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NURS 6100 Exam 3 Questions With Complete Solutions How do red blood cells appear in sickle cell anemia? Correct Answers sickle shaped (which causes occlusion) How do you differentiate pain from a stable and unstable angina? Correct Answers stable angina pain is relieved with rest or nitroglycerin unstable angina pain occurs at rest with minimal exertion and last longer than 15 minutes; not relieved by nitroglycerin How does iron deficiency anemia appear microscopically? Correct Answers microcytic and hypochromic How does the involvement of heart muscle influence the type of infarction? Correct Answers a transmural MI or STEMI involves the full thickness of the ventricular wall; occurs with obstruction of single artery a subendocardial MI involves the inner third to inner half ventricular wall; occurs often with severely narrowed arteries How does the nurse differentiate chest pain of pericarditis from an MI? Correct Answers chest pain caused by pericarditis will not be relieved with nitroglycerin, but it can be relieved by positioning How is cardiac output measured? Correct Answers stroke volume x heart rate
How is cardiac tamponade treated? Correct Answers pericardiocentesis How is mean arterial pressure (MAP) calculated? Correct Answers [SBP + 2(DBP)]/ How long do platelets survive in circulation? Correct Answers 7-10 days How long do RBCs live? Correct Answers 120 days How should the nurse educate a patient diagnosed with von Willebrand disease? Correct Answers Avoid aspirin; use Tylenol instead Avoid injury and contact sports Remember RAAS pathway and its effect on blood pressure! Correct Answers angiotensin II is a vasoconstrictor to raise blood pressure What are "baby" bands? Correct Answers "baby" white blood cells with a horseshoe-shaped nucleus What are cytokines? Correct Answers mediators that stimulate the proliferation, differentiation, and functional activation of various blod cells What are mature segs? Correct Answers mature white blood cells with a segmented nucleus
What are the clinical manifestations of von Willebrand disease? Correct Answers spontaneous bleeding despite normal platelet counts and prolonged bleeding time What are the clinical signs of venous insufficiency? Correct Answers hyperpigmentation severe edema ulceration What are the clinical symptoms of Raynaud's disease? Correct Answers fingers (or toes) appear white, then cyanotic, then red What are the complications associated with atherosclerotic plaque lesion rupture? Correct Answers MI, stroke, or peripheral arterial occlusion What are the components of blood? Correct Answers plasma (55%) buffy coat leukocytes and platelets (<1%) erythrocytes (45%) What are the components of plasma? Correct Answers albumin (54%) globulins (38%) fibrinogen (7%)
What are the components of the circulatory systems? Correct Answers pulmonary circulation includes the right side of the heart and the pulmonary artery, capillaries, and veins systemic circulation includes the left side of the heart, the aorta and its branches, the capillaries supplying the brain and peripheral tissues, and the systemic venous system and vena cava What are the desired cholesterol levels? Correct Answers total cholesterol: <200 mg/dL HDL >40 mg/dL (male) >50 mg/dL(female) LDL <130 mg/dL (70-100 mg/dL high risk) triglycerides <150 mg/dL What are the functions of basophils? Correct Answers inflammation mediators What are the functions of neutrophils? Correct Answers defend against bacteria, fungi, cell debris, and foreign bodies What are the functions of WBCs? Correct Answers part of the body's defense system through immune and inflammatory responses What are the guidelines for blood pressure? Correct Answers normal: <120 mmHg and <80 mmHg
chronic phase: permanent scarring/stenosis of the heart valves (mitral) What are the mechanism of blood pressure regulation? Correct Answers short-term regulation (neural, humoral) long-term regulation (renal) What are the ports of entry for infective endocarditis? Correct Answers oral cavity (dental patients), cutaneous invasion, infections, invasive procedure/surgery What are the primary targets of PAD? Correct Answers iliac artery common and superficial femoral arteries distal popliteal artery What are the signs and symptoms of leukemia? Correct Answers anemia, fatigue, bleeding, infection, bone pain, splenomegaly What are the signs and symptoms of polycythemia? Correct Answers hypertension, headache, dizziness, hearing/vision problems (related to increased blood volume and viscosity) What are the signs and symptoms of venous thrombosis? Correct Answers tenderness, pain, and swelling at the site
