Pathophysiology HESI Review Exam Elaborations. (A+ GRADED)

What is TPA? What are at least 2 conditions where you might see it given as a medication? Why would we not give it? tPA: clot busting agent used to reduce the effects of CVA (stroke) in some individuals. It is contraindicated for anticoagulant drugs. The release of tissue plasminogen (tPA) from injured blood vessels and tissues, converts plasminogen to plasmin. Plasmin is a potent enzyme that digests fibrin strands (this leads to clot dissolution). 2. Know the triad that would lead you to conclude your patient is experiencing cardiac tamponade Fluid compresses the heart, prevents stretching & filling, reduces CO Arterial pressure falls, venous pressures rise, pulse pressure narrows Beck’s Triad: Distant, muffled heart sounds (like under water, fluid), JVD, decreased BP =EMERGENCY pericardiocentesis with surgical repair as appropriate is needed (16-18 gauge needle inserted into pericardial space to relieve pressure and analyze fluid) Manifestations include heavy feelings over the chest, shortness of breath, tachycardia, cough, dysphagia, hiccups, hoarseness, nausea, vomiting, excessive perspiration, decreased level of consciousness, pulses paradoxes, distant or muted heart sounds, and extreme anxiety, neck vein distension 3. The 3 Ps of diabetes Polydipsia: osmolality, polyuria: osmotic diuresis, and polyphagia: cell starvation 4. What electrolyte is of most concern with kidney failure patients? Potassium: cardiac 5. Review the signs of hypokalemia and hyperkalemia Hypokalemia: muscle cramps, weakness, cardiac arrhythmias, flattening of the T wave, confusion and drowsiness, and irritability Hyperkalemia: peaked T wave, v-fib, cardiac arrest, muscle weakness, respiratory distress