BSNC 1000 MIDTERM EXAM QUESTIONS WITH CERTIFIED SOLUTIONS A VERIFIED A+ PASS

BSNC 1000 MIDTERM EXAM QUESTIONS WITH CERTIFIED SOLUTIONS A VERIFIED A+ PASS “• Illness - CORRECT ANSWER ◦ Illness is a subjective experience of loss of health" "• Health - CORRECT ANSWER ◦ beyond absence of diseases multi approaches like physical mental social and spiritual health objective process functional stability" "• Disease - CORRECT ANSWER ◦ objective states of ill health pathological process detected by medical science involves abnormalities" "◦ Incidence - CORRECT ANSWER Number of new cases" "◦ Prevalence - CORRECT ANSWER who has it for how long certain time" "◦ Morbidity - CORRECT ANSWER proportion of illness in a population" "◦ Mortality - CORRECT ANSWER incidence of death in a population" "◦ Risk - CORRECT ANSWER the chance or likelihood that something would cause harm to one's health" "◦ changes in any part of the triangle causes - CORRECT ANSWER disease" "Epidemiological triad - CORRECT ANSWER contains agent host environment" "• Epidemiological triad - CORRECT ANSWER agent host environment:" "‣ Host - CORRECT ANSWER living person to get infected (genetic age sex immune diet" "‣ Environment - CORRECT ANSWER host or the agent that gets influenced or influences others (climate, plant animal, education resources" "• Web of causation - CORRECT ANSWER ◦ Many factors that work together to increase the risk of disease ◦ diabetes: lifestyle, environment, education, diet, family hx" "• Chain of infection 6 types - CORRECT ANSWER ◦ Infectious Agent bacteria ◦ Reservoir lives needs food h20 etc ◦ Portal of exit urine stool bile ◦ Mode of transmission indirect direct contact ◦ Portal of entry breaks in skin ◦ Host gets infected love immune." "Stochastic Theory abnormal changes - CORRECT ANSWER • Aging is seen as events that occur randomly & accumulate overtime errors • Some examples? falling disease cancer cognitive decline." "How does understanding the biological theories of aging, influence nursing? care? - CORRECT ANSWER allows us to change our care as needed and the way required to the resident" "How are health & wellness impacted by the biological aging process? - give examples? - CORRECT ANSWER As a person's quality of life can be decreased" "Module 3 Capacity building Capacity Building: - CORRECT ANSWER "the process of empowering others and strengthening their capabilities" "Involves human resource and skill development, as well as leadership, partnership, resource allocation, and policy formulation."" "Module 4 - CORRECT ANSWER Perfusion Definition of perfusion: • the flow of blood through arteries and capillaries delivering nutrients and oxygen to cells. Perfusion is a normal physiological process that requires the heart to generate sufficient cardiac output to transport blood" "CVS components property and function - CORRECT ANSWER • heart pump generates pressure • arterial pressure reservoir outgoing expand recoil • capillary network exchanges gasses deliver • venous volume reservoir low pressure distensible" "Purpose of perfusion - CORRECT ANSWER • delivers oxygen and nutrients to tissues and removes cellular waste" "Scope of perfusion - CORRECT ANSWER • The scope of perfusion ranges from optimal perfusion to impaired perfusion (ischemia) to no perfusion (infraction)" "• Central Perfusion - CORRECT ANSWER ◦ by cardiac output the amount of blood pumped by the heart each minute, normal cardiac output is 4-6 L/min affected by the stroke volume and heart rate and SVR" "• Tissue perfusion - CORRECT ANSWER ◦ refers to the volume of blood that flows through target tissues, the force of the ventricular contractions creates a pressure that pushes blood through the capillaries to the cells" "systemic vascular resistance - CORRECT ANSWER • impediment to blood flow • affected by blood vessels radius • viscosity determined by erythrocytes i.e. anemia • elasticity expand and recoil to pressure" "Blood volume - CORRECT ANSWER • stays constant but switches between arterial and venous system" "When going from venous system to arterial system it increases? - CORRECT ANSWER SVR. CO: HR x SV" "BP - CORRECT ANSWER CO x SVR" "HR x SV = - CORRECT ANSWER CO" "CO x SVR = - CORRECT ANSWER BP" "Variations duration and degree and permanent - CORRECT ANSWER Duration of impairment: Acute sudden chronic slow over time months years Degree of impairment Ischemia Infraction: Ischemia: injury from decreased blood supply Infraction: cell death from shock" "• Impaired central perfusion - CORRECT ANSWER ◦ decreased cardiac output by changes in myocardial conductions problems with heart valves, problems with the heart muscles, increased SVR significant result leads to shock decrease CO and blood loss or vasodilation" "• Impaired tissue perfusion - CORRECT ANSWER ◦ decreased volume of blood to the interstitial space between the arteries to capillaries can result from poor central perfusion or the organ itself has problems can lead to excessive edema constriction or collapse of arterioles" "Consequences • Consequences of Central perfusion - CORRECT ANSWER ◦ occurs in conditions that decrease cardiac output or cause shock. Cardiac output is decreased when there is inadequate perfusion to the myocardium, inadequate impulse conduction through the heart, or malfunction of a heart valve Shock, (cardiogenic shock), (hemorrhagic shock), (anaphylactic, neurogenic, or septic shock)" "• Consequences of impaired