What are the stages of lesions associated with atherosclerosis? Correct Answers stage 1: fatty streak stage 2: fibrous plaque development stage 3: plaque rupture (complicated lesion) What are the symptoms of an abdominal aortic aneurysm? Correct Answers sudden, severe abdominal pain/back pain; shock What are the symptoms of PAD? Correct Answers intermittent claudication (cramping, aching pain in legs precipitated by activity) resolves within 10 min or less with rest What are the three characteristics of damage after a myocardial infarction? Correct Answers ischemia: tissue viability may not be damaged if circulation is restored in time (ST depression) injury: tissue is viable as long as circulation is adequate; increasing O2 may save area (ST elevation) infarction: O2 deprived, irreversible damage (Q wave) What are the three critical factors affecting stroke volume? Correct Answers preload: volume of blood to be pumped out afterload: pressure required to move blood out of heart
carries metabolic waste to kidneys and other excretory organs circulates electrolytes and hormones transports immune substances helps regulate body temperature What are the two autonomic control centers for cardiac function and blood pressure? Correct Answers vasomotor center: sympathetic nervous system; mediated by norepinephrine, epinephrine, and dopamine cardioinhibitory center: parasympathetic nervous system; mediated by acetylcholine What are the two main locations of an aortic aneurysm? Correct Answers thoracic and abdominal aorta What are the two main types of cardiomyopathies? Correct Answers dilated: enlarged, weakened left ventricle unable to pump enough blood to meet body's demand hypertrophic: left ventricle cannot fully relax between heartbeats, resulting in less blood flow What are the two parts of the circulatory system? Correct Answers pulmonary: moves blood through lungs and allows for gas exchange systemic: supplies all the other tissues of the body
What are the two types of circulation? Correct Answers central: blood in heart and in pulmonary circulation peripheral: blood outside of central circulation What are the types of bone marrow? Correct Answers red bone marrow (produces erythrocytes yellow bone marrow (made up primarily of fat cells) What causes aortic dissection? Correct Answers chronic hypertension What causes orthostatic hypotension? Correct Answers decreased venous return to the heart due to pooling in lower extremities inadequate circulatory response to decreased cardiac output and a decrease in blood pressure What causes varicose veins? Correct Answers aging, decreased muscle mass, increased hydrostatic pressure from standing What cells originate from the bone marrow? Correct Answers erythrocytes leukocytes platelets
What does Virchow's Triad include? Correct Answers predisposition to blood clot: venous stasis hypercoagulability vessel injury What ECG abnormalities would you expect to see in a patient actively suffering from angina? Correct Answers T wave inversion and ST segment depression What ECG abnormalities would you expect to see in a patient with acute injury from an MI? Correct Answers ST elevation What ECG abnormalities would you expect to see in a patient with cell death/necrosis from an MI? Correct Answers pathologic Q wave What happens to a vessel with decreased compliance when pressure increases? Correct Answers the vessel will become rigid and unable to accommodate extra blood flow What is a normal cardiac output? Correct Answers 3.5 - 8. L/min What is a pulmonary embolism? Correct Answers a clot that travelled from an infarction of the lower extremity to the lung
What is acute coronary syndrome? Correct Answers spectrum of ischemic coronary disease ranging from unstable angina through myocardial infarction What is an incompetent or regurgitant valve? Correct Answers distortion of the valve so it does not close properly What is atrial fibrillation? Correct Answers rapid impulses from many foci depolarize in the atria What is cardiac reserve? Correct Answers maximum percentage of increased cardiac output that can be achieved above the normal resting level What is cardiac tamponade? Correct Answers slow or rapid compression of the heart due to accumulation of fluid, pus, or blood in the pericardial sac What is compliance? Correct Answers ability to expand and accommodate extra blood flow for each mmHg rise in pressure What is diastole? Correct Answers period of ventricular relaxation and filling What is disseminated intravascular coagulation (DIC)? Correct Answers widespread coagulation and bleeding in vascular compartment that occurs as a complication to another condition What is hematopoiesis? Correct Answers formation of blood cells
