BSNC 1000 MID TERM (MODULE 1- 3) QUESTIONS AND DETAILED ANSWERS 100% VERIFIED CORRECT

BSNC 1000 MID TERM (MODULE 1- 3) QUESTIONS AND DETAILED ANSWERS 100% VERIFIED CORRECT “One of the basic concepts in epidemiology is the concept of risk. Which of the following statements best defines risk? a. The prevalence of an event occurring over a lifetime. b. The probability that an event will occur within a specified time period. c. The proportion of the population that will develop an event. d. The rate of development of new cases. - CORRECT ANSWER b. The probability that an event will occur within a specified time period." "Which of the following is the most accurate about the determinants of health? a. If a pathogenic organism can be shown to cause a disease, no other determinants are relevant b. They reflect underlying forces that are at work in the subsequent development of disease. c. One determinant is operating to bring about each disease d. Each determinant can usually be traced to specific diseases - CORRECT ANSWER b. They reflect underlying force that are at work in the subsequent development of disease." "What is illness? - CORRECT ANSWER The experience of being sick, perception of and reaction to a physical/psychological condition, subjective" "If fewer people get the flu or they recover fast, what will the prevalence rate reflect? a. No change b. An increase c. A decrease d. A flat line - CORRECT ANSWER c. A decrease" "Population health - CORRECT ANSWER To improve the health of populations and decrease health inequities by looking at and acting upon the broad range of factors and conditions that have a strong influence of health (DOH)" "Which nurse will have the best understanding of the focus of population health nursing? The nurse who: a. Understands the needs of individuals that comprise the populations b. Focuses on the population as a whole rather than on individuals and families c. Is diligent about keeping abreast of new treatments and technologies d. Applies a single population-based strategy to achieve health and wellness - CORRECT ANSWER a. Understand the needs of individuals that comprise the populations." "A nurse is designing a teaching session for a client recently diagnosed with COPD. After developing a nurse-client relationship, which should the nurse do next? a. Use a variety of teaching methods appropriate for the client. b. Identify the client's level of control. c. Formulate an achievable, measurable, and realistic client goal. d. Assess the client's current understanding of the content to be taught. - CORRECT ANSWER d. Assess the client's current understanding of the content to be taught" "What are some risk factor that impact growth and development? a. Prenatal factors, b. birth factors, c. individual factor, d. situational, e. DOH, f. toxic stress, g. health status h. All of above - CORRECT ANSWER h. All of above" "Erikson theory - CORRECT ANSWER - psychosocial development theory - integrity vs disparity for older adult stage (65 to death) - reflection of life (look back on the event of their lives) - if unsuccessful during this stage and may experience many regrets, they will feel despair/bitterness. - if feel proud of the accomplishment, they will feel integrity/satisfaction." "Why is the older adult population divided into three aggregates? - CORRECT ANSWER - Different age , they have different expectation, smoke is not good and life is longer who has not smoking - Age 65 and older more change to get chronic disease - Senior attitude changes - More educated parents then children more educate" "The nurse is teaching an older person about successful aging. Which of the nurse's questions addresses an important contributor to successful aging? a. "Are you largely free of acute or chronic illnesses?" b. "Do you feel financially secure?" c. "Do you feel like you actively engage with life?" d. "Do you have a reliable support network?" - CORRECT ANSWER c. "Do you feel like you actively engage with life?"" "The best type of education for clients living with chronic disease should include (select all that apply) - CORRECT ANSWER - Disease specific education tailored to the individual circumstance - General managing skills (e.g. problem solving, finding and using resources, working with healthcare team) - Use of strategies that increase client confidence (i.e.,self efficacy) in their