tissue perfusion - CORRECT ANSWER ◦ Impairment of tissue perfusion is associated with occlusion, constriction, or dilation of arteries or veins. Atherosclerosis or thrombi. Examples of dilation are aneurysms in arteries and varicose veins. Ischemia is reversible cellular injury decreased oxygen leads to decrease apt breakdown of sugar instead of oxygen leads to lactic acid build up" "When ischemia persists, irreversible cell injury or cell death occurs from - CORRECT ANSWER necrosis" "• Symptoms asymptomatic progressive disease of BP - CORRECT ANSWER higher than 140mm Hg stage 1 stage 2 160 above crisis is 180 higher" "Clinical manifestation in the heart? - CORRECT ANSWER • Increase workload in the left ventricle leads to left ventricular hypertrophy overtime the heart can give up and have a MI cut contractility impaired = heart failure" "Clinical Manifestation in the arterial system? - CORRECT ANSWER • Changes large and small blood vessels • macro-vascular heart brain stiffening narrowing weakening of the blood vessels walls arteriosclerosis • microscopic changes eyes and kidneys decrease in density and number of arterioles and capillaries rarefaction." "Effects of perfusion on the arteries kidneys eyes brain - CORRECT ANSWER Systemic arteries: tunica intima atherosclerosis Coronary arteries: compression vessels angina and myocardial infarction brain: increased pressure in the arteries of the brain can lead to aneurysm bulging ruptured vessels can impair perfusion hemorrhagic stroke presents as headaches vomiting trouble loss of vision. kidneys: increased pressure in the afferent arterioles of the kidney can leads to affected to GFR presents as proteinuria stiffening of renal arterioles nephrosclerosis and renal failure. Eyes: increased pressure leads to compression and bleeding from ruptured blood vessels can present as reduced visual acuity pain and pressure in the headaches." "Hypertension in the elderly - CORRECT ANSWER • stiffening of the large arteries, particularly the aorta decreased baroreceptor sensitivity increased peripheral vascular resistance and decreased renal blood flow." "◦ Orthostatic or postural hypotension is defined - CORRECT ANSWER as a decrease in systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg within 3 minutes of standing caused by bed rest or immobility or drug induced aging in general altered ANS function ◦ treatment is done by non-pharmacological fix what was causing." "Physiological factors that regulate HR, and SV? - CORRECT ANSWER • preload, afterload, contractility, hormones SNS and PNS." "Assessment of BP - CORRECT ANSWER • Diagnosis by monitoring bp over time" "• lifestyle medications - CORRECT ANSWER weight reduction physical cavity no alcohol" "• pharma logical treatment - CORRECT ANSWER diuretics blocks sodium, β-adrenergic receptor inhibitors decrease HR, ACE inhibitors or angiotensin II receptor blockers decreases levels of angiotensin 2, calcium channel blockers decrease caladium in the cells, central α2-adrenergic agonists, α1- adrenergic receptor blockers, and vasodilators" "Focus assessment interview inspect auscultate palpate - CORRECT ANSWER • Focus interview perfusion: ◦ chest pain SOB edema cough fatigue leg pain skin changes injury. • Inspect perfusion: ◦ face lips ears for cyanosis, chest for scars, bi lateral arms ahead CWMS cap refill, Bi lateral legs distended veins cap refill edema calf size for DVT pain during dorsiflexion. • Auscultate perfusion: ◦ apical pulse heart and rhythm. • Palpate perfusion: ◦ radial brachial dorsalis pedis and posterior timbales pulses" "• Ventilation affected by the 3 things - CORRECT ANSWER ◦ Pressures, Chest and muscles Because of the change in size and pressure of the chest cage, diaphragm Controlled by the phrenic nerve muscles Lung compliance: Elastic properties: stiffness distensibility is easily elastic recoil coming back to normal after breathing surface tension: surfactant protect the lungs support lung expansion Airway resistance: airway radius, lung volume, neural and local control of airway diameter laminar and turbulent airway" "Compensatory mechanisms of ventilation, ventilation perfusion match, gas transport - CORRECT ANSWER - Ventilation: change of breathing pattern use of WOB - Ventilation perfusion breathing: increasing depth of breathing increase perfusion to the lungs - Gas transport: increased erythrocytes" "Exchange and Transport of Gases ventilation perfusion diffusion - CORRECT ANSWER • (1) ventilation or the flow of gases into and out of the alveoli of the lungs, • (2) perfusion or flow of blood in the adjacent pulmonary capillaries, ◦ the amount of air in the gas exchange, the movement of blood through the pulmonary cap- alary bed requires that the mean pulmonary arterial pressure be greater than the mean pulmonary venous pressure. shunt helps in the movement of gas/blood from one area to another. • (3) diffusion or transfer of gases between the alveoli and the pulmonary capillaries" "• The term affinity refers to - CORRECT ANSWER hemoglobin's ability to bind oxygen. Hemoglobin binds oxygen more readily when its affinity is increased and releases it more readily when its affinity is decreased" "• Oxygen transport - CORRECT ANSWER ◦ Alveoli-to-Capillary Transfer. ◦ In the lung, O2 moves from the alveoli to the pulmonary capillary- is as a dissolved gas. ◦ Hemoglobin Binding and Transport. ◦ Oxygen Dissociation in the Tis s u e