WGU D236 Patho Study Guide
Pressure that is due to albumin in the bloodstream? - ANSOncotic
Oncotic - ANSa form of osmotic pressure exerted by proteins
In the blood, _____ is the most common plasma protein and is, therefore, a primary determinant
of oncotic pressure - ANSalbumin
_____ controls osmotic pressure in vascular system, builds volume - ANSAlbumin
One question was about the difference in children and adult immunity - ANSPossible answer:
naive T cells
Learning check question: Which differences in immunity make children and older adult patients
more susceptible to infections? Choose 2 answers
Younger patients have fewer memory cells to combat infection
Older adult patients have a dwindling population of naive T cells
Older adult patients have more memory cells to combat infection
Younger patients have a large population of naive T cells
Older adult patients have a large population of naive T cells - ANSYounger patients have fewer
memory cells to combat infection
Older adult patients have a dwindling population of naive T cells
Rationale: younger patients have not been exposed to many pathogens, which means that they
have fewer memory cells than adults. The primary immune response is relatively weak
compared to a secondary response mediated by memory cells.
Older adult patients do not have as many T cells compared to younger patients. When these
patients encounter novel pathogens, the reduced number of naive T cells gives clonal selection
fewer opportunities to "find" T cells that will be effective.
Fluid and electrolyte levels are regulated by _______, which regulates actions such as thirst,
ADH, the kidneys, and RAAS. - ANSosmoreceptors
Fluid deficit causes - ANS-Excessive loss
,-Inadequate intake
-Or combination of both
Fluid deficit risk factors - ANS-Vomiting/diarrhea
-Excessive sweating
-Insufficient water intake
Fluid deficit manifestations - ANS-dry mucous membranes
-decreased skin turgor
-decreased urine output
-low blood pressure
-tachycardia
-confusion
ROME for ABGs - ANSRespiratory Opposite Metabolic Equal
If pH and pCO2 are moving in opposite directions, then it is pCO2 levels that are causing the
imbalance and it is respiratory in nature
If they are moving the same direction then it is metabolic in nature
Buffers, renal compensation, and respiratory compensation help to maintain a blood pH of
_______ - ANS7.35-7.45
A patient with a viral illness and severe vomiting has an elevated CO2 level and a blood pH of
7.53. She is breathing slowly. What condition does the patient have?
Metabolic alkalosis
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis - ANSMetabolic alkalosis
The patient's pH and CO2 level are both elevating (moving in the same direction). This indicates
metabolic alkalosis. The CO2 level is high because her respiratory system is attempting to
compensate for the high pH by exhaling less and retaining more CO2
To prevent changes in pH, the body employs buffer systems. The body utilizes 3 buffer systems:
- ANSproteins, phosphates, and the carbonic acid-bicarbonate system
Carbonic acid-bicarbonate system first line of defense is _____, second line of defense is _____
- ANSrespirations; kidneys
Carbonic acid-bicarbonate system equation - ANSThe equation moves in both directions
CABS Equation:
,When CO2 levels are elevated, the equation moves ________, forming more H+ and HCO3-
ions - ANStoward the right
CABS Equation:
When H+ ions are elevated, the equation moves _____, as H+ ions are converted to CO2 and
the CO2 is exhaled. - ANStoward the left
CO2 levels - ANS35-45
HCO3 levels - ANS22-26
Michael's pulmonary edema leads to respiratory acidosis. How does pH impact Michael's basal
metabolic panel? Choose 3 answers.
His CO2 level is increased because his lungs have difficulty removing it from the bloodstream.
His K+ is elevated because, as H+ moves inside of cells in an attempt to get it out of the
bloodstream, K+ moves from cells into the bloodstream.
His sodium level is decreased due to hypervolemia.
His calcium level is reduced because the elevated concentration of H+ makes it easier for Ca+
to bind to albumin.
His CO2 level is decreased because his lungs have difficulty adding it into the bloodstream -
ANSHis CO2 level is increased because his lungs have difficulty removing it from the
bloodstream.
His K+ is elevated because, as H+ moves inside of cells in an attempt to get it out of the
bloodstream, K+ moves from cells into the bloodstream.
His sodium level is decreased due to hypervolemia.
