NUR 507 Week 9 Complete Set Final Exam 2026 Well Defined !!!

NUR 507 NUR 507 NUR 507 Week 9 Complete Set Final Exam 2026 Well Defined !!! Endometrial cycle - -The 28 days of the menstrual cycle as they apply to the events in the uterus. The endometrial cycle has four subphases: menstruation, the proliferative phase, and the secretory phase, and the ischemic phase . Proliferative phase - -The second phase of the uterine (endometrial) cycle, during which the endometrium (shed off during menstration is rebuilt). This phase of the cycle is under the control of estrogen, secreted from the follicle developing in the ovary during this time period. The proliferative phase typically lasts from day 6 to day 14 of the menstrual cycle. Secretory phase - -The third phase of the uterin (endometrial) cycle, during which the rebuilt endometrium is enhanced with glycogen and lipid stores. The secretory phase is primarily under the controll of progestone and estrogen (secreted from the copus luteum during this time period), adn typically lasts from day 15 to day 28 of the menstrual cycle. Ischemic phase - -Approximately 3 days before menstruation to onset of menstruation. due to the decreased production of estrogen or progesterone and the endometrium becomes blood starved Menstrual cycle - -Cycle during which an egg develops and is released from an ovary and the uterus is prepared to receive a fertilized egg. Ovulation - -The process of releasing a mature ovum into the fallopian tube each month uterine prolapse - -the condition in which the uterus slides from its normal position in the pelvic cavity and sags into the vagina risk factors for uterine prolapse - -menopause, pregnancy, coughing, constipation, obesity, pelvic floor trauma, vaginal birth, hysterectomy, connective tissue disorders, spina bifida Uterine prolapse treatment - - - kegel exercises - estrogen therapy - maintaining a healthy bmi, preventing constipation, treating chronic cough - pessary - surgical option s last resort Polycystic ovarian syndrome – -defined as two of the following three features NUR 507 NUR 507 - irregular ovulation -elevated adrogens (testosterone) - and the appearance of polycystic ovaries on ultrasound differentials for pcos - -- thyroid dysfunction - hyperprolactinemia - congenital adrenal hyperplasia Characteristics associated with PCOS - --metabolic dysfunction - dyslipidemia - insulin resistance - obesity polycystic ovarian syndrome treatment - -(1) diagnosis and education; (2) lifestyle change - loss of 10% of body weight may help; (3) birth control pills help with some symptoms; (4) diabetes medications & dietary treatment may slowly normalize physiology (lower sugar, lower insulin, fewer androgens) testicular cancer - -malignant tumor in one or both testicles commonly developing from the germ cells that produce sperm; classified in two groups according to growth potential conditions that increase risk of testicular cancer - -- being a man between the ages of 20-45 - cryptochidism (undescended testicle) - family history - previous testicle cancer - white men are more likely symptoms of breast cancer - -change in the shape or appearance of your breasts, skin or nipple changes such as dimpling of the skin, Squeeze each nipple gently to identify any discharge, chest pain (mets to the lung) signs of premenstrual dysphoric disorder - -physical - breast tenderness, abdominal bloating, headache and swelling of extremities emotional - depression anger, irritability and fatigue resolve with menstruation causes of dysfunctional uterine bleeding - -can be due to structural (polyp, malignancies and hyperplasia) or non structural causes (coagulopathy, ovulatory dysfuction, endometrial treatment for abnormal uterine bleeding - -- NSAIDS (reduce prostaglandin, causes vasoconstriction, and decreased menstrual bleeding) - Oral contraceptives NUR 507 NUR 507 - Depo provera - Levonorgestrel intrauterine device Pathophysiology of prostate cancer - -- more than 90% of all cancer arising from the *prostate are adenocarcinomas (glandular tissue)* - tumor becomes clinically relevant when local invasion or distant metastasis -- starts with genetic mutation of luminal or basal cell - RF are old age, obesity and high fat low fiber diet Treatment of prostate cancer - -chemotherapy, radiation, hormones, prostatectomy HPV and the development of cervical cancer - -HPV is a necessary precursor to development of cervical dysplasia which is a necessary step for