s" "Control of Breathing - CORRECT ANSWER • Control of breathing has both automatic and voluntary components. The automatic regulation of ventilation is controlled by two types of receptors chemoreceptors, which monitor blood levels of carbon dioxide, oxygen, and pH central near the medulla and peripheral in the carotid and lung receptors, which monitor the status of breathing in terms of airway resistance and lung expansion. • The first, or dorsal, group of neurons is concerned primarily with inspiration control the phrenic nerve" "• Hypoxemia - CORRECT ANSWER Hypoxemia refers to a decrease in blood oxygen levels that results in a decrease in tissue oxygenation. Hypoxemia can occur as the result of hypoventilation, diffusion impairment, shunt, and ventilation-perfusion abnormalities. Acute hypoxemia is manifested by increased respiratory effort (increased respiratory and heart rates), cyanosis, and impaired sensory and neurologic function. The body compensates for chronic hypoxemia by increased ventilation, pulmonary vasoconstriction, and increased production of red blood cells" "• Hypercapnia - CORRECT ANSWER ◦ Hypercapnia refers to an increase in carbon dioxide levels. The manifestations of hypercapnia consist of those associated with a decrease in pH (respiratory acidosis) vasodilation of blood vessels, including those in the brain and depression of central nervous system function" "• Obstructive airway disorders are caused by conditions - CORRECT ANSWER that limit expiratory air flow." "◦ COPD #1 emphysema - CORRECT ANSWER with enlargement of air spaces and destruction of lung tissue loss of lungs elasticity and abnormal enlargement of air spaces and loss of elastin leads to decreased surface area airway collapse air trapping increased work for breathing, damage to alveoli smaller to bigger airways overproduction of enzymes leads to membrane damage" "Dyspnea - CORRECT ANSWER SOB subjective" "Hyperventilation - CORRECT ANSWER ventilation that goes above need decrease in CO2" "Shallow breathing - CORRECT ANSWER without diaphragm reduces depth of breathing" "◦ COPD #2 chronic obstructive bronchitis - CORRECT ANSWER productive cough for 3 months for over 2 years with increased mucus production increased goblet production affects larger airways before smaller leads to decreased patency and more resistance v/q mismatch compensatory hypoxic pulmonary vasoconstriction" "One of the consequences of compensatory hypoxic pulmonary vasoconstriction? - CORRECT ANSWER increased pulmonary pressure" "Which lung volumes and capacities are affected by COPD the two - CORRECT ANSWER Chronic bronchitis Decreased airway patency leads to decreased Expiratory reserve volume. Emphysema Increased air trapping and over inflated lungs increased residual volume" "Compensatory mechanisms in COPD with why 3 types - CORRECT ANSWER - Use of accessory respiratory muscles: ability to inhale more air. - Tachycardia: to push more oxygen-rich blood - Elevated erythrocyte count: more RBC to carry more o2 polycythemia" "renin-angiotensin-aldosterone system (RAAS) - CORRECT ANSWER Renin (from kidneys) → Angiotensin I (from angiotensinogen) → Angiotensin II (via ACE) → Increases blood pressure and volume through vessel constriction, aldosterone, and ADH." "Respiratory alkalosis is caused by - CORRECT ANSWER hyperventilation leading to low CO₂ levels and high pH (alkaline blood)." "Respiratory acidosis is caused by - CORRECT ANSWER hypoventilation leading to high CO₂ levels and low pH (acidic blood)." "Blue bloater - CORRECT ANSWER Hypoxemia, hypercapnia (chronic bronchitis)" "Pink puffer - CORRECT ANSWER Dyspnea, hyperventilation (emphysema)" "partial pressure of oxygen - CORRECT ANSWER higher in the alveoli than the pulmonary artery" "external respiration - CORRECT ANSWER External respiration, also known as pulmonary respiration, is the process by which oxygen is exchanged with carbon dioxide between the alveoli (tiny air sacs) in the lungs and the blood in the pulmonary capillaries" "internal respiration - CORRECT ANSWER also known as tissue respiration or cellular respiration, is the process by which oxygen is delivered from the blood to the body's tissues and cells, and carbon dioxide is removed from these cells and transferred back into the blood" "surfactant - CORRECT ANSWER chemical produced in the lungs to maintain the surface tension" "Po2 - CORRECT ANSWER 75-100mmhg" "Pco2 - CORRECT ANSWER 34-45mmhg" "Heurig-Breuer Reflex - CORRECT ANSWER regulate the rhythm of breathing and prevents over-inflation of the lungs" "volume reservoir - CORRECT ANSWER veins" "pressure reservoir - CORRECT ANSWER arteries" "identity vs. role confusion - CORRECT ANSWER adolescence finding who they are" "intimacy vs isolation - CORRECT ANSWER Finding their partners or staying alone" "Generative vs stagnation - CORRECT ANSWER Contributing to society working family" "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" "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" "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." "• Determinants of health types - CORRECT ANSWER - definition factors that influence the risk for or distribution of health outcomes - Types: Income and income distribution Education Unemployment and job security Employment and working conditions Early childhood development Food insecurity Housing Social exclusion social safety network Health services Indigenous status Gender Race