Classification of bones – classified by shape
• Long bones
• Short bones
• Flat bones
• Irregular bones
Subjective vs. Objective findings
• Subjective - patient reported symptoms that cannot be observed by the nurse such as pain
• Objective - can be measured by the nurse such as blood pressure
Miliary TB – pathophysiology
• Organism invades bloodstream and spreads to multiple organs with complications
including headaches, neck sti?ness, drowsiness, or pericarditis (dyspnea, swollen neck
veins, pleuritic pain, hypotension)
TB – transmission
• Mycobacterium tuberculosis transmitted by oral droplets from persons with active infection
Thirst mechanism – where is it controlled in the brain
• In hypothalamus triggered by osmoreceptor cells
Benign vs. Malignant tumors
• Benign à encapsulated with connective tissue, does not spread to adjacent tissue,
resemble tissue or origin, grow slowly
• Malignant à can have necrotic (dead tissue) areas, invasive (go to other areas of the body)
– metastasize, dysfunctional, grow rapidly
Glycosylated HgB
• monitor glucose levels over several months
Type 1 hypersensitivity reaction
• Allergic reaction - causing massive bronchoconstriction and vasodilation-low blood
pressure (anaphylactic shock)
Vomiting Center
• Located in medulla
• Coordinates activities involved in vomiting
• Protects airway during vomiting
, • Activated by stimuli from various parts of the brain as a response to unpleasant
sights/smells, ischemia, pain/stress, vestibular apparatus of inner ear (motion), stimulation
of chemoreceptor trigger zone, distension of irritation in digestive tract, increase ICP
UTI
• Commonly caused by escheria coli
Calculation of cardiac output (formula)
• Heart rate (the number of contractions of the ventricles each min) x stroke volume (the
amount of blood ejected from each ventricle with contraction)
Crohn’s Disease vs Ulcerative Colitis
Crohn’s disease Ulcerative colitis
Region aSected Terminal ileum, sometimes colon Starts in rectum and progresses
– usually small intestine through colon
Distributions of Transmural, all layers, skip Mucosa only, continuous, di?use
lesions lesions - a?ected areas separated
by areas of normal tissue
Characteristic Loose, semi formed Frequent, watery, with blood and
stool mucus
Granuloma Common No
Fistula, fissure, Common No
abscess
Stricture, Common Rare
obstruction
Malabsorption, Yes - Hypoproteinemia, Not common – but Tissue
malnutrition avitaminosis, malnutrition, destruction interferes with
possibly steatorrhea absorption of fluid and
electrolytes in the colon
Complications Adhesions between loops may Severe acute episodes- toxic
/symptoms form and fistulas may develop megacolon may develop; marked
diarrhea, with up to 12 stools per
day – contains blood and mucus,
accompanied by cramping pain
Treatment Glucocorticoid n/a
Timing often during adolescence – Second or third decade
delayed growth and sexual
maturation
Stages of General Adaption Syndrome
• Alarm stage à the body's defenses are mobilized by activation of the hypothalamus,
sympathetic nervous system, and adrenal glands
o Initial symptoms body experiences when under stress
o Fight or flight response, physiological response to stress
, o Increased HR, adrenal gland releases cortisol (stress hormone) and you receive a
boost of adrenaline which increases energy
• Resistance stage à hormonal levels are elevated, and essential body systems operate at
peak performance
o Body begins to repair itself
o Body continues to secrete cortisol and blood pressure remains elevated
o Irritability, frustration, poor concentration
• Stage of exhaustion à occurs when the body is unable to respond further or is damaged
by the increased demands
o Result of chronic or prolonged stress
o May give up or feel situation is hopeless
o Fatigue, burnout, depression, anxiety, decreased stress tolerance
o Weakened immune system
ABG interpretation
• Hypoxemia – decreased PaO2 less than 80 mm Hg
• Hypocarbia – decreased PaCO2 less than 35 mm Hg; early in attack
• Hypercarbia – increased PaCO2 greater than 45 mm Hg; later in attack
• Respiratory acidosis - Can result from an increase in carbon dioxide levels (acid) due to
respiratory problems
o Causes: respiratory depression, CNS depression, narcotics OD, COPD,
pneumothorax, atelectasis
• Respiratory alkalosis - Can result when increased respirations cause a decrease in carbon
dioxide (less acid)
o Causes: hyperventilation, pain, anxiety
• Metabolic acidosis - Can result from a decrease in bicarbonate ions (base) because of
metabolic or renal problems
o Causes: Diabetes mellitus, shock, diarrhea, renal failure, liver diseases, sepsis
• Metabolic alkalosis - Can result from the loss of hydrogen ions through the kidneys or the
gastrointestinal tract
o Causes: prolonged vomiting, NG suction, NaHCO3 ingestion, diuretic therapy
without K
Normal ABG values
• pH: 7.35 – 7.45
• pCO2: 35 – 45
• pO2: 75 – 100
• HCO3: 22 – 26
• O2: greater than 95%
Dysphagia – di?iculty or painful swallowing
• Caused by neurological deficit – infection, stroke, brain damage, achalasia, failure of lower
esophageal sphincter to relax because of lack of innervation