What is percutaneous transluminal coronary angioplasty (PTCA)? Correct Answers a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle What is pericardial effusion? Correct Answers accumulation of fluid in the pericardial cavity What is pericarditis? Correct Answers inflammatory process of the pericardium (acute, chronic, or constrictive) What is peripheral artery disease (PAD)? Correct Answers atherosclerotic disease of arteries that perfuse the limbs, especially lower extremities What is polycythemia? Correct Answers primary: overproduction of RBCs, WBCs, and platelets secondary: due to increased EPO levels in hypoxic conditions (COPD) What is primary hypercholesterolemia? Correct Answers elevated cholesterol levels that develop independent of other health problems or lifestyle behaviors What is primary or essential hypertension? Correct Answers chronic elevation in blood pressure that occurs without evidence of other disease (most common in adults)
What is secondary hypercholesterolemia? Correct Answers elevated cholesterol levels associated with other health problems or lifestyle behaviors What is secondary hypertension? Correct Answers elevation of blood pressure that results from some other disorder, such as kidney disease (most common in children/adolescents) What is systole? Correct Answers period of ventricular contraction What is the best way to prevent a sickle cell crisis? Correct Answers hydration What is the biggest concern with neutropenia? Correct Answers huge risk for opportunistic infection What is the cardiac reserve of a normal young adult? Correct Answers 300-400% (CO of up to 32 L/min) What is the difference between a stable and unstable angina? Correct Answers a stable angina has a fixed, fibrous cap surrounding the atherosclerotic plaque an unstable angina has a rupture of the fibrous cap with platelet aggregation What is the Frank-Starling mechanism? Correct Answers the ability of the heart to change its force of contraction (and therefore stroke volume) in response to changes in venous return
body attempts to repair damage with inflammatory cells (monocytes) monocytes turn into macrophages macrophages oxidize and ingest LDL, forming foam cells What is the pathophysiology of chronic venous insufficiency? Correct Answers chronic inadequate venous return (i.e., immobility, CHF, venous obstruction), leads to valve damage, which results in retrograde flow and pooling What is the pathophysiology of varicose veins? Correct Answers valvular incompetence allows for the backflow of blood with increased pressure, causing venous distension and edema What is the primary component of an athersclerotic lesion? Correct Answers foam cells What is the process of red blood cell production? Correct Answers decreased oxygen stimulates erythropoietin production by kidneys erythropoietin increases red blood cell production (which takes about one week) What is the purpose of hemostasis? Correct Answers to prevent blood loss from a damaged vessel
What is the treatment for Raynaud's? Correct Answers avoid cold and stress What is the value of arterial pressure and its function? Correct Answers 90-100 mmHg propels blood to all other tissues in the body (systemic circulation) What is the value of venous pressure and its function? Correct Answers 12 mmHg propels blood through the lungs (pulmonary circulation) What is thrombocytopenia? Correct Answers too few platelets What is thrombocytosis? Correct Answers too many platelets What is turbulent blood flow? Correct Answers disordered flow of blood moving crosswise and lengthwise within the vessels What is valve stenosis? Correct Answers narrowing of valve opening so it does not open properly What is ventricular fibrillation? Correct Answers chaotic, rapid rhythm causing ventricles to quiver fatal if not treated within 3-5 minutes treatment: defibrillate, CPR, O2, epinephrine, antidysrhythmics
