Term
| What are the Lymphoid and Myloid cells and what do they do? |
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Definition
| Lymphoin and Myeloid are mulitpotent stem cells. Lymphoid= T,B & Natural Killer. Myloid= Platelets, erythrocytes & monocytes. |
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Term
| What does Leukopenia mean? |
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Definition
| Decreased in all WBC problems= infection |
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Term
| What does Neutropenia mean? |
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Definition
| Decrease in ONLY neutriphils |
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Term
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Definition
| Decreased in ALL myeloid stem cells you loose granulocytes, RBC & platelets |
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Term
| Where does Mononucleosis come from? |
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Definition
| EBV in saliva effects B cells |
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Term
| What does that mean to you? What do b cells do? |
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Definition
| B cells are plasma/ memory cells= Plasma cells make antibodies, because B cells are effected you will have problems with antibody/antigen complex. |
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Term
| Deifference b/t Leukemoa & Lymphoma? |
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Definition
- Leukemia= WBC are formed and differentiated in bone marrow, now neoplasma arise in bone marrow= leukemia
- WBC travel to Lymphoid organs to mature, neoplasma arise here are lymphomas, Lymphomas are less malignant because they are more differianted.
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Term
| Difference b/t non Hodkins vs Hodkins |
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Definition
- Non- Hodkins effect B&T cells, more common & aggressive respond better to treatment because of high growth rate.
- Hodkin Progressive invasion of lymohoid classified by Reed Sternberg Cells (malignant B cells)
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Term
| What are the S/S of Leukemia? |
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Definition
| Patient will have bone pain and rist of fracture d/t WBC grows in bone Marrow. Anemia d/t no RBC. Thrombocytopenia d/t no platelets, Immuno suppression d/t no WBC. Patient will then be SOB/ Fatigues. Leukemia can be a s/e of Chemotherapy. |
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Term
| When you have Leukemia you get abdnormal WBC build up in bone marrow what problem does this cause? |
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Definition
| When you have too many WBC you wiill release inflammaotry mediators(swelling,fever) infitrated peripheral Lymphoid organs(swollen lymhnodes) increased blood viscosity and this in turn caused problems with kidney and liver. |
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Term
| A chiild with Leukemia has fevers, weak pale,Cervical lymphnodes enlarged, nose bleeds & hyperkalemia. |
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Definition
| Fever d/t increase wbc, pale and fatigued d/t no RBC, Enlarged nodes d/t WBC proliferate, nose bleeds d/t no platelets. hyperkalemia d/t chemo kills pottassium in cells. |
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Term
| What are the two kinds of multiple myloma and what is mulitple myloma? |
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Definition
Mulitiple myloma is abnormal b-cells proliferation that causes osterolytic bone lesions.
- M protien- most common 80%
- Bence Jones- excreted thru urine and damages the kidneys their is abnoral interleukin, interferon & colony growth factor
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Term
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Definition
| Occurs when their is injury to the tissue, blood vessels constrict, Cytokines & Platelets are released and come to make a platelet plug |
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Term
| What has to be present to make a platelet plug |
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Definition
- Von Willebran
- Thromboxin
- Collagen
Once you have plug then cascaude can start |
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Term
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Definition
| Prothrombin- Thrombin- Fibrinogen= Fibrin |
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Term
| The Clot will retract before it can get off what happens? |
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Definition
| Tissue Plasminogen causes plasminogen to turn to plasmin... Plasmin breaks the blot |
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Term
| What upsets platelet function/ clotting activity? |
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Definition
Hypercoagulbility,
- increase platelet function
- increases clotting activitiy
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Term
What are three ways to come up with a platelet disorder?
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Definition
- Decreased production
- Breaking down/trapping
- Platelets used up in forming clots
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Term
| Know the difference b/t 2 platelets disorders? |
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Definition
- ITP- Breaking down platelets for unknown reasons, autoimmune type 2 reaction, bruising/bleeding, steroids/ spleenectomy
- TTP- Use up platelets caused by enzyme deficiency, rare, Petchiae & Purpura.