the cell changes leading to cervical cancer - multiple sex partners, smoking, long history of oral contraceptive use use of vaginal douches and immunocompromised are at higher risk as well body's process for adapting to high hormone levels - -negative feedback system occurs telling the endocrine system to stop secreting hormones because there are enough hormones in the bloodstream Cushing's syndrome - -- a condition caused by prolonged exposure to high levels of cortisol - adrenal glands secrete cortisol - severe muscle bone and skin breakdown - elevated blood glucose levels and high insulin levels - central obesity - amplify catecholamines on blood vessels and causes high blood pressure - inhibit gonadotropin releasing homone messing up ovarian and testicle function - dampens inflammatory and immune response - caused by medications (steroids) - excess ACTH by benign pituitary adenoma (cushings disease) Causes of hypoparathyroidism - -Autoimmune damage to parathyroids, surgical excision, DiGeorge syndrome DiGeorge Syndrome - -failure 3rd/4th pharyngeal pouches to develop; T cell deficiency; absent thymus lab results that indicate primary hypothyroidism - -occurs from thyroid dysfunction - increased level of TSH - low free T4 pathophysiology of thyroid storm - -- autoimmune disease where b-cells produce antibodies against thyroid proteins - create a hypermetabolic state due to too much thyroid hormone (T3 and T4) NUR 507 NUR 507 - effect of excess thyroid hormone is magnified due to more unbound thyroid hormone, tissues becoming more sensitive to the thyroid hormone, or body being more sensitive to catecholamines activating the sympathetic nervous system Signs of thyrotoxicosis - -- fever - agitation confusion seizures and coma - cardiac arrhythmias and high output cardiac failure Dermatomes - -area of skin innervated by cutaneous branches of single spinal nerve substance release at the synapse - -neurotransmitters are sent across open space to surrounding synapse to send a signal spondylolysis - -the breaking down of the vertebral structure; uni or bilateral -risk factors are extreme sport during adolescence - pain, lumbar spine pressure sensation, antalgic gait, hamstring tightness - tx pain management, boston brace, pt motor and sensory areas of the brain - -- frontal lobe controls movement and executive function - cerebellum works with coordinating movement, precision and balance (muscle memory) midbrain also effects motor control - parietal effects sensory information - pons = sentation pathophysiology of cerebral infarction - -- sudden or complete blockage of blood vessel - plaques fibrous cap is ripped of and clot is formed and completely occlude the artery - blood clot breaks off from one location and gets lodged in another area ( emerge from atherosclerosis or from afibb in the heart) - loss of blood flow providing oxygen and glucose to the brain creates ischemia in the brain Excitotoxins - -Toxins that overstimulate glutamate release and cause neuron suicide. agnosia - -Often there is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective nor is there any significant memory loss. Agnosia only affects a single modality, such as vision or hearing. subarachnoid hemorrhage - -- can be lethal - caused by traumatic injury, aneurysmv(marfans syndrome), AVM increase pressure in vein causing rupture - rupture causes pooling and puts pressure on skull brain tissue and blood vessels and less blood is flowing drownstream - vasospasm occurs decreasing bloodflow to other parts increasing ischemic injury - fluid builds up in the brain causing hydrocephalus and increased ICP NUR 507 NUR 507 - s/s thunderclap headache, nuchal regidity (meninges irritation), seizures, vomiting, vision changes confusion - surgery for clipping or coil insertion most common cause of meningitis - -infection - neisseria meningitidis -herpes simplex virus diet and prevention of prostate cancer - -low fat high fiber diet BPH effects on bladder/urethra - -1.Urethra is "choked" -- urinary problems 2.Bladder wall becomes thicker -- irregular contraction transcription - -synthesis of an RNA molecule from a DNA template effects of genetic mutations - -~little or no effect ~produce beneficial variations ~negatively disrupt gene function ~produce proteins with new or altered functions that can be useful to organisms in different or changing environments trisomy - -a condition in which an extra copy of a chromosome is present in the cell