bility to engage in behaviours that are needed to manage their condition on a daily basis - Adequate peer role models and support networks that help in the initiation and maintenance of the desired behavioral changes." "The nurse is setting up an education session with an 85 year-old client who will be going home on new medications. Which strategy would best reflect consideration of aging changes that may exist with this client? a. Show a colorful video about the new medication b. Present all the information in one session just before discharge c. Give the client pamphlets about the medications to read at home d. Develop large-print handouts reflecting the information presented - CORRECT ANSWER d. Develop large-print handouts reflecting the information presented." "The value of capacity building on the client as it relates to health status - CORRECT ANSWER Health enhancement and wellness, prevention of diseases, empowerment, strength-based, client-centered" "Attribute that relates to capacity building - CORRECT ANSWER respect and valuing pre-existing capacities, partnership, collaboration, advocacy, equity" "Through action on the SDOH, includes 3 recommendations with corresponding principles of action: - CORRECT ANSWER - Improve daily living conditions - Tackle the inequitable distribution of power, money and resources - Understand the problem and assess the impact of action." "Why SDOH is important and directly related to the health of individuals, groups and all Canadians - CORRECT ANSWER SDoH from an integral component of community health nursing practice" "The epidemiology triad (triangle) - CORRECT ANSWER - Host (Newborn baby, living being: human/patients, animal/pigs, spread: need vaccination,) - Agent (bacteria, virus, arsenic) - Environment (pollution, sanitation climate is crucial, temperature, if too hot then it could affect people who has respiratory problem. To prevent spread disease like covid 19, the school close - Vector (animal/insect that carry disease and spread it around ---(fleas, rodents, birds, ticks, racoon, mosquitoes (malaria), bat (rabies))" "The nurse understands that population health includes different levels of chronic disease prevention to promote health and prevent illness. Which of the following strategy is an example of a secondary level of prevention? Why? a) surveillance of influenza and risk factors across the Lower Mainland b) blood pressure screening clinic at the Primary Care Unit c) self-management support group for cardiovascular disease d) community fitness initiatives at the local community centre. - CORRECT ANSWER b) blood pressure screening clinic at the Primary Care Unit" "Which of the following characteristics are NOT associated with a chronic disease? a. Disease will subside and be cured with effective treatment and/or therapy b. Disease normally has a gradual onset c. The disease can cause a significant decrease in the quality of your life d. The disease can also affect other organs at the same time and can lead to secondary illnesses - CORRECT ANSWER a. Disease will subside and be cured with effective treatment and/or therapy" "Why is the concept of Growth & Development important for nurses to understand? Select all that apply a. Nurses will care for clients & family members of all ages. b. To provide a framework for thinking about human growth & learning c. To enhance interactions & better understand the needs and perspectives of the client d. To help predict the health of populations and better inform healthy public policy. - CORRECT ANSWER a, b, c, d" "What percentage of older adults in Canada have low health literacy to the point it impacts informed decision making? a. 12% b. 47% c. 67% d. 88% - CORRECT ANSWER d. 88%" "About what percentage of Canadian adults are impacted by low literacy rates? a. 26% b. 38% c. 60% d. 82% - CORRECT ANSWER c. 60%" "How does the body compensate for low oxygen supply? - CORRECT ANSWER - increased respiration to get more O2 in - increased speed and depth of lungs to assist with WOB - perfusion will increase heart rate as tissues need more gas exchange to occur - increased RBC synthesis to help carry more O2 to tissues" "Explain central chemoreceptors - CORRECT ANSWER monitors PaCO2 and pH of blood in cerebrospinal fluid/ brain and increases respiration when pH decreases through increased PaCO2" "Explain peripheral