Disability" "• Community - CORRECT ANSWER refers to people as they develop and commonly share a physical environment, or an Institution has 3 dimension People place and function of the activities in the communities is created by people over time and it is chosen can be positive negative communities i.e. drinking and AA meeting" "• Population - CORRECT ANSWER ◦ A group of people interconnected by their location or by politics you are given this and most likely cannot change, external" "◦ Primary Health promotion - CORRECT ANSWER ‣ before a condition health immunization and decreasing risk factors environmental protection" "◦ Secondary health promotion - CORRECT ANSWER ‣ during the condition develops early detection of the diseases screening for cancer" "◦ Tertiary Disease health promotion - CORRECT ANSWER ‣ after the condition occurs having cardiac rehab after a heart attack deal with the disease" "• Example Diabetes primary secondary tertiary health promotion - CORRECT ANSWER ◦ Primary education on high or low BG can be, healthy habits diet and exercise family history ◦ Secondary testing HBA1C q3months, check for skin medical hx ◦ Tertiary medications management of s/s high or low insulin metformin education on safe BG checks and skin management" "• Chronic Disease - CORRECT ANSWER ◦ Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both" "◦ The strategy for chronic diseases consists of three pillars - CORRECT ANSWER ‣ promoting health by addressing the conditions that lead to unhealthy eating, physical inactivity, and unhealthy weights ‣ preventing chronic disease through focused and integrated action on major chronic diseases and their risk factors ‣ and supporting the early detection management of chronic diseases. ◦ self-management, delivery system, information system, supportive environment, community action, public health" "• Epidemiology - CORRECT ANSWER ◦ Is the study of the distribution of factors that determine health related states in a population information offers way to control health problems investigation of patterns." "◦ Descriptive epidemiology - CORRECT ANSWER terms of what, who, where, and when." "◦ Analytical Epidemiology - CORRECT ANSWER examines the etiology (origins or causes) of a disease and associated determinants of health" "◦ Important for Nursing of epidemiology - CORRECT ANSWER ‣ uses epidemiology to assess the complex interplay of social and environmental factors that affect the client's well-being and understand the broader context in which the client lives." "Growth and Development - CORRECT ANSWER 'Sequence of physical, psychosocial & cognitive developmental changes that take place over the human lifespan" "• Developing Theorist ◦ Freud - CORRECT ANSWER ‣ Psychoanalytic model of personality development of the mature development" "◦ Piaget - CORRECT ANSWER ‣ cognitive development addresses the development of children's organization and how they think reason perceive and make meaning of the world" "◦ Kohlberg - CORRECT ANSWER ‣ theory of moral development" "◦ Erikson FINAL EXAM - CORRECT ANSWER ‣ Psychosocial theory of development" "‣ Integrity vs. Despair (Late Adulthood, 65+ years) - CORRECT ANSWER Older adults reflect on their lives. If they feel a sense of fulfillment and satisfaction, they develop integrity. If they feel regret and disappointment, they may experience despair" "Why is the concept of Growth & Development important for nurses to understand - CORRECT ANSWER • nurses will care for clients and family framework for thinking enhance thinking predict better outcome" "Risk for 65 plus injury - CORRECT ANSWER young old falls chronic diseases" "Developmental domains - CORRECT ANSWER • Physical, social/emotional, communication, cognitive, motor, adaptive" "Older adultdefinition and the 3 sections of older adults: - CORRECT ANSWER The term older person is the most appropriate term for persons over the age of 65 years. Sometimes the older age group is broken down into groups of youngest old, old, and oldest old, with oldest old comprising people over 85 as the life expectancy increases the groups to accommodate the health's" "Developmental tasks - CORRECT ANSWER • These are tasks that arise at, or about a certain period in life, unsuccessful achievement may lead to inability to perform tasks associated with the next stage in life" "The effects of social isolation and loneliness - CORRECT ANSWER • increased BP heart disease obesity depression anxiety Alzheimer's • Loneliness is considered a public health issue and across several countries' attention toward social isolation and loneliness has been realised" "Identify some common psychosocial changes that occur in adults and how they impact and common impact on DOH - CORRECT ANSWER • Transition of life stage retirement: active to inactive lifestyle DOH: income • social isolation depression stress DOH decrease in health behaviours • abuse • Housing and environment changes lead to depression loss of control DOH access to health care, environment environment • Death acceptance and denial DOH: • Sexuality" "Age related changes Skin - CORRECT ANSWER Loss of skin elasticity, thinking hair sensitive skin, can impact job and not being able to do the same tasks as before at risk for injury" "Age related changes Respiratory - CORRECT ANSWER decrease coughing ability decreased muscle strength, increased infection risk movement their mobility is at risk chest wall stiffen