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NURS 3366 NEW EXAM 3 WITH COMPLETE SOLUTIONS 100% VERIFIED
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NURS 3366 NEW EXAM 3 WITH COMPLETESOLUTIONS 100% VERIFIED
2 things contribute to "bloat"
1. need to conserve energy--they don't hyperventilate & they don't move around a
lot→gain weight
2. often have cor pulmonale, which means usually lots of peripheral edema (swelling =
"bloat")
ABG for chronic bronchitis
patients with chronic bronchitis more likely to chronically retain CO2 than emphysemics
because of the inability to exchange gases --mucus, etc, prevents good diffusion of O2 in
& CO2 out to alveoli; so chronic hypercapnia > respiratory acidosis
chronic hypercapnia (chronic bronchitis)
carbon dioxide retention that occurs over long periods
ABG stats for chronic bronchitis
pH less than 7.35, PCO2 more than 45, HCO3 is normal, PO2 less than 80, and SO2 less
than 97% (not concerning unless it gets acutely worse)
some degree of resp alkalosis "normal"
1. in asthma exacerbation
2. as daily state in emphysema
,some degree of resp acidosis "normal"
ex. chronic bronchitis
when heart compensation techniques don't work.
if there continue to be ischemic stressors and oxygen delivery cannot keep up with
oxygen demand of this bigger muscle, decompensatory process may occur, such as
heart failure
"lub"
sound of closure of AV valves just before systole
"dub"
sound of closure of P & A valves just before diastole
other heart disorders
1. valvular disorders
2. heart failure (HF)
normal valve function
valves open and close "crisply," thus accomplishing full opening so that blood can pass
through from one chamber to the next and full closing so that blood doesn't back up into
the previous chamber
valvular disorders
disease processes which can cause valve malfunction include autoimmune processes
such as rheumatic fever (post-strep autoantibodies invade & inflame heart valves,
joints, and/or kidneys)
,sequela of valve problems
depend on severity & which valves involved, but generally negatively affect CO in one
way or another
categories of valvular problems:
1. stenosis (narrowing, stiffening)
2. incompetence ("floppiness"); also called prolapse and insufficiency
stenosis (valvular disorder)
prevents "full opening," valve orifice is constricted & narrowed so blood cannot easily
flow forward through it
stenosis (valvular disorder) cont.
blood flowing through smaller opening generates more turbulence—there is a rumbling
sound know as a murmur
incompetent (floppy) valve (valvular disorder)
also called valvular prolapse, insufficiency or regurgitation; also prevents “full closing”
incompetent (floppy) valve (valvular disorder) cont.
results in regurgitation of blood back into the chamber it came from; backflow of
regurgitation also can cause turbulence → murmur
heart failure (HF)
, epidemic; HF is a general term used to describe several types of cardiac dysfunction
secondary to the failure of the heart to eject / propel blood forward effectively
heart failure (HF) cont.
HF can be left HF (LHF) & right HF (RHF), each has a different set of S&S; it IS possible
to have both
the term "congestive" heart failure (CHF) or acute decompensated heart failure (ADHF).
is often used interchangeably with "heart failure."
"congestive" refers to the fact that heart failure.
almost always involves fluid overload, whether manifested in the lungs or periphery or
both
patho of HF
three causes:
1. pump problem
2. increased resistance
3. increased preload
pump problem (HF)
heart contractility has been weakened
increased resistance (HF)
there is increased afterload to forward flow
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