NUR 502 Advanced Pathophysiology – Dissertation Consulting Company

A) myometrium.
B) perimetrium.
C) endometrium.
D) epimetrium.

A) Ovary
B) Uterus
C) Fornix
D) Vestibule

A) ductus deferens.
B) fundus.
C) endocervical canal.
D) fallopian tube.

A) fundus.
B) cervix.
C) fornix.
D) isthmus.

A) reproduction.
B) ejaculation.
C) menarche.
D) ovulation.

A) estriol.
B) estradiol.
C) estrone.
D) estrase.

A) ovaries.
B) uterus.
C) anterior pituitary.
D) posterior pituitary.

A) Development of secondary sex characteristics
B) Stimulating uterine smooth muscle contraction
C) Maintaining the endometrium during pregnancy
D) All of the above

A) lunar phase.
B) follicular phase.
C) adrenarche phase.
D) luteal phase.

A) Ischemic
B) Secretory
C) Proliferative
D) Menstrual

Terms in this set (54)

– Inflammatory reaction in the alveoli and interstitium caused by an infectious agent
– Causative microorganism influences symptoms and signs, treatment and prognosis

Causes
– Aspiration of oropharyngeal secretions composed of normal bacterial flora or gastric contents (25%-35%)
– Inhalation of contaminants
– Virus
– Mycoplasma
– Contamination from the systemic circulation
– Bacteremia from infections in the body or IV drug abuse

Patho
– Acquired when normal pulmonary defense mechanisms are compromised
– Aspiration of oropharyngeal secretion is the most common route of lower respiratory tract infection.
– Inhalation of microorganisms.
– Bacteria from bacteremia.
Organism enters lung, multiply, and trigger pulmonary inflammation
– Inflammatory response to organism
– Alveolar spaces fill with fluid and inflammatory cells invade the site
– Acute bacterial pneumonia can be associated with significant V/Q mismatch and hypoxia d/t fluid
– Viral pneumonia does not produce exudative fluids

S/S
Presentation varies due to pathogen, age of pt, and severity of disease
– Some just have fever, others have rales (crackles) and bronchial breath sounds over affected lung.
– Pleuritic chest pain, myalgia, headache, chills, fever, productive cough, chest splinting, tachycardia, dyspnea, tachypnea
– Viral pneumonia can present with fever, cough, hoarseness with wheezing and/or rales
– Mycoplasma pneumonia is common in older children and adults. Fever cough, headache and malaise
On auscultation: crackles, wheezing, bronchial breath sounds, breath sounds may be decreased or absent, tactile fremitus, dullness on percussion

…

Impaired Gas Exchange resulting in abnormal ABGs
– PaO2 ≤ 60 mmHg; PaCO2 ≥ 50mmHg; pH ≤ 7.3 on room air

Caused by direct or indirect injury to lungs, airways, or chest wall (physical injury, or disease processes)
– A potential complication of any major surgical procedure
– Common complications include atelectasis, pneumonia, pulmonary edema, pulmonary emboli

Symptoms vary with the cause (hypoxemia or hypercapnia)
– Headache, dyspnea, confusion, restlessness, hypertension followed by hypotension and tachycardia…

Treatment depends on primary cause – often both
– hypercapnia (↑CO2)-inadequate arteriolar ventilation
-Requires ventilatory support

– hypoxemic – inadequate O2 exchange between alveoli and capillaries
– Requires supplemental O2

Pulmonary inflammation
Increased capillary permeability
Severe pulmonary edema*
Shunting
V/Q mismatch
Hpoxemia

Risk Factors:
Classified into several groups based on cause
– No known cause
– Heart disease
– Chronic lung disease or hypoxia (COPD common)
– Multifactorial mechanisms (blood, metabolic and systemic diseases)
Hypoxemia causes vasoconstriction of pulmonary arteries

Pathologic changes:
– Endothelial dysfunction – ↑ vasoconstrictors, ↓ vasodilators
– Hypertrophy of smooth muscles in the pulmonary artery wall, narrowing the small pulmonary artery (arterioles)
– Remodeling: Fibrosis and thickening of vessel walls increasing vascular resistance
– ↑ pressures in the lung, ↑pressures in right ventricle

Emphysema
– Progressive loss of lung tissue
– “Pink puffer”
– Weight loss
– Mild hypoxemia, no hypercapnia initially
– Hypoventilation and hypercapnia noted in later stages
– Few secretions

Chronic Bronchitis
– Chronic airway inflammation
– “Blue bloater”
– Obese
– Hypoxemia and hypercapnia
– Increased hematocrit
– Cor pulmonale
– Lots of secretions

– Hyper secretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years.

Inflammation d/t inspired irritants or an upper respiratory infection
– Infiltration of neutrophils, macrophages, and lymphocytes into bronchial wall
– Continued inflammation leads to chronic bronchitis

Increased mucus production – ↑number of goblet cells resulting in ↑ mucus

– Edema and spasms – chronic inflammation
-Chronic cough – Impaired movement and eradication of cilia
– Airways collapse early in expiration trapping air in distal portion of lung

Hypoxemia
– V/Q abnormalities
– Hypoventilation and hypercapnia

Clinical:
– Overweight, smoker, shortness of breath upon exertion, excessive sputum, chronic cough
– Copious amounts of sputum as disease progresses with frequent pulmonary infections.
– ABGs: Hypoxemia, hypercapnia, respiratory acidosis
– Evidence of airway obstruction
-Spirometry: Decreased FEV1; decreased FEV1/FCV (<70%)
– ↑ residual volume as airway obstruction and air trapping become more pronounced