decrease surface area for diffusion decreased capillary network" "Age related changes Cardiovascular - CORRECT ANSWER thickening of vessels, calcification of the valves, increased BP" "Age related changes MSK - CORRECT ANSWER decreased muscle mass joint changes dehydration of discs." "Age related changes endocrine - CORRECT ANSWER less thyroid pancreas increased fibrosis and decreased sensitivity to insulin" "Age related changes immune system - CORRECT ANSWER decreased thymus and T cell work less, and core temp decreased" "Non-stochastic Theory normal changes - CORRECT ANSWER • Aging is seen as certain predetermined, timed phenomena, physical changes expected pre detrained problems that random major population has it • Some examples? grey hair cancer disease grey hair vision hearing loss muscle changes bone decrease in density menopause." "• Where does capacity building take place? - CORRECT ANSWER ◦ Health care setting their homes pre and post admission schools' organizations social media workplace doctor's office hospital pharmacy" "• What does a capacity building approach include? - CORRECT ANSWER ◦ Teaching understanding evaluating teach back method assessing previous knowledge dealing with issues helping them overcome challenges what is it that we can help for them to feel better promotion collaboration relational inquiry demonstration" "• Why it is important for nurses to understand 'health literacy'? - CORRECT ANSWER ◦ Need to know to teach and be able to see how much another person knows and teach accordingly using the DOH how best to provide education advocate for their care questions" "• How would a client with 'good' health literacy present? Connect to chronic disease management - CORRECT ANSWER ◦ Know their disease and be able to explain treatment and what is good and bad knows good healthy habits coping mechanisms" "• What do we mean by capacity building? In nursing, whose capacity are we building? - CORRECT ANSWER ◦ Educating developing a better outcome skill development the patient and family member's friend" "• Explain the value of capacity building on the client as it relates to health status? - CORRECT ANSWER ◦ If helps the patient do better after discharge avoids read mission health promotion" "• Explain the meaning of the attribute as it relates to capacity building & provide an example of what it would look like in nursing practice for chronic disease management - CORRECT ANSWER ◦ Respect value existing capacities advocacy collaborations partnership equity responding to context developing well planning" "Patient-centred care is a standard of care - CORRECT ANSWER that positions the patient as the focus of care delivery and as a partner in the delivery of care" "• Health literacy definition - CORRECT ANSWER Health literacy refers to the patient's ability to find, understand, and utilize services and information to make health-related decisions, such as taking medication" "◦ Health literacy details is a strong predictor of a - CORRECT ANSWER person's health status. Because at some point in our lives, we all need to be able to find, understand, and use health information and services. ◦ Health literacy can help us prevent health problems and protect our health, as well as better manage those problems and unexpected situations that happen, this connects back to capacity building in CDM ◦ Understand and teach again apply ◦ We use this to understand someone's literacy of health" "• capacity building means to - CORRECT ANSWER address health issues and overcome barriers to achieve enhanced quality-of- life outcomes Nurses may work with community members to identify the type of coalition or network that best fits their intended purpose, to clarify leadership roles, to create links between the coalition or network and the community at large, and to provide requested support to the coalition or network" "Basic Learning Principles - CORRECT ANSWER • before teaching understanding how to learn dependent on the environment and how much can they learn and teach in their situation" "• Learning environment - CORRECT ANSWER Ability to learn ◦ emotional capability ◦ intellectual capability ◦ physical capability" "Domains of learning - CORRECT ANSWER cognitive and affective psychomotor. : • cognitive (understanding): includes all intellectual behaviours and requires thinking example: discussion, storytelling, lecture question and answer, pamphlets. • affective (attitudes): Affective learning concerns expressions of feelings and acceptance of attitudes, opinions, or values role play group discussion reflective journals. • psychomotor (motor skills): Psychomotor learning requires the integration of mental and muscular activity to acquire a skill, such as the ability to walk or to use an eating utensil example demonstration or return demonstration and practice intendent projects and games injection." "Strategies for Communicating Effectively with Older Persons - CORRECT ANSWER • Try to find a quiet room with minimal outside noises for communication. • Sit facing the patient so that they can watch your lip movements and facial expressions. • If masks must be worn for safety, consider how to maintain an interaction that is warm, open, and demonstrates interest • If needed, make sure that glasses and hearing aids are being worn. • Speak slowly and clearly (do not speak loudly). • Keep your tone of voice low older persons can hear low- frequency sounds better