NURS 3366 FINAL EXAM WITH COMPLETE
SOLUTIONS 100% VERIFIED
Stats to know
pH
CO2
HCO3
PaO2
blood glucose
normal capillary refill
7.35-7.45
35-45
22-28
80-100
70-99
<2 seconds
Your patient presents with diabetes insipidus. Describe the pathophysiology that has
caused their fluid volume deficit.
- under secretion of ADH
- polyuria, dilute urine
- increased serum osmolality
- sunken eyes, dry membranes, poor skin turgor
A patient with a brain injury presents to the ER. They begin to suddenly develop
peripheral edema and crackles in the lungs. What is a possible cause, and why?
,- SIADH
- large, over-secretion of ADH
- causes body to hold on to a ton of water (oliguria)
- fluid volume overload, causes water to shift into tissues
A patient presents with symptoms and signs of Grave's. Which symptoms and signs
would you suspect they have progressed into a crisis state?
thyroid storm
- severe tachycardia, HF, shock, 103-105, agitation, delirium, seizures
- due to very high metabolism
Lab: T4 high, TSH low
A patient presents with acute coronary syndrome. One of the subdivisions of this
syndrome is unstable angina. What is the pathophysiology behind this? In their lab work,
what levels would be high?
-sudden plaque blockage or sudden worsening
-leads to worse angina, which worsens the ischemia
-eventually leads to infarction; cells dying because no oxygen
-CK and troponin would be high
A patient has left-sided heart failure. During treatment, what are you listening to their
lungs for?
- crackles, specifically pulmonary edema
- due to the "backflow" of blood from their left side not pupping out much blood
A patient presents with a coma. They have breathing that is slow, irregular, and shallow.
What is the compensation mechanism for this state?
, - they are in respiratory acidosis
- kidneys will compensate by holding onto HCO3 or they will make more
A patient comes into the ER after vomiting profusely all night. They have slow, shallow
breaths. What might this indicate?
- metabolic alkalosis, due to the extreme loss of metabolic acids
A common, low V/Q disorder is pneumonia. Why would it be considered that?
- restrictive disorder
- debris collects in lungs (from microbe) and blocks off alveoli
these collapse called atelectasis
some become stiff consolidation
essentially, no air can come in
A high V/Q disorder is a pulmonary embolus, explain why?
blockage of blood getting O2 from the lungs
related to a DVT or Virchow's triad
A patient comes in with an asthma attack. Describe their signs and symptoms.
hyperventilation, wheezing upon exhalation
A person with emphysema is known as a pink puffer. Explain why this is their nickname.
- usually smoking irritants can inflame the airways
- alveoli become stiff, the lungs become hyper-inflated
- they tend to hyperventilate, which keeps them oxygenated
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