning malignant cells only within superficial layer of
tissue; no extension into deeper tissue)
-T1, T2, T3, T4 (Ascending degrees of tumor size and involvement,
Description of primary tumor based on size and/or invasion into nearby
structures; the higher the T number, the larger the tumor and/or the more it
has grown into nearby tissues )
COMPLETE SOLUTION
What are the risk factors for renal failure? - ANSWER Trauma or surgery,
infection, hemorrhage, severe heart failure, severe liver disease, and lower
urinary tract obstruction, hypertension, diabetes
What lab values are indicative of renal failure? How do you know the patient
is getting better? - ANSWER Urine analysis: 1.005-1.025 (normal)
- Proteinuria (excess proteins) if glomerular damage is the cause
- Decreased presence of RBC's (glomerular dysfunction)
- Creatinine and BUN: Elevated
- Serum electrolytes: Monitor fluid and electrolytes status.
- Potassium is elevated in renal failure
- ABG: Show metabolic acidosis (low bicarbonate)
- CBC: Show reduced RBCs, moderate anemia, and low hematocrit
- ARF decreases erythropoietin secretion and RBC production.=Anemia
What is erythropoietin for? - ANSWER a hormone secreted by the kidneys
that increases the rate of production of red blood cells in response to falling
levels of oxygen in the tissues
What are the risk factors for cancer? Modifiable and non-modifiable -
ANSWER Six major topic areas associated with reducing cancer risk are found
within Healthy People 2020, including Cancer History, Tobacco Use,
,Nutrition, Weight Status, Oral Health, and Genomics
- Heredity
- One of the greatest risk factors for cancer is advanced age
- Gender: Risk for a certain type of cancers such as breast cancer
- Poverty/Racial and Economic Disparities: Inadequate access to health care,
preventative screenings
- Stress: unhealthy coping mechanisms such as overeating, drinking, smoking
- Diet: Some foods are considered genotoxic, such as nitrosamines and
nitrous indoles found in preserved meats and salted foods.
- Occupation: Considered controllable and uncontrollable. Working outside,
exposure to solar radiation.
- Infection: some viruses have been linked to cancer. Other like genital
herpes, HPV, or genital warts can be avoided by practicing safe sex.
- Smoking increases the risk of developing lung cancer and many other
cancers, including those involving the nasopharynx, nasal cavity, lip, oral
cavity, pharynx, esophagus, pancreas, ovary, kidney, and bladder as well as
colorectal cancers and some leukemias. Smoking is also a major risk factor
for cardiovascular disease and death
- Alcohol use: alcohol enhances contact with carcinogens, such as those in
cigarettes.
- Recreational drug use: promotes an unhealthy life style
- Obesity: excessive fat may be linked to hormone-dependent cancers. Poor
nutrition and a sedentary lifestyle—along with excessive weight—represent
,significant risk factors. Being overweight or obese is associated with
increased risk for developing cancers and cancer recurrence
- Sun exposure: as the ozone lay thins, more ultraviolet light reaches the
earth.
-Carcinogen exposure: sun exposure; environmental pollutants in the air,
water, soil, or food (such as radon or asbestos); or a
Name the hemoglobin found in patients with SCD. How is SCD inherited? -
ANSWER - Manifestations include: Pain, pallor, irritability, fatigue, and
jaundice
- Hemoglobin is replaced with hemoglobin S in RBCs
-autosomal recessive genetic defect. If both parents have the trait, then with
each pregnancy the risk of having a child with the disease is 25%.
- If child inherits sickle cell from only one parent, they are a carrier and have
no symptoms. If they inherit from both parent's, they are subject to sickle
cell crisis.
-most commonly affects people of African descent
Sickle Cell Crisis is the term used to describe painful periods resulting from
ischemia due to vascular occlusion. Any condition that increases the body's
need for oxygen or alters the transport of oxygen, such as infection or
trauma, may result in sickle cell crisis. Although potential causes include
those known to trigger sickling, in more than 50% of cases, the exact cause
of sickle cell crisis is not identifiable. Dehydration increases blood viscosity,
which can predispose an individual to sickle cell crisis.
What are the purposes of radiation? - ANSWER a. application of high-energy
, x-rays or particles for the purpose of damaging or killing cancer cells
b. localized treatment intended to affect only one body region
c. goal- tumor shrinkage prior to surgery, prevention of postoperative tumor
recurrence, and eradication of cancer cells in other parts of the body
Know cancer staging, T, N, M: What is bad and what is worst
A consistent mechanism used for clinical staging for most cancers is the TNM
Classification System.14 The staging is based on three factors:
1. TUMOR size and invasiveness
2. presence or absence of regional spread to lymph NODES
3. METASTASIS to distant organs. Although the TNM Classification System is
used for the majority of cancers, not all cancers can be staged in this way
because of variability in the growth and distribution of malignant cells.
Examples include leukemias and brain cancers. - ANSWER T:
relative tumor size, depth of invasion, and surface spread
-TX (Tumor cannot be measured)
-TO (No evidence of primary tumor, tumor cannot be found)
-Tis (Tumor in situ, meaning malignant cells only within superficial layer of
tissue; no extension into deeper tissue)
-T1, T2, T3, T4 (Ascending degrees of tumor size and involvement,
Description of primary tumor based on size and/or invasion into nearby
structures; the higher the T number, the larger the tumor and/or the more it
has grown into nearby tissues )