than high-frequency sounds. • Periodically summarize what has been said to clarify that you have understood what the older person was saying and repeat key points. • Ask the older person to explain what they understood and invite questions to clarify information. There may also be cultural aspects related to communication. (Please refer to Chapter 18 for more information.) • Emphasize and integrate emotional and personal values in the acquisition of skills and ideas." "Client education - CORRECT ANSWER "a process whereby clients learn health-related behaviours that can be applied to 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"" "Characteristics chronic disease management - CORRECT ANSWER • community action self-management, health public policy, information system, decision support, supportive environment, health public policy." "Clinical education techniques - CORRECT ANSWER • 5 As Advise, Assess, Agree: ◦ Assess ‣ To assess importance, for example, ask "How important do you think it is to check your blood glucose before breakfast each day?" Use a 1-10 scale, from not at all important to very important. To assess confidence, for example, ask "How confident are you that you can control any symptoms Use a 1-10 scale, ◦ Advise ‣ Provide specific personalized information about health risks and benefits of change, Make the source of the advice clear, personalize lab values, health status and how choices affect outcomes. Ask the client to restate what you said. ◦ Agree ‣ Collaboratively set goals based on the client's interests and confidence in their ability to change the behaviour. If their self-rated confidence is low, the goal may need to be changed: e.g., select one aspect of the goal that the client feels more confident about attaining." "• Ask Tell Ask - CORRECT ANSWER ◦ Ask what they already know ◦ tell fill in knowledge gaps." "• Teach Back - CORRECT ANSWER a type where they teach back what they have learned." "How is client education defined? - CORRECT ANSWER • a process whereby clients learn health-related behaviours that can be applied to daily life." "What is the overall outcome of client education for clients? - CORRECT ANSWER • health outcomes ability to make informed decisions on their outcomes" "How are capacity building & client education related? - CORRECT ANSWER • if you educate that lad to capacity building providing education leads to building" "Client education for what chronic disease management - CORRECT ANSWER self-management • everyone has a role to play in maintaining health • client education is the most important to build capacity • health literacy is the single most important predictor to good health • client education is the most important strategy to manage chronic disease" "Risk factors of perfusion - CORRECT ANSWER • greatest risk are the ones who are middle age and older adults, males and African males' children and young adults from trauma peoples who are affected by atherosclerosis, older adults are by just change in advanced age • birth defects old age males' pregnancy chronic illness environment" "Blood pressure MAP and PP - CORRECT ANSWER • MAP: avg pressure in the arteries during one cardiac cycle normal 70-100" "• PP - CORRECT ANSWER difference between systolic and diastolic pressure normal 40mmhg." "• Neural Regulation of BP - CORRECT ANSWER ◦ cardiovascular centres in the ANS sends impulses through the Vagus nerve baroreceptors in heart high in ceratoid when detect low contract vessels or low-pressure receptors in pulmonary vessel detect respond with like hormonal effects (vasopressin) send back to the cardiovascular center ◦ changes detected by baroreceptors direct innervation from ANS on vessels high map reduced HR vasodilation Low MAP: increased HR vasoconstrictions" "• The humoral control of blood pressure - CORRECT ANSWER ◦ Angiotensin + renin = angiotensin I + ace = angiotensin II affects kidneys (aldosterone) and vessels to vasoconstriction" "• Autoregulation of blood pressure - CORRECT ANSWER ◦ changes in bp leads to local compensatory mechanism i.e. kidneys brain heart" "• Systolic Pressure - CORRECT ANSWER The systolic blood pressure reacts the amount of blood (stroke volume) that is ejected from the heart with each beat" "• Diastolic Pressure - CORRECT ANSWER The diastolic blood pressure recasts the closure of the aortic valve, the energy that has been stored in the elastic beers of the large arteries during systole, and the resistance to ow through arterioles into the capillaries" "old age on blood pressure - CORRECT ANSWER elasticity of the aorta and other arteries decreases in older people, stiffness to arteries decreases cardio output decrease elastin production myocardial hypertrophy." "Hypertension - CORRECT ANSWER • sustained elevation of bp within the arterial circuit" "• In primary hypertension - CORRECT ANSWER , the chronic elevation of blood pressure occurs without evidence of other disease conditions idiopathic" "◦ Most common risk factors for primary HTN - CORRECT ANSWER family hx race age insulin risk factors lifestyle high salt diet excessive weight alcohol modifiable and non-modifiable genetics age African." "• In secondary hypertension - CORRECT ANSWER the elevation of blood pressure results from some other disorder," "In secondary hypertension caused by 3 mains - CORRECT ANSWER ◦ kidney disease controls bp increases Angiotensin #2 for no reason and sodium retention ◦ birth