chemoreceptors - CORRECT ANSWER monitors PaO2 in arterial blood/ aorta and will increase respiration when PaO2 < 60 mmHg" "What is the normal value of PaCO2? - CORRECT ANSWER 35-45 mmHg" "What is the normal value of PaO2? - CORRECT ANSWER 75-1ooo mmHg" "What is vital capacity? - CORRECT ANSWER - the amount of air that can be exhaled with max effort after max inspiration - used to assess strength of thoracic muscles and pulmonary function" "What is tidal volume? - CORRECT ANSWER amount of air inhaled and exhaled during a normal breathing cycle." "What is forced expiratory volume? - CORRECT ANSWER - % of vital capacity exhaled in 2 second - normal range is 75-85% in adults" "How is CO2 transported into blood from tissues and then to lungs? - CORRECT ANSWER By dissolving in blood, binding to hemoglobin and as bicarbonate ions" "What is CO2 converted into and what does it later dissociate into? - CORRECT ANSWER converts to H2CO3 (carbonic acid) and then dissociates into HCO3 (bicarbonate) and H+ (hemoglobin)" "What is the equation for the transport of CO2 in blood? - CORRECT ANSWER CO2 + H2O = H2CO3 = H + HCO3" "What happen when we exhale and remove CO2 from blood? - CORRECT ANSWER carbonic acid decreases and blood pH increases" "What is CO2 mainly transported as in the blood? - CORRECT ANSWER bicarbonate ions" "What is perfusion and what is the scope? - CORRECT ANSWER the flow of blood through blood vessels delivering O2 and nutrients to tissues. The scope ranges from optimal --> impaired --> no perfusion" "What is the difference between systolic vs. diastolic blood pressure? - CORRECT ANSWER systolic = blood pressure during contraction of the heart/ TOP number diastolic = blood pressure between beats or when the heart is resting/ BOTTOM number" "What is central perfusion? - CORRECT ANSWER - flow of blood from the heart, to tissues and back to the heart - is generated by cardiac output" "What is tissue perfusion? - CORRECT ANSWER flow of blood through blood vessels to target tissues" "What are the three determinants of perfusion? - CORRECT ANSWER 1. Blood pressure 2. Cardiac Output 3. Peripheral resistance" "What is cardiac output? - CORRECT ANSWER the amount of blood pumped out by the heart per minute" "What is the normal value of cardiac output? - CORRECT ANSWER 4-6L / minute" "How to calculate cardiac output? - CORRECT ANSWER CO = HR x SV" "What is stroke volume? - CORRECT ANSWER the amount of blood ejected by the heart in any one contraction" "What is peripheral resistance? - CORRECT ANSWER the force that must be overcome to push blood through the circulatory system" "What is peripheral resistance influenced by? - CORRECT ANSWER blood viscosity and blood vessel radius" "What is the most important factor influencing peripheral resistance? - CORRECT ANSWER blood vessell radius" "How does hypertension lead to hypertensive retinopathy? - CORRECT ANSWER excessive exertion of pressure in blood vessels of the back of the eye leads to changes in structure and stiffening of arterioles. This results in a "copper wire" effect and can lead to hemorrhages to occurs and death of light - sensing retinal cells can lead to blindness" "How does hypertension lead to nephrosclerosis? - CORRECT ANSWER hypertension causes damage to kidney tissues which activates the RAAS system to cause a continuous cycle of elevated BP" "How does hypertension lead to hemorrhagic strokes? - CORRECT ANSWER high BP encourages the development and rupture of tiny aneurysms in small arterioles which increases inter-cranial pressure" "What is the difference between ischemia and infarction? - CORRECT ANSWER Ischemia is due to impaired perfusion and reduces blood flow & supply to body Infarction is complete impairment and obstruction of blood flow which results in necrosis and cellular death" "How might the narrowing of the blood vessels supplying the kidney cause hypertension? - CORRECT ANSWER it can cause increased production of renin which is triggered by the RAAS which leads to release of angiotensin II resulting in vasoconstriction and causes salt + water retention which increases BP" "Would chronically high/ low aldosterone levels cause hypertension? - CORRECT ANSWER Yes. Due to retention of H2O and Na. Aldosterone stimulates sodium intake which increases water intake which increases BP" "Explain how periods of exercises increases BP but sustained