nuclei, causing developmental abnormalities. Down Syndrome - -- a condition of mild to severe intellectual disability and associated physical disorders caused by an extra copy of chromosome 21 - organ changes include septal defects in the heart, duodenal atresia in GI tract, acute lymphoblastic leukemia, mental retardation and alzheimer disease, sterility in males - physical characteristics include flat face simian crease, gap between first two toes, eye fold - RF maternal age Klinefelter syndrome - -- XY person has an extra X chormosome causing less testosterone production - inhibin and testosterone is not made causing issues with testes maturation, sperm production and secondary male characteristics - most noticable during puberty -hypogonadism, sterile, tall with long legs, short torse broad hips - less facial and body hair, breast development - weaker bones - lower energy levels - increased risk of breast cancer and osteoporosis - tx hormone therapy diseases that have multifactorial traits - -hypertension, diabetes, ASD, pyloric stenosis NUR 507 NUR 507 multifactorial inheritance - -a pattern of inheritance in which a trait is influenced by both genes and environmental factors Duchenne muscular dystrophy - -- A human genetic disease caused by a sex-linked recessive allele (more common in males) ; - loss of dystrophin which supports the muscle -characterized by progressive weakening and a loss of muscle tissue. - children walk later in life, psuedohypertrophy calf, waddling gait, - gowers sign (standing with use of arms) - wheelchair, respiratory failure, scoliosis, dilated cardiomyopathy, heart failure - high CK - musclebiopsy - treatments are limited neurofibromatosis - -- autosomal dominant; fibrous tumors orginating from the nervous system - non cancerous growths in the nervous system - Type I affects nerves in extremities and skin , painless mobile lumps under skin, cafe au lait spots, increase risk of seiures, learning difficulties, malignant peripheral nerve tumors, and can press on the kidneys Chromosome 17 - Type II tend to develop schwannomas tumors along 8th cranial nerve bilaterally, tinnitis andhearing loss - meningiomas; can compress spinal cord or in brain cause seizures, visual changes, muscle weakness, cataracts - surgery for tumors Chromosome 22 ions that initiate muscle contraction - -- calcium growth of long bones in children - -- humerus, radius, ulna, matacarpals, phalanges, femur, tibia, fibula, metatarsals, phalanges - grow from the piphysial plate which is the area of growing tissue near the ends of the long bones appendicular skeleton - -Bones of the limbs and limb girdles that are attached to the axial skeleton how vaccines are formed - -- live attenuated and inactivated vaccines are the whole virus or bacteria - subunit or toxoid vaccines are fractionated only on part is used to make the vaccines - Memory T and B cells develop after populations at risk for fungal and parasitic infections - -- minorities, immigrants, people living in poor or disadvantaged communities - weakened immune system NUR 507 NUR 507 - those with foreign material in their body systemic manifestations of infection - -fever, weakness, headache, malaise, anorexia, nausea mechanisms responsible for the increase in antimicrobial resistance worldwide - -- over prescription of antibiotics - pts not finishing the entire antibiotic course - overuse of antibiotics in livestock and fish farming - gene sharing in pathogens - absence of new antibiotics being discovered functions of normal flora - --Maintain normal function and health of the colon -Synthesize some vitamins and nutrients -Prevent pathogen colonization -Protect against pathogens -Aids in digestion -Breaks down nutrients allergy desensitization - --Injections of small doses of the offending antigen are given 1x-2x/week for an extended period of time -Induces IgG, upon encounter with allergen, IgG binds antigen before it can bind IgE mast cell -Mast cell and basophils become decreasingly sensitive as less IgE is made Left shift in WBC differential - -caused by band neutrophil or earlier immature neutrophils Forms of Immunity - -- Innate, present at birth - Adaptive, after birth - Active, antibodies develop after exposure to antigen - Passive, antibodies are transferred from another source innate immunity - -A form of defense common to all animals that is active immediately upon exposure to pathogens and that is the same whether or not the pathogen has