There is a question about hypoventilation or hyperventilation - ANSMetabolic acidosis pH <7.35
= respirations increase in depth and rate to blow off CO2
Metabolic alkalosis pH >7.45 = respirations slow down to increase CO2 retention
Respiratory acidosis = excess CO2 has accumulated which is generating H+
Respiratory alkalosis = lungs blow off too much CO2, creating less H+ in blood
What is excreted in response to fluid volume overload? - ANSNatriuretic peptides
, Natriuretic peptides - ANShormonal signals released by the brain and heart in response to
excess fluid in the body
Natriuretic peptides signals _____ urine output and ____ fluid volume - ANSincrease; reduce
A hormonal panel was done on a patient with congestive heart failure and fluid volume overload.
Which elevated hormone on the patient's chart is indicative of the body's attempt to reduce the
fluid overload? - ANSBNP - it's released when fluid volume excess is present
Compare and contrast hemodialysis and peritoneal dialysis - ANSHemodialysis:
-machine pumps blood from the body and filters waste
-3x a week for hours in a clinic
-acute kidney failure
Peritoneal:
-no machine, injection into abdominal cavity and waste products diffuse into cavity then drained
-continuous filtration and less disruption but requires some training
-not for overweight or severe kidney failure patients
Hemodialysis takes blood out of the body via a _____, and puts blood back into body through a
_____ - ANSPIV; central line
*NOTE* there are several questions about signs and symptoms of different electrolyte
imbalances - ANS
Sodium levels - ANS135-145
Hyponatremia causes - ANSVomiting
Diuretics
Excessive administration of dextrose and water IVs
Burns, wound drainage
Excessive water intake
SIADH
Hyponatremia manifestations - ANSpoor skin turgor, dry mucosa, headache, decreased
salivation, decreased blood pressure, nausea, abdominal cramping, neurologic changes,
lethargy, confusion, seizures
Hypernatremia causes - ANSexcess water loss, excess sodium administration, diabetes
insipidus, heat stroke, hypertonic IV solutions
Hypernatremia manifestations - ANSthirst; elevated temperature; dry, swollen tongue; sticky
mucosa; neurologic symptoms; restlessness; weakness
Pressure that is due to albumin in the bloodstream? - ANSOncotic
Oncotic - ANSa form of osmotic pressure exerted by proteins
In the blood, _____ is the most common plasma protein and is, therefore, a primary determinant
of oncotic pressure - ANSalbumin
_____ controls osmotic pressure in vascular system, builds volume - ANSAlbumin
One question was about the difference in children and adult immunity - ANSPossible answer:
naive T cells
Learning check question: Which differences in immunity make children and older adult patients
more susceptible to infections? Choose 2 answers
Younger patients have fewer memory cells to combat infection
Older adult patients have a dwindling population of naive T cells
Older adult patients have more memory cells to combat infection
Younger patients have a large population of naive T cells
Older adult patients have a large population of naive T cells - ANSYounger patients have fewer
memory cells to combat infection
Older adult patients have a dwindling population of naive T cells
Rationale: younger patients have not been exposed to many pathogens, which means that they
have fewer memory cells than adults. The primary immune response is relatively weak
compared to a secondary response mediated by memory cells.
Older adult patients do not have as many T cells compared to younger patients. When these
patients encounter novel pathogens, the reduced number of naive T cells gives clonal selection
fewer opportunities to "find" T cells that will be effective.
Fluid and electrolyte levels are regulated by _______, which regulates actions such as thirst,
ADH, the kidneys, and RAAS. - ANSosmoreceptors
Fluid deficit causes - ANS-Excessive loss
,-Inadequate intake
-Or combination of both
Fluid deficit risk factors - ANS-Vomiting/diarrhea
-Excessive sweating
-Insufficient water intake
Fluid deficit manifestations - ANS-dry mucous membranes
-decreased skin turgor
-decreased urine output
-low blood pressure
-tachycardia
-confusion
ROME for ABGs - ANSRespiratory Opposite Metabolic Equal
If pH and pCO2 are moving in opposite directions, then it is pCO2 levels that are causing the
imbalance and it is respiratory in nature
If they are moving the same direction then it is metabolic in nature
Buffers, renal compensation, and respiratory compensation help to maintain a blood pH of
_______ - ANS7.35-7.45
A patient with a viral illness and severe vomiting has an elevated CO2 level and a blood pH of