elevated BP is associated with hypertension and impairs perfusion? - CORRECT ANSWER During exercises, the work imposed is high but during rest is low. A transient in BP is good for the heart. However, sustained elevated blood pressure causes the heart to work overtime and the imposed stress will cause a problem as vessels will wear out overtime" "List the stages of hypertension & value - CORRECT ANSWER 1. Normal = less than 120/80 2. Pre = 120-139 / 80-89 3. Stage 1 = 140-159 / 90-99 4. Stage 2 = 160+ / 100+ 5. Crisis = 180+ / 110+" "How does the activation of the SNS impact BP? - CORRECT ANSWER when activated, tension in the wall is increased and causes increased peripheral resistance which increases arterial pressure" "What is neural control of BP regulation? - CORRECT ANSWER regulatory system based in medulla oblongata and controls vasomotor and cardiac control centers" "What factors help monitor/ influence BP? - CORRECT ANSWER 1. Baroreceptors = found in BV of the heart & brain, monitor BP. If BP is high, causes vasodilation and slows HR to lower BP. If BP is low, it causes vasoconstriction and raises HR to increase BP 2. Chemoreceptors = monitor chemical changes such as O2, CO2, and H levels in carotid and aortic bodies. Help regulate ventilation and communicates with the brain for vasoconstriction. They are stimulated when arterial BP is low to diminish O2 and CO2 buildup." "A breast cancer screening program screened 8000 females. They discovered 35 females previously been diagnosed with breast cancer and 20 females with no previous history of breast cancer diagnosed as result of the screening. The incidence proportion would reflect a. newly diagnosed cases of breast cancer in this population of females b. current and past breast cancer events in this population of females c. past breast cancer events in this population of females d. the population of females who had no evidence of breast cancer - CORRECT ANSWER a. Newly diagnosed cases of breast cancer in this population of females" "A business executive develops symptoms of the flu 1 day after returning by air from a cross Atlantic business trip that ran for 2 consecutive stressful 10-hour days. This individual's development of flu symptoms illustrates the relationship between: a. host and agent. b. host, agent, and environment. c. risk and causality. d. morbidity and disease. - CORRECT ANSWER b. Host, agent, and environment" "Which of the following statements would indicate to a community nurse that the flu season is ending? a. Increase in incidence and decrease in prevalence b. Decrease in incidence and increase in prevalence c. Increase in incidence and decrease in prevalence d. Decrease in incidence and decrease in prevalence - CORRECT ANSWER d. Decreases in incidence and decrease in prevalence" "What is a healthy diet for.... - CORRECT ANSWER Yogurt, dried peach," "What is could be cause of the upstream condition in the population? - CORRECT ANSWER Air pollution" "Which of the following best describes disease? 1. Results in inability to perform at desired level 2. Something that is individualized 3. Is a subjective experience of ill health 4. Is an objective experience of ill health - CORRECT ANSWER 4. Is an objective experience of ill health" "For infectious disease, how the simple/ easiest way to break the chain of infection. - CORRECT ANSWER Washing hand" "In chain of infection, how the germs get out (Portal of exit) - CORRECT ANSWER Mouth (vomit, saliva), cuts in the skin (blood), During diapering and toileting (stool)" "How the germs get in (portal of entry) - CORRECT ANSWER Mouth, cut in the skin, eyes" "How the germs get around (mode of transmission) - CORRECT ANSWER Contact (hands, toys, sand), droplets (sneeze, cough, speak)" "Next sick person (susceptible host) - CORRECT ANSWER Babies, children, elderly People with a weakened immune system, unimmunized people, anyone" "The nurse is gathering community assessment data about concerns of the elderly. Which term best describes the group of elders in this situation? a. Community b. Neighborhood c. Population d. Aggregate - CORRECT ANSWER d. Aggregate" "Which of the following characteristics are NOT associated with a chronic disease? a. Disease will subside and be cured with effective treatment and/or therapy b. Disease normally has a gradual onset c. The disease can cause a significant