been encountered previously. adaptive immunity - -the ability to recognize and remember specific antigens and mount an attack on them passive immunity - -An individual does not produce his or her own antibodies, but rather receives them directly from another source, such as mother to infant through breast milk active immunity - -immunity produced by exposure to an antigen, as a result of the immune response NUR 507 NUR 507 major histocompatibility class i antigens - -- found on surface for cytotoxic T cells to identify - lead to recognition of non body by T cells - inside any cell with a nucleus made by ER Inflammatory Chemicals Blocked By Antiinflammatory Drugs - -- Prostaglandin - COX 1 - COX 2 Characteristics of acute phase reactant C-reactive protein - -- synthesized in response to inflammation - CRP attaches to bacteria or dying cell and has macrophages kill the cell - high CRP relate to disease activity Process by which a deep pressure ulcer heals - -- heal by secondary intention due to edges being too far apart - Complications of the development of contractures during wound healing - -when wound heals over a joint the scar matures thickens and tightens and can prevent movement Causes of respiratory acidosis - -- aspiration, atelectasis, abdominal distention, drug overdose, CNS disease, pleural/lung disease, trauma -Tx: spirometry, deep breathing, pain control, ventilation Molecules that act as buffers in the blood - -- bicarbonate - carbonic acid Most common cardiac valve disease in women - -mitral valve disease When myocardial ischemia may be reversible - -if bloodflow is re-established quickly through a stent or fibrinolytic therapy Symptoms of stable angina - -- pain during exertion - pain goes away with rest - Orthostatic hypotension - -Decrease in blood pressure related to positional or postural changes from lying to sitting or standing positions Isolated systolic hypertension - -a condition most commonly seen in the older adult in which the systolic pressure is greater than 140 mm Hg and the diastolic pressure is within normal limits (less than 90 mm Hg) Results of sustained controlled hypertension - -- endothelial cell damage MI, aneurysm, stroke NUR 507 NUR 507 Insulin resistance on primary hypertension - -rebound hypertension from RAAS activation in the renal system Defects in the normal secretion of natriuretic hormones and the impact on renal system - -too much ANP and BNP can lead to sustained hyperfiltration and injury to the nephron Complications of unstable plaque in the coronary arteries - -fibrous cap is take off top and then clots creating a blockage and ischemia to the brain Dyslipidemia associated with the development of the fatty streak in atherosclerosis - high LDL Signs and symptoms of left sided heart failure - --paroxsymal nocturnal dyspnea (being awakened by breathlessness) -orthopnea (inability to breathe unless sitting upright) -cough with pink frothy sputum hemoptysis (blood-streaked sputum) -crackles -hypoxia -cyanosis -restless -confused Right heart failure versus Left heart failure - -left side think respiratory due to fluid backing up into lungs - right side fluid backs into the body causing peripheral edema and JVD with ascities, and enlarged liver and spleen infective endocarditis - -inflammation of the inner layer of heart tissue as a result of an infectious microorganism -RF open wound, dental or surgical procedure or IV drug use - RF prosthetic valves, congenital heart defects - vegetation stick to clot in heart and sit causing infection Treatment of infective endocarditis - --prolonged antibiotics - surgery in severe cases - prophylactic antibiotics in high risk groups pathophysiology of deep vein thrombosis - -- injury is caused to endothelium and platelets adhere and are activated by collagen and tissue factors and platelet plug is formed - coag cascade starts and fibrin creates hard clot at site of injury - clot prevents blood flow and increases blood pressure NUR 507 NUR 507 - pressure causes clot to break free and thrombo embolus travels to heart, lungs or brain Vichow's Triad - - 1. slowed blood flow (stasis) can happen durin inactivity 2. hypercoagulation - genetics, surgery, medications 3. damage to endothelial cell lining - infection, chronic inflammation, toxins (smoke) Physiological response to hypoxia in anemia - -- Erythropoietin production stimulated - does not help so incomplete RBC are released resulting in poikilocytosis and anisocytosis RBC