7.53. She is breathing slowly. What condition does the patient have?
Metabolic alkalosis
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis - ANSMetabolic alkalosis
The patient's pH and CO2 level are both elevating (moving in the same direction). This indicates
metabolic alkalosis. The CO2 level is high because her respiratory system is attempting to
compensate for the high pH by exhaling less and retaining more CO2
To prevent changes in pH, the body employs buffer systems. The body utilizes 3 buffer systems:
- ANSproteins, phosphates, and the carbonic acid-bicarbonate system
Carbonic acid-bicarbonate system first line of defense is _____, second line of defense is _____
- ANSrespirations; kidneys
Carbonic acid-bicarbonate system equation - ANSThe equation moves in both directions
CABS Equation:
,When CO2 levels are elevated, the equation moves ________, forming more H+ and HCO3-
ions - ANStoward the right
CABS Equation:
When H+ ions are elevated, the equation moves _____, as H+ ions are converted to CO2 and
the CO2 is exhaled. - ANStoward the left
CO2 levels - ANS35-45
HCO3 levels - ANS22-26
Michael's pulmonary edema leads to respiratory acidosis. How does pH impact Michael's basal
metabolic panel? Choose 3 answers.
His CO2 level is increased because his lungs have difficulty removing it from the bloodstream.
His K+ is elevated because, as H+ moves inside of cells in an attempt to get it out of the
bloodstream, K+ moves from cells into the bloodstream.
His sodium level is decreased due to hypervolemia.
His calcium level is reduced because the elevated concentration of H+ makes it easier for Ca+
to bind to albumin.
His CO2 level is decreased because his lungs have difficulty adding it into the bloodstream -
ANSHis CO2 level is increased because his lungs have difficulty removing it from the
bloodstream.
His K+ is elevated because, as H+ moves inside of cells in an attempt to get it out of the
bloodstream, K+ moves from cells into the bloodstream.
His sodium level is decreased due to hypervolemia.
There is a question about hypoventilation or hyperventilation - ANSMetabolic acidosis pH <7.35
= respirations increase in depth and rate to blow off CO2
Metabolic alkalosis pH >7.45 = respirations slow down to increase CO2 retention
Respiratory acidosis = excess CO2 has accumulated which is generating H+
Respiratory alkalosis = lungs blow off too much CO2, creating less H+ in blood
What is excreted in response to fluid volume overload? - ANSNatriuretic peptides
, Natriuretic peptides - ANShormonal signals released by the brain and heart in response to
excess fluid in the body
Natriuretic peptides signals _____ urine output and ____ fluid volume - ANSincrease; reduce
A hormonal panel was done on a patient with congestive heart failure and fluid volume overload.
Which elevated hormone on the patient's chart is indicative of the body's attempt to reduce the
fluid overload? - ANSBNP - it's released when fluid volume excess is present
Compare and contrast hemodialysis and peritoneal dialysis - ANSHemodialysis:
-machine pumps blood from the body and filters waste
-3x a week for hours in a clinic
-acute kidney failure
Peritoneal:
-no machine, injection into abdominal cavity and waste products diffuse into cavity then drained
-continuous filtration and less disruption but requires some training
-not for overweight or severe kidney failure patients
Hemodialysis takes blood out of the body via a _____, and puts blood back into body through a
_____ - ANSPIV; central line
*NOTE* there are several questions about signs and symptoms of different electrolyte
imbalances - ANS
Sodium levels - ANS135-145
Hyponatremia causes - ANSVomiting
Diuretics
Excessive administration of dextrose and water IVs
Burns, wound drainage
Excessive water intake
SIADH
Hyponatremia manifestations - ANSpoor skin turgor, dry mucosa, headache, decreased
salivation, decreased blood pressure, nausea, abdominal cramping, neurologic changes,
lethargy, confusion, seizures
Hypernatremia causes - ANSexcess water loss, excess sodium administration, diabetes
insipidus, heat stroke, hypertonic IV solutions
Hypernatremia manifestations - ANSthirst; elevated temperature; dry, swollen tongue; sticky
mucosa; neurologic symptoms; restlessness; weakness