control: progesterone and estrogen cause sodium rent ion ◦ hormones: hyperaldosteronism increases an in the body coshing system increase glucocorticoid (Cortisol) increases blood pressure ◦ Pheochrocytoma: Like adrenal medullary cells, the tumor cells of a pheochromocytoma produce and secrete the catecholamines epinephrine and norepinephrine" "Components of a perfusion assessment? Hx Exam Tests - CORRECT ANSWER - Client health and history data o Lifestyle, diet, chronic diseases, medication hx, - Physical Examination o LOC LOO airway Vitals pain score o Inspection: Pallor, cyanosis, SOB, Cold and calmy, Decrease RR o Palpation: Pulse pitting non pitting edema heat? o Auscultation: listening to HR RR o Communication: asking the pt. - Diagnostic tests o Blood test, ECG, Cardiac stress tests, Xray US" "S/S of optimal Perfusion - CORRECT ANSWER - Stable vitals - Warm to touch pink cap refill <2 secondary. - Breathing easy and regular - No edema - Clear lung sounds - Clear amber urine." "S/S of impaired perfusion - CORRECT ANSWER - Pain i.e. chest decreased O2 to cells. - Dyspnea - Edema swelling - Dizziness fainting - Central perfusion - Hypotension bradycardia - Altered LOC confusion. - Abnormal heart signs - Increased aldosterone - Delayed cap refill - Clubbing of fingers" "Factors affect blood pressure - CORRECT ANSWER pain caffeine medications full bowel equipment problems poor assessment." "Clinical Management of BP Primary secondary tertiary - CORRECT ANSWER Primary prevention - Heart healthy lifestyle not smoking. Secondary prevention - BP screening Lipid screening" "Interventions of BP tertiary - CORRECT ANSWER - Nutrition activity excursive heart healthy diet weight loss rehab after attack - Pharmacotherapy: vasodilators vasopressors diuretic anticoagulants antiplatelets lipids lowering - Procedures: pacemakers' cardioversion with a defalcator heart valve surgery cardiac transplant coronary artery bypass" "Definition of gas exchange - CORRECT ANSWER • the process by which oxygen is transported to cells and carbon dioxide is transported from cells" "Scope of gas exchange - CORRECT ANSWER • From the broadest perspective, the scope of gas exchange represents a spectrum of optimal gas exchange and impaired gas exchange. The further gas exchange is impaired" "Physiological process of gas exchange - CORRECT ANSWER • chemoreceptors in the medulla sense co2 levels when increases send impulses to the diaphragm to contract negative pressure pulls in oxygen from the environment airways are lined with type 1 cells are thicker and type 2 secretes surfactant high pressure causes diffusion into the plasma and attaches to hemoglobin oxygen in the artery is Pao2 and o2 attached to the hemoglobin is measured by Sao2 then into the cells to be used • the opposite occurs during exhalation high pressure of the co2 in cells causes it to diffuse into the plasma Paco2 and when it decreases medulla turns off" "Optimal gas exchange is determined by the follow processes - CORRECT ANSWER - Ventilation diffusion perfusion and transport" "Ventilation 3 factors inspiration vs expiration - CORRECT ANSWER - 12 -20 breaths a min - Influenced by many factors like neuromuscular function airway resistance radius lung complain ace how much it will expand elastin fibers expand and recoil and the surfactant help expand and recoiled. - Inspiration is active vs expiration is passive." "Alveolar capillary diffusion - CORRECT ANSWER - Movement of oxygen and carbon dioxide at the capillary interphase - Affected by pressure gradient distance and area." "Ventilation and perfusion match - CORRECT ANSWER is the ratio that determines the efficiency of gas exchange" "Ventilation and perfusion Mismatch - CORRECT ANSWER leads to inadequate transport and delivery of oxygen" "Spo2 - CORRECT ANSWER bound to hemoglobin in arterial blood normal range 95%-99%" "PaO2 - CORRECT ANSWER in plasma partial pressure in arterial blood 75-100mmHg" "Feedback regulation - CORRECT ANSWER - Changes in the PaCO2, PaO2 and oh in the blood vessels by central(brain) and peripheral (aortic arch) chemoreceptors - Signal sends to the respiratory center. - Then to the respiratory muscles to change depth and rate of respiration" "• Ventilation definition - CORRECT ANSWER ◦ o2 in and co2 out can be impaired by many things like inadequate bone muscles nerve function into the lungs, narrowed airways asthma obstruction (cuff) poor gas diffusion in the alveoli pneumonia" "• Transport of oxygen altered leads to - CORRECT ANSWER ◦ Altered transport of oxygen occurs when an insufficient number or quality of erythrocytes is available to carry oxygen or when the amount of hemoglobin in the blood is low" "• Perfusion definition - CORRECT ANSWER ◦ blood to transport oxygen-containing hemoglobin to cells and return carbon dioxide-containing hemoglobin to the alveoli caused by decreased cardiac output by thrombi" "Consequences of impaired gas exchange - CORRECT ANSWER • mild only leads to fatigue more pronounced a reduction of oxygen at the cellular level leads to decrease oxygen and no more kerbs cycle, co2 builds up leads to metabolic acidosis" "Risk factors of impaired gas exchange - CORRECT ANSWER greatest risk infants have fetal hemoglobin up to 5 months leading anemia older adults as they change, and muscles of the chest decrease in effective not be able to cough smokers drug overdose bed rest chronic diseases" "Exchange of Gases