decrease in the quality of your life d. The disease can also affect other organs at the same time and can lea to secondary illnesses. - CORRECT ANSWER a. disease will subside and be cured with effective treatment and/or therapy" "Which of the following is an example of high-level wellness? a. Following an imposed physical training regimen for someone else's benefit b. Managing one's chronic illness, doing the most one can c. Recovering quickly from a broken arm d. Keeping up a level of perfect physical health - CORRECT ANSWER b. Managing one's chronic illness, doing the most one can" "Primary prevention - CORRECT ANSWER Before condition occurs. Ex: Vaccination, immunizations, Educating community" "Secondary prevention - CORRECT ANSWER During development of condition. Ex: Health screening" "Tertiary prevention - CORRECT ANSWER After condition has occurred. Ex: cardiac rehabilitation, Monitoring test like breast cancer, therapy, monitoring blood sugar." "Key strategy of population health - CORRECT ANSWER Promoting health, preventing injury by addressing the levels of prevention" "Characteristics of chronic disease management (7 pillars) - CORRECT ANSWER - Self management, - decision support, - delivery system design/reorient health care services, - information system, - health public policy, - supportive environments, - community actions" "Chronic disease management includes all of the following factors EXCEPT: a) Requires an ongoing, planned, integrated approach within an easily navigated system b) Involves clients to be passive partners in managing their condition c) Requires a multidisciplinary approach d) Warrants health promotion & disease prevention strategies - CORRECT ANSWER b) Involves clients to be passive partners in managing their condition" "Why is growth and development an important concept for nursing? a. Nurses will care for patients & family members of all ages b. Providing a framework for thinking about human growth and development and learning c. Important to have an understanding of where clients are from both a developmental and a cognitive perspective d. Enhance your interactions and better understand the needs of the client. e. All of above - CORRECT ANSWER e. All of above" "What is Growth and Development? - CORRECT ANSWER The sequence of physical, psychological and cognitive development changes that take place over time human lifespan" "Stochastic theory - CORRECT ANSWER a. Aging is seen as events that occur RANDOMLY and accumulate overtime b. Explains aging as being the result of an accumulation of errors in the synthesis of cellular DNA and RNA, the basic building blocks of the cell. c. E.g. cancer, grey hair, skin changes, bone health." "Non stochastic theory - CORRECT ANSWER a. Aging is seen as certain predetermined, timed phenomena (CERTAIN TIME) b. Theory (programmed aging): thought to be predetermined or programmed at the cellular level, thus each cell has a natural life expectancy. c. E.g. menopause, skin changes, thinning hair, cardiac changes." "Common psychological changes that occur for older adults - CORRECT ANSWER - Lost of "loves ones" including pets. - Retirement—change in income (become low income), change in health insurance, loss of professional identity, lost of status, lost of social opportunities. - loss of independence--can be caused in traumatic. - shrinking social world-- can cause loneliness and isolation." "How does having an understanding of the biological theories of aging, influence nursing care? (Aging theories implication for nursing) Select all that apply a. Biological theory alone does not provide a comprehensive explanation of the aging process. b. As a person age, various adaptive changes occur with or accepting some of the biologic changes. c. Human development is a process that occurs over a lifespan d. Help us understand the difference between age related changes vs pathologic ones e. Promote health of older adult. For ex: smoking cessation (smoking cause increase cell turnover) or decrease free-radical damage by promoting a healthy nutritious diet or proper body mechanics to minimize injuries which can lead to wear and tear type injuries, etc. - CORRECT ANSWER a, b, c, d, e" "What is capacity building? - CORRECT ANSWER - the process of empowering others and strengthening their capabilities - involves human resources and skill development, as