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Term
| Where is Fluid and how does it move around? |
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Definition
| Most fluid is found in the intracellular space. Fluid can be found in intra/ extra space, cells, vessels & tissue. Fluid moves around via osmosis. Water moves from the side that has fewer particles to the side that has more so that it can dilute particles. |
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Term
| What is a Hypertonic soultion? |
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Definition
| Few concentration inside the cell, H20 is pulled out of the cell and the cell shrinks. |
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Term
| What is a hypotonic solution? |
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Definition
| High concentration of solute in cell causes h20 to flow into cell and given for pt who is dehydrated |
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Term
| What is Hydrostatic Pressue |
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Definition
| Is the prssure that pushes fluid out of the cap d/t pressure being excerted on the cell wall. |
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Term
| What is Colloid Osmotic pressure |
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Definition
| Is the prssure that keeps fluid inside of the capilarries, it pulls the fluid to try and dilute self evenly |
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Term
| What maintains your H20 balance and what does it look @? |
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Definition
Hypothalmus
Serum osmolality & BV, if you have a decrease in B/V you will have increase osmolality |
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Term
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Definition
| Thirst, Drink, Adh release, water reabsorbed= no urine |
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Term
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Definition
| n thirst, no drink, decrease ADH urine |
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Term
| Diabetes insipidus what does it look like? |
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Definition
| Decresead ADH production causes increase urine, hypertonic dehydration, Increase sodium, decrease B/v & B/P. |
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Term
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Definition
| Failure of hypothalmu, dilutional hyponatremia, excessive ADH decreased urine & sodium, increased B/v & Pressure |
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Term
| What is the import thing about Sodium? |
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Definition
| Nrain & Neurons are concerned about sodium. Retaining sodium causes increase BP. If you have high sodimm in your blood it pulls H20 from your brain cells. As a nurse you can't give a hypotonic solution in this cause because it would worsed the brain cells and cause swelling= cerebral edema |
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Term
| How Does body compensate on its own? |
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Definition
| Increased blood osmolality causes cells to shrink do to water gets pulled ouf of these cells and into the vascular space, nerve cells produce intracellular osmoles to keep their psmolaity balanced with the blood.... MUST DO SLOW |
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Term
How is Potassium important in cell resting potential?
- Hyperkalemia
- HypoKalemia
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Definition
1. Serum potassium in blood rises resting potential toward threshold and cells fire more easy have to be concerned about tachydysrythmia
2. Low serum potassium in blood pulls away from the threshold and makes it hard for the cell to fire we are now concerned about braddysrithmia |
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Term
Potassium and its role as a Buffer
- Alkalosis
- Acidosis
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Definition
1. No enough H+ ion in blood, cells relase H and take in K.. Blood K will now decrease= hypokalemia
2. Too many H ions, cells keep H ion and Relase K, blood K willincrease Hyperkalemia |
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Term
What does Calcium do?
1. Hypercalcemia?
2. HypoCalcemia? |
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Definition
Extracellulary they block sodium receprots which then effects neuro transport
- Block Na gates nerve less able to fire
- Block fewer na gates nerve fire more easily
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Term
| Major concern with Magnesium? |
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Definition
| Causes life threatening heart arrythmias interdepenant with k+ |
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Term
| If you do not have normal PH what will happen. |
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Definition
| Acid base balance has to be normal to hav enormal metabolism |
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Term
| What is exchanges for what to reduce acidity |
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Definition
| K+ exchanges for H+ to reduce acidity |
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Term
| What do lungs and Kidney do in acidic and alkolinic states? |
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Definition
- Lungs release C02 in aciditic state, retain co2 in alkalinie state
- Kidney hangs on to H and release K if acidic, Dump HC03 into urin when alkalinic
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Term
- Explain Respiratory Acidosis
- Explain Respiratory Alkalosis
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Definition
- Excessive C02,hypoventilation, ineffective resp
- Decreased C02, Hyperventilation, excessive resp
HIGH CO2 = acidosis |
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Term
Explain metabolic Acidosis
Explain metabolic Alkalosis |
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Definition
- Decreased HC03/ increased h+=increase lactic acid
- Increased HC03/decrease H+
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Term
Normal