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Exam 2: NURS618/ NURS 618 (Latest 2024/ 2025 Update) Pathophysiology Guide | Qs & As | 100% Correct (Verified Answers)- Southeastern Louisiana

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Course NURS618/ NURS 618 (NURS618)
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Exam 2: NURS618/ NURS 618 (Latest 2024/ 2025 Update) Pathophysiology Guide | Qs & As | 100% Correct (Verified Answers)- Southeastern Louisiana Q: Oxy-Hg dissociation curve Answer: - Hemoglobin with bound oxygen. Hemoglobin bounds to oxygen more readily when its affinity is increased and releases it more readily when its affinity is decreased. The affinity of hemoglobin for oxygen changes with hemoglobin saturation. It is also influenced by pH, CO2 concentration, and body temp. Binds oxygen more readily with increased pH (alkalosis), decreased CO2 concentration, and decreased body temp. - Hemoglobin is composed of four polypeptide chains, which means it can bind four molecules of oxygen when its fully saturated. - The relation between the oxygen carried in combination with hemoglobin and the PO2 of the blood. - X-axis depicts the PO2 or dissolved oxygen in the lungs. The left Y-axis depicts Hg saturation or the mount of oxygen that is carried by Hg. The right y-axis depicts oxygen content or total amount of the oxygen content being carried in the blood. S shape of the curve reflects the effect that oxygen saturation has on the conformation of the hemoglobin molecule and its affinity for oxygen. PO2 is approximately 100 mm Hg when room air is breathed but can rise to 200 mm Hg or higher when oxygen enriched air is breathed. At 100 mm Hg PO2, a plateau occurs. At this point, the hemoglobin is 98% saturated. Increased the alveolar PO2 above this level does not increase the hemoglobin saturation. Between 60-40 mm Hg, it represents the removal of oxygen from the hemoglobin as it moves through the tissue capillaries. This portion reflects a considerable transfer of oxygen from hemoglobin to the tissues with only a small drop in PO2. This ensures a gradient for oxygen to move into body cells. The tissues normally remove approximately 5 mL of oxygen per 100 mL of blood and the hemoglobin of mixed venous blood is approximately 75% saturated as it returns to the right side of the heart. In this portion of Q: a shift to the right in the Oxy-Hg curve Answer: indicates that the tissue PO2 is greater for any given level of hemoglobin saturation and represents reduced affinity of the Hg for oxygen at any given PO2. Usually caused by conditions that reflect increased tissue metabolism, such as fever or acidosis, or by increase in PO2. High altitude and conditions such as pulmonary insufficiency, heart failure and anemia can also shift curve to left or right. Q: a shift to the left in the Oxy-Hg curve Answer: - represents an increased affinity of Hg for oxygen. Occurs in situations associated with a decrease in tissue metabolism, such as alkalosis, decreased body temp, and decreased PO2 levels. Q: Metabolic acidosis Answer: reduction in pH because of a decrease in HCO3-. Causes an increase in ventilation to decrease in PCO2 Q: Respiratory acidosis Answer: decrease in pH, reflecting a decrease in ventilation and an increase in PCO2. Causes an increase in H+ excretion and increased HCO3- reabsorption Q: AntiHTN therapy Answer: aims to slow the progression of nephron loss by lowering intraglomerular hypertension and hypertrophy. HTN increases proteinuria because of transmission of the elevated pressure to the glomeruli. ACE-I and ARBs (which have a unique effect on the glomerular microcirculation) are increasingly being used in the treatment of HTN. HTN in CKD can include increased vascular volume, elevation of peripheral vascular resistance, decreased levels of renal vasodilator prostaglandins, and increased activity of the renin-angiotension system. Early treatment of HTN has been shown to slow the progression of kidney disease. Q: Diuretics Answer: - can be used to help with kidney problems because people with CKD tend to have an increased prevalence of LV dysfunction, with depressed LV EF and impaired ventricular filling. This is caused from fluid overload. Congestive HF and pulmonary edema tend to occur in late stages of kidney failure. - block the reabsorption of sodium in the renal tubules, and some exert osmotic effects that prevent water reabsorption in the water permeable parts of the nephron. By blocking reabsorption, they create an osmotic pressure gradient within the nephron that prevents the passive reabsorption of water - Na and water are retained in the tubule - promoting excretion of both. Q: Osmotic Diuretics Answer: proximal tubule; accounts for 65% of filtered sodium reabsorption Q: Loop diuretics Answer: thick ascending loop of Henle; accounts for 20% of filtered Na reabsorption

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Examl2:lNURS618/lNURSl618l(Latest
lUpdate)lPathophysiologylGuidel|lQsl&lAsl|l
100%lCorrectl(VerifiedlAnswers)-
lSoutheasternlLouisiana
Q:lOxy-Hgldissociationlcurve