populations at the highest risk for developing folate deficiency anemia - -- pregnant women, restrictive diet for longer than 6 weeks, increased alcohol consumption and certain medications such as phenytoin and methotrexate Causes of iron deficiency anemia - -Ulcers, menstrual bleeding, left colon cancer, elderly and poor children, malabsorption, gastrectomy, hookworm, Plummer-Vinson Lab results with long standing iron deficiency anemia - -- low Hgb - low MCV - low serum iron - low ferritin - high total iron binding capacity - increased red blood cell distribution width (due to different RBC sizes) sickle cell anemia - -- a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape - autosomal recessive gene - acidosis and low flow vessels causes Hgb to dumb oxygen and then RBC sickles - structure is compromised and promotes premature destruction occurs - deficiency of RBC causes increase production of reticulocytes and new bone formation - vaso occlusion causing pain in bones hands feet or cause spleen to need removal - tx oxygen and fluids, opiods for pain, blood transfusion, hydroyurea Causes of aplastic anemia - -radiation, drugs, hepatitis, HIV genetic disorders fanconi's anemia Neoplastic infiltration of bone marrow Pathophysiology of autoimmune hemolytic anemia - -alteration of appearance occurs in hematopoietic stem cells due to genetic disorder or environmental agents and non self antigens appear Secondary polycythemia - -Increased RBC production due to tissue hypoxia from high altitude or lung disease severe obesity or defective oxygen transport. - tx low dose aspirin, blood letting or oxygen therapy NUR 507 NUR 507 anemia of chronic renal failure - -Failure of the renal endocrine function impairs erythropoietin production and bone marrow compensation osmoreceptors that stimulate thirst and the release of ADH - --hypothalamus has supraoptic nuclei and senses decreased water - baroreceptors detect decreased blood volume and tells hypothalamus again Causes of hypernatremia - -Decreased sodium excretion (corticosteroids, Cushing's Syndrome, Renal failure, Hyperaldosterone) Increased sodium intake (excessive oral soidium ingestion or administration of sodium containing IV fluids) Decreased water intake (NPO) Increased water loss (increased rate of metabolism, fever, hyperventilation, infection, excessive diaphoresis, watery diarrhea, diabetes insipidus) Effects of increased aldosterone - -- decreased K increased sodium increased blood volume and pressure - increase in ph Dependent edema - -Swelling in the part of the body closest to the ground, caused by collection of fluid in the tissues; a possible sign of congestive heart failure. Definition of isotonic - -a solution whose solute concentration is equal to the solute concentration inside a cell Capillary oncotic pressure - -osmotically attracts water from the interstitial space back into the capillary Fluid compartments in the body - -2 main: -2/3 by volume is in the INTRACELLUAR FLUID COMPARTMENT -1/3 of body water is outside the cells in the EXTRACELLULAR FLUID COMPARTMENT pulmonary embolus prevention - --Health teaching prior to surgery -Anti-embolic stockings -Exercise to prevent thrombosis -Use of anticoagulant drugs cause of tactile fremitus - -dense or inflamed lung tissue from disease like pneumonia types of pneumothorax - -1. Primary spontaneous = no underlying lung disease 2. Secondary spontaneous = complication of pre-existing pulmonary disease NUR 507 3. Traumatic = from penetrating or blunt trauma 4. Iatrogenic = from thoracentesis, biopsy, catheter, bronchoscopy, positive-pressure ventiltion 5. Tension = air enters pleural space on inspiration but doesn't leave on expiration Results of the loss of alph-1-antitrypsin in emphysema - -- panacinar emphysema - damage from proteases in aveolar sacs - lower lobes effected Result of loss of surfactant in ARDS - -surfactant coats alveoli preventing alveoli collapse - loss of surfactant results in alveoli collapse due to more surface tension Cheyne-Stokes respiration - -repeated breathing pattern characterized by fluctuation in the depth of respiration: first deeply, then shallow, then not at all Causes of hypovolemic shock - - 6* Diarrhea * vomiting * hemorrhage (internal and external) * inadequate fluid intake * osmotic diuresis * third-space losses * large burns How body maintains glucose levels during shock - -cells shift to glycogenolysis gluconeogenesis and lipolysis to generate fuel NUR 507