well as leadership, partnership, resources allocation and policy formulation." "Exemplar of capacity building - CORRECT ANSWER Health literacy and capacity building" "Health literacy - CORRECT ANSWER The ability to access, understand, evaluate and communicate information as away to promote, maintain, improve health in a variety of setting across the lifespan" "what is the connection between DoH and health literacy - CORRECT ANSWER 1. Low literacy and low health literacy contribute to low incomes and decrease community engagement which are related to poor health 2. Approximately 55% of working aged Canadian adults have less than adequate health literacy skills 3. Approximately 88% of older adults (65 and older) have less than adequate health literacy skills 4. Approximately 10% of Canadians live with a learning disability, approximately 80% of whom experience difficulty learning to read 5. Canadian with the lowest health literacy scores are two and half times more likely than Canadians with high health literacy scores to report their health status as fair to poor." "What is further limit health literacy - CORRECT ANSWER Chronic condition, vision impairment and hearing impairment" "It's important for nurses to have an understanding of health literacy because? - CORRECT ANSWER Nurse promote, teach, communicate with the client to prevent and manage the disease/ill" "How is client education defined? - CORRECT ANSWER - a process whereby clients learn health-related behaviours that can be applied a daily life. - Clients are provided information that is individualized and includes ways to promote health, reduce risk for illness or disease, and self-manage illness and chronic disease." "Client with good health literacy present - CORRECT ANSWER - Understand and carry out activities for self care - Plan and achieve the lifestyle adjustment required for improved health - Make informed positive health related decisions - Know how and when to access health care - Share health promoting instructions with others - Address health issues in the community and society." "The 3 levels of prevention are categorized into 2 levels of care - CORRECT ANSWER 1. Episodic care: the curative and restorative aspect of practice (secondary and tertiary prevention) 2. Distributive care: to the health maintenance, disease prevention, and health promotion (primary prevention)" "8 key elements population health approach - CORRECT ANSWER a. Focus on the health of population b. Address the DOH and their interaction c. Base decisions on evidence d. Increase upstream investments e. Apply multiple interventions and strategies f. Collaboration across sectors and levels g. Employ mechanisms for public involvement h. Demonstrate accountability for health outcomes" "Upstream thinking - CORRECT ANSWER - looks beyond the individual to take a macroscopic, big picture POPULATION FOCUS Include primary prevention perspective and is a population health approach. - At this level, CHNs ask: "how can we change the causes of the causes, or the conditions that set up conditions for the illness or injury?" "Developmental domain - CORRECT ANSWER 1. Physical/physiological, ex: Understanding an infant whose head is disproportionately larger than the body 2. Social/emotion Ex Explaining to and adolescents why the teacher intervened between two students who were fighting 3. Communication Ex: listening to children arguing and noticing the parent not taking sides 4. Cognitive Ex: explaining to a family member of a client with head trauma why they no longer have the ability to calculate math. 5. Motor Ex: Hearing from parents that their child can sit, stand, walk, run, and play, a client need to learn to administer insulin 6. Adaptive Ex: Understands how the older adult client feels after falling from the ladder" "The birth rate in Canada is 1.7 that is very low and its not enough to replace the death rate. What Canada do to replace is - CORRECT ANSWER - Bringing immigrant - Creating brain drain when you bring people from other country - We need to increase the birth rate ( increase the young age)" "What is teaching strategy with client experiencing of hearing loss - CORRECT ANSWER The nurse faces the client and speaks slowly and concisely using familiar words" "Ask-Tell-Ask example - CORRECT ANSWER Ask-- what do you know about diabetes Tell-- The nurse comments, A1C