Answer:
-
lHemoglobinlwithlboundloxygen.lHemoglobinlboundsltoloxygenlmorelreadilylwhenlitslaffinityl
islincreasedlandlreleaseslitlmorelreadilylwhenlitslaffinitylisldecreased.lThelaffinityloflhemoglob
inlforloxygenlchangeslwithlhemoglobinlsaturation.lItlislalsolinfluencedlbylpH,lCO2lconcentrati
on,landlbodyltemp.lBindsloxygenlmorelreadilylwithlincreasedlpHl(alkalosis),ldecreasedlCO2lco
ncentration,landldecreasedlbodyltemp.
-
lHemoglobinlislcomposedloflfourlpolypeptidelchains,lwhichlmeanslitlcanlbindlfourlmoleculeslo
floxygenlwhenlitslfullylsaturated.
-
lThelrelationlbetweenltheloxygenlcarriedlinlcombinationlwithlhemoglobinlandlthelPO2loflthelbl
ood.
-lX-axisldepictslthelPO2lorldissolvedloxygenlinlthellungs.lThelleftlY-
axisldepictslHglsaturationlorlthelmountlofloxygenlthatlislcarriedlbylHg.lThelrightly-
axisldepictsloxygenlcontentlorltotallamountlofltheloxygenlcontentlbeinglcarriedlinlthelblood.lSl
shapeloflthelcurvelreflectsltheleffectlthatloxygenlsaturationlhaslonlthelconformationloflthelhem
oglobinlmoleculelandlitslaffinitylforloxygen.lPO2lislapproximatelyl100lmmlHglwhenlroomlairli
slbreathedlbutlcanlriseltol200lmmlHglorlhigherlwhenloxygenlenrichedlairlislbreathed.lAtl100lm
mlHglPO2,lalplateauloccurs.lAtlthislpoint,lthelhemoglobinlisl98%lsaturated.lIncreasedlthelalveo
larlPO2labovelthisllevelldoeslnotlincreaselthelhemoglobinlsaturation.lBetweenl60-
40lmmlHg,litlrepresentslthelremovallofloxygenlfromlthelhemoglobinlaslitlmoveslthroughltheltis
suelcapillaries.lThislportionlreflectslalconsiderableltransferlofloxygenlfromlhemoglobinltolthelti
ssueslwithlonlylalsmallldroplinlPO2.lThislensureslalgradientlforloxygenltolmovelintolbodylcells
.lTheltissueslnormallylremovelapproximatelyl5lmLlofloxygenlperl100lmLloflbloodlandlthelhem
oglobinloflmixedlvenouslbloodlislapproximatelyl75%lsaturatedlaslitlreturnsltolthelrightlsideloflt
helheart.lInlthislportionlof

,Q:lalshiftltolthelrightlinlthelOxy-Hglcurve

Answer:
indicateslthatltheltissuelPO2lislgreaterlforlanylgivenllevelloflhemoglobinlsaturationlandlreprese
ntslreducedlaffinityloflthelHglforloxygenlatlanylgivenlPO2.lUsuallylcausedlbylconditionslthatlr
eflectlincreasedltissuelmetabolism,lsuchlaslfeverlorlacidosis,lorlbylincreaselinlPO2.lHighlaltitud
elandlconditionslsuchlaslpulmonarylinsufficiency,lheartlfailurelandlanemialcanlalsolshiftlcurvelt
olleftlorlright.




Q:lalshiftltolthelleftlinlthelOxy-Hglcurve

Answer:
-
lrepresentslanlincreasedlaffinityloflHglforloxygen.lOccurslinlsituationslassociatedlwithlaldecrea
selinltissuelmetabolism,lsuchlaslalkalosis,ldecreasedlbodyltemp,landldecreasedlPO2llevels.




Q:lMetaboliclacidosis

Answer:
reductionlinlpHlbecauseloflaldecreaselinlHCO3-
.lCauseslanlincreaselinlventilationltoldecreaselinlPCO2




Q:lRespiratorylacidosis

Answer:
decreaselinlpH,lreflectinglaldecreaselinlventilationlandlanlincreaselinlPCO2.lCauseslanlincrease
linlH+lexcretionlandlincreasedlHCO3-lreabsorption




Q:lAntiHTNltherapy

, Answer:
aimsltolslowlthelprogressionloflnephronllosslbylloweringlintraglomerularlhypertensionlandlhyp
ertrophy.lHTNlincreaseslproteinurialbecauselofltransmissionloflthelelevatedlpressureltolthelglo
meruli.lACE-
IlandlARBsl(whichlhavelaluniqueleffectlonlthelglomerularlmicrocirculation)larelincreasinglylbe
inglusedlinltheltreatmentloflHTN.lHTNlinlCKDlcanlincludelincreasedlvascularlvolume,lelevatio
nloflperipherallvascularlresistance,ldecreasedllevelsloflrenallvasodilatorlprostaglandins,landlincr
easedlactivityloflthelrenin-
angiotensionlsystem.lEarlyltreatmentloflHTNlhaslbeenlshownltolslowlthelprogressionloflkidney
ldisease.




Q:lDiuretics

Answer:
-
lcanlbelusedltolhelplwithlkidneylproblemslbecauselpeoplelwithlCKDltendltolhavelanlincreasedl
prevalenceloflLVldysfunction,lwithldepressedlLVlEFlandlimpairedlventricularlfilling.lThislislca
usedlfromlfluidloverload.lCongestivelHFlandlpulmonaryledemaltendltoloccurlinllatelstagesloflk
idneylfailure.
-
lblocklthelreabsorptionloflsodiumlinlthelrenalltubules,landlsomelexertlosmoticleffectslthatlpreve
ntlwaterlreabsorptionlinlthelwaterlpermeablelpartsloflthelnephron.lBylblockinglreabsorption,lthe
ylcreatelanlosmoticlpressurelgradientlwithinlthelnephronlthatlpreventslthelpassivelreabsorptionl
oflwaterl->lNalandlwaterlarelretainedlinltheltubulel->lpromotinglexcretionloflboth.




Q:lOsmoticlDiuretics

Answer:
proximalltubule;laccountslforl65%loflfilteredlsodiumlreabsorption




Q:lLoopldiuretics

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