between the Atmosphere and the Lungs two types - CORRECT ANSWER • There are two types of ventilation: pulmonary and alveolar. Pulmonary ventilation refers to the total exchange of gases between the atmosphere and the lungs, and alveolar ventilation to the transfer of gases within the gas exchange portion of the lungs" "• S/s of general COPD - CORRECT ANSWER chronic cough and shortness of breath and chest discomfort" "Pursed lip breathing - CORRECT ANSWER overcomes pressure that collapses lung keeps airway open more co2 out" "Barrel chest - CORRECT ANSWER hyperinflation of lungs and increased work of breathing" "Late stage copd leads to in the heart - CORRECT ANSWER cor pulomanle" "Emphysema s/s - CORRECT ANSWER decreased lung recoil requires forced expiration increased repiraotry muscle fatigue" "Bronchitis s/s - CORRECT ANSWER airway obstruction leads to airflow limitation mismatched VQ inadequate oxygenation increased muscle fatigue" "• Diagnosis of problems - CORRECT ANSWER exercise intolerance o2 levels nutritional status" "• Tx of COPD - CORRECT ANSWER smoking stopping breathing excursive bronchodilators and corticosteroids Inhaled β2-agonists and oxygen" "COPD - CORRECT ANSWER heterogenous diseases caused by expiratory airflow" "RF for COPD - CORRECT ANSWER smoking environmental irritants genetic alpha one antitrypsin deficiency family hx repeated resp infections as a child, age above 40" "What it the role of cilia smooth muscle and cartilage in regulating the diameter of the airways - CORRECT ANSWER - Cilla maintains patient airway by removing airway debris. - Smooth muscles expansion and relaxing of airway. - Cartilage provides support with great pressure changes helps not collapse" "Clinical manifestations of emphysema - CORRECT ANSWER - Decreased lung recoil forced expiration to remove air, increased work to breath muscle fatigue diminished breath sounds decreased" "Clinical Manifestations of bronchitis - CORRECT ANSWER - Airway obstruction limited airflow inadequate oxygenation increased fatigue larger airways to smaller airways wheezing crackles increased mucus ( inflammatory response)" "Age related changes to the respiratory system - CORRECT ANSWER - Decreased strength of muscles reduces maximum inhalation and exhalation alveoli become less elastin" "Assessment - CORRECT ANSWER Normal for lung assessment: - Breathing quiet and effortless, oxygen levels 95-100 skin nails lips appropriate for race trachea midline clear bilaterally" "Abnormal Lung Assessment - CORRECT ANSWER - Subjective hx of disease environment of pt. medications allergies - Cough, Chest pain, SOB. - Increased HR, RR, O2 below 95 - Inspect: anxious work to breath, pursed lip breathing, clubbing of nails asymmetric expansion of chest tracheal deviation - Auscultation: wheezing and stridor crackles rhonchi" "Tests for lungs - CORRECT ANSWER lab tests bag CBC sputum exam skin test radiological study chest Xray CT" "• Focussed interview questions for respiratory questions inspection auscultate - CORRECT ANSWER medical hx respiratory diseases smoking environmental exposure smoking SOB? • Inspect respiratory: ◦ accessory muscles symmetry of the chest pneumothorax rib fracture resps skin color o2 stat. • Auscultate lungs for sounds: ◦ crackles edema wheezing asthma rhonchi pneumonia pleural friction pleurisy" "Clinical Management primary secondary lungs - CORRECT ANSWER Primary prevention: - Infection control PPE hand washing smoking cessation immunization (flu measles pneumococcal) Secondary prevention: - Screening early diagnosis, skin tests for tb." "‣ Agent - CORRECT ANSWER real or fake present or lacking for disease (infectious, chemical physical agents)" "Why does the airflow limitation in COPD affect expiration more than inspiration?: - CORRECT ANSWER Increased airway resistance caused by a combination of airway collapse and narrowed airway which leads to a greater effort to expire air than inspire air" "Interventions tertiary for lungs - CORRECT ANSWER - Pharma logical antihistamines decongestants corticosteroids antimicrobials smoking cessation groups - Oxygen therapy, positioning, nutrition high protein - Airway support ET rube Chest tubes thoracentesis Bronchoscopy" "muscles for inspiration and expiration - CORRECT ANSWER external intercoastals plus the diapharm internal intercoastals" "how is co2 carried - CORRECT ANSWER Bicarbonate, plasma and free" "main type of sensors used - CORRECT ANSWER baro receptors chemoreceptors proprioreceptors" "health promotion - CORRECT ANSWER the process of enabling people to increase control over, and to improve, their health political income acess of health" "population vs community vs aggregate - CORRECT ANSWER In summary, while all three terms refer to groups of individuals, "community" emphasizes social interaction and shared characteristics, "population" refers to the entirety of a group being studied, and "aggregate" describes combined data or characteristics of a group." "afterload and preload - CORRECT ANSWER preload is about how much the heart fills up before squeezing, and afterload is about how hard it has to push against resistance to get the blood out." 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.)" "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 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 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" "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"