is another way to measure how your diabetes is doing Ask-- When the nurse confirms understanding by asking the client to repeat" "Strategy to avoid fatigue and distractions - CORRECT ANSWER The nurse comments, A1C is another way to measure how your diabetes is doing" "Health literacy is a strong predictor of what - CORRECT ANSWER Person's health status" "Empowerment can be outcome of which 2 concepts? - CORRECT ANSWER Capacity building and client education" "Example of assess - CORRECT ANSWER client responses, I'm ready to cut sugar out of my diet" "Teaching strategy for forgetfulness client - CORRECT ANSWER Nurse encourages the client to put the schedule on the fridge so seen frequently" "Teaching strategy for vision impairment - CORRECT ANSWER Nurse ensures pamphlet has large black font on white background" "Ann is 84 years old. During a health assessment, she tells you she feels tired all the time. What is the best response by the nurse? Ans: a. "Feeling tired is a normal part of aging. Others often tell me they feel the same way." b. "That must be difficult for you. Can you tell me what sorts of activities you used to be able to do that you can't do now?" c. Are you getting enough sleep? This may be why you are tired" d. "How are you managing your hypertension? Do you take you medications as prescribed?" - CORRECT ANSWER b. "That must be difficult for you. Can you tell me what sorts of activities you used to be able to do that you can't do now?"" "what is prevalence? a. Proportion of individuals in a population that have a disease at a particular time b. The prevalence of an event occurring over a lifetime. c. The probability that an event will occur within a specified time period. d. The proportion of the population that will develop an event. e. The rate of development of new cases. - CORRECT ANSWER a. Proportion of individuals in a population that have a disease at a particular time" What are the differences between illness vs. disease? - CORRECT ANSWER Illness is SUBJECTIVE and is the experience of being sick/ the reaction to a physical or psychological condition Disease is OBJECTIVE and is a physical/ psychological dysfunction or abnormality" "What are the three domains of learning? - CORRECT ANSWER cognitive, affective, psychomotor" "Explain capacity building - CORRECT ANSWER the process of empowering others and strengthening their capabilities. Used to address health concerns in nursing in order to implement decisions, actions or teach" "What can lead to hypoxia? - CORRECT ANSWER hypoxemia, ischemia, anemia" "What is hypoxemia? - CORRECT ANSWER low oxygen in the blood" "What is hypoxia? - CORRECT ANSWER low O2 content in tissues" "What is ischemia? - CORRECT ANSWER lack of oxygenated blood flow" "What is histoxic hypoxia? - CORRECT ANSWER Cells fail to use oxygen" "What is anoxia? - CORRECT ANSWER complete lack of oxygen in tissues" "What is emphysema? - CORRECT ANSWER airflow limitation due to a destruction of elastin fibers and abnormal enlargment of alveoli" "What is the pathogenesis for emphysema? - CORRECT ANSWER Neutrophils in alveoli secrete protease (elastase) to kill pathogens. Alveoli are coated with alpha-antitrypsin (AAT) to prevent elastase from further damaging alveoli. When under persistant irritation, neutrophils increase which causes elastase overproduction which further damages alveoli." "What are key manifestations of emphysema? - CORRECT ANSWER a) pursed lip breathing: used to control SOB b) barrell chest: caused by lung hyperinflation" "What is stroke volume? - CORRECT ANSWER the amount of blood ejected by the heart in any one contraction" "What three factors affect stroke volume? - CORRECT ANSWER a) Preload = amount of blood in ventricles at end of diastoli b) Contractility = strength of myocardial contraction c) Afterload = force of ventricles must exert to open the semilunar valves" "How does weak respiratory muscles impact gas exchange? - CORRECT ANSWER weaker diaphragm, intercostals and accessory muscles don't allow for full expansion to allow for ventilation" "How does cardiac dysfunction impair gas exchange? - CORRECT ANSWER Blood vessels are stiff which causes a higher pressure gradient so blood cannot be pumped as the heart is overloaded" "How does fibrous and less elastic alveoli impair gas exchange? - CORRECT ANSWER Decreases O2 diffusion due to decreased