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NUR2063: Essentials of Pathophysiology Exam 1 Blueprint Winter 2021
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NURSING1 NUR2063: Essentials of Pathophysiology Exam 1 Blueprint Winter 2021
1. Pathophysiology basics
a. Homeostasis
i. What is it? equilibrium, balance, consistency, and stability. vital signs such as
blood pressure, pulse, and temperature.
ii. Why do we have this? self-regulating, give-and-take system that responds to
minor changes in the body through compensation mechanisms. Compensation
mechanisms attempt to counteract those changes and return the body to its
normal state
b. Adaptation to stress and illness
i. Resilience: How one bounces back from sickness or illness
ii. Adaptation: How one adapts to sickness
iii. Maladaptation: Not adapting correctly
c. Cellular structures & functions
i. Ribosomes: make proteins, protein synthesis
ii. Mitochondria: cell power plant, ATP is made
iii. Lysosomes: breakdown cell products & foreign bodies
iv. Cell membrane: semipermeable membrane surrounding the cytoplasm of a cell
1. Receptors: Ion channels, protein-linked signals, Enzyme-linked cell
funtion
2. Passing ions/nutrients across membrane
v. Atrophy vs. hypertrophy: Atrophy: cell decrease in size and function.
Hypertrophy: overworked cells (heart disease), increase size
vi. Hyperplasia vs. metaplasia vs dysplasia: Hyperplasia: overgrowth of tissues,
increase workload. Metaplasia: change in cells, abnormal cells. Dysplasia:
mutated abnormal size
vii. Apoptosis: planned cell death-90 days then die
viii. Cell death d/t necrosis: Necrotic: dead tissue (coagulative, liquefactive, caseous,
fatty)
ix. Gangrene—what it is & the presentation: dead tissue caused by an infection or
lack of blood flow. Dry: coagulative Wet: liquefactive Gas: release of gas from
decomposition into tissue
2. Fluids and electrolytes
a. Fluid regulation & distribution: Fluid regulation: intracellular 2/3 of fluid volume &
extracellular 1/3of fluid volume. Water & sodium go together. Distribution: interstitial
fluid=between cells, intravascular=inside blood vessels, transcellular= third space-a
space it doesn’t belong
b. Osmosis: movement of fluid. Molecules of a solvent pass through a semipermeable
membrane from a less concentrated solution into a more concentrated one, equalizing
the concentrations on each side
c. Tonicity: Isotonic: equal concentrations between intracellular and extracellular
Hypotonic: lower solute concentration. Hypertonic: higher solute concentration
d. Sodium/water relationship: where sodium goes water goes
e. Alterations in electrolytes
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, 2 NUR2063: Essentials of Pathophysiology Exam 1 Blueprint Winter 2021
f.
Fluid movement through body –basic principles: fluid intake, absorption, Distribution
between vascular and interstitial, excretion
g. Antidiuretic hormone (ADH): tells kidneys to hold onto water, promotes reabsorption of
water in the kidneys
h. Aldosterone: Hold on to water and sodium
i. Sensible vs. insensible fluid losses: Sensible fluid loss: measurable (pee, diarrhea, blood).
Insensible fluid losses: cannot be measured (sweat, fluid loss while talking/breathing)
j. Abnormal fluid loss: Emesis(vomitus), Hemorrhage, wounds
k. Fluid balance control: Antidiuretic Hormone (ADH): “tap water”, kidneys reabsorb plain
water. Aldosterone: “salt water” hormone, cause kidney to reabsorb sodium and water.
l. Fluid excess causes/presentation: Excessive sodium or water intake, High sodium diet,
hypertonic fluid administered. Difficulty breathing(dyspnea), bouncing pulse, fast heart
rate (tachycardia), polyuria, rapid weight gain.
i. Third spacing – what is this? Fluid leaks into interstitial tissues
m. Fluid deficit causes/presentation: inadequate sodium or water elimination,
hyperaldosteronism, Cushing’s syndrome, renal failure, liver failure, heart failure.
Dehydration
3. Normal electrolyte levels (table below)
a. Sodium and associated disorders Normal range 135-145
i. Implications of sodium imbalances: Hypernatremia: excess sodium ingested,
hypertonic saline administered, deficient water, excessive sweating, prolonged
hyperventilation. Hyponatremia: deficient sodium, excessive water intake
b. Potassium and associated disorders 3.5-5
i. Implications of potassium imbalances: hyperkalemia: deficient excretion; renal
failure, excessive intake, increase release from cells. Hypokalemia: excessive
loss, deficient intake, increased shift into cell
c. Calcium 9-11
i. Chvostek’s signs: the healthcare practitioner taps the patient’s facial nerve in
front of the ear. A spasm or brief contraction of the corner of the mouth, nose,
eye, and muscles in the cheek is considered a positive sign and indicates
increased neuromuscular irritability
ii. Trousseau’s signs: The inflated cuff is left in place for approximately 3 minutes.
The test is considered positive for increased neuromuscular irritability if it elicits
a carpal spasm
d. Phosphorus 2.5-4.5
i. Lab relationship with calcium: phosphorus has an inverse relationship with
calcium. Absorption of phosphorus is decreased when it is ingested with foods
containing calcium, magnesium, and aluminum—all of which bind with
phosphorus.
e. Magnesium 1.8-2.5
4. Acid-base balance
a. Normal pH & what it means: 7.35-7.45. pH indicates hydrogen ions. Hydrogens=acid.
More hydrogen ions=lower pH
b. Buffers (video): Carbonic acid (H2CO3), Phosphate (PO4), Hemoglobin, Protein
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