surface area for gas exchange to take place. Residual volume is also decreased, so expiration is not as effective which increases build of of CO2" "Describe some signs and symptoms of COPD in older adults - CORRECT ANSWER SOB, coughing, wheezing, fatigue, cyanosis, pursed lips, barrell chest" "Explain components of a gas exchange assessment - CORRECT ANSWER 1. BASELINE HISTORY = includes history on lifestyle, diet, allergies, medications, etc. and includes a PROBLEM BASED HISTORY assessment which checks symptoms such as coughing, SOB, and pain. 2. EXAMINATION FINDINGS = vital signs ( HR, SaO2, RR, temp), inspection (anxiety, impaired mentation, flaring nostrils, skin colour, etc.) and Auscultation (wheezing, crackling, etc.) 3. DIAGNOSTIC TESTS = lab tests showing ABGs (pH, O2, HCO3, SaO2, etc.)" "Explain how CO2 is transported by the bicarbonate system and is diffused into RBCs - CORRECT ANSWER 1. Tissue will expel CO2 into blood and enters RBC to bind with H2O using carbonic anhydrase to create H2CO3 2. H2CO3 dissociates into HCO3 + H 3. H will bind to hemoglobin 4. HCO3 is exchanged for chloride and leaves the RBC 5. RBC then enters lungs and reverses process to remove CO2 6. HCO3 will exchange with chloride to re-enter cell and H is released from hemoglobin 7. HCO3 and H combine to form H2CO3 8. H2CO3 dissociates into H2O and CO2 9. CO2 binds to hemoglobin to be moved out of RBC to enter blood which is transported to lungs to be exhaled" "What impacts normal respiratory function? - CORRECT ANSWER 1. ventilation 2. alveolar/ capillary diffusion 3. pulmonary perfusion" "What does ventilation depend on? - CORRECT ANSWER neuromuscular function, lung compliance, airway resistance" "What is health literacy? - CORRECT ANSWER ability to read, understand, and act on health information" "What are examples of factors that can lead to changes in blood viscosity, vessel radius and elasticity? - CORRECT ANSWER - hydration levels - exercise - diseases - aneurysms - shock - artherosclerosis" "Explain COPD - CORRECT ANSWER chronic and recurrent obstruction of airflow in lungs / pulmonary airways" "What are the two distinct diseases of COPD? - CORRECT ANSWER 1. Emphysema = destroyed lung tissues and enlarged airspaces 2. Chronic Bronchitis = obstructions of small airways by inflammation" "What are "pink puffers"? - CORRECT ANSWER Those with emphysema due to lack of cyanosis and uses pursed-lip breathing" "What are "blue boaters"? - CORRECT ANSWER Those with chronic bronchitis due to cyanosis and fluid retention associated with right sided heart failure" "What is the pathogenesis of chronic bronchitis? - CORRECT ANSWER mucus hyper-secretion and inflammation obstruct larger bronchi and can progress to affect smaller bronchioles." "What are key manifestations of chronic bronchitis? - CORRECT ANSWER productive cough for at least 3 months / year for more than 2 years, wheezing and coughing" "What controls peripheral resistance? - CORRECT ANSWER the SNS through epinephrine and norepinephrine in order to cause vasodilation or vasoconstriction" "What is hormonal control of blood pressure? - CORRECT ANSWER blood pressure controlled by the renin-angiotensin-aldosterone system (RAAS) to raise BP as needed" "What factors help monitor/ influence hormonal control of BP? - CORRECT ANSWER When BP decreases, the kidney releases renin which joins with angiotensin I which passes through the lungs and becomes angiotensin II which targets smooth muscle cells in arteries to vasoconstrict & increases Na + H2O retention which results in increased vascular resistance and increased blood pressure." "What hormones influence blood pressure? - CORRECT ANSWER epinephrine and norepinephrine which determine whether to constrict or dilate BVs" "What are some physiological age-related changes to perfusion? - CORRECT ANSWER - thickening of heart muscle - stiffening of arteries - decreased baroreceptor sensitivity which increases risk of falls and leads to orthostatic hypertension" "What is arterial compliance? - CORRECT ANSWER - the elasticity of BVs and their ability to widen and expand" "How does hypertension lead to left ventricular hypertrophy? - CORRECT ANSWER due to the increases workload of the heart from increased blood pressure, the heart adapts by increasing in muscle mass of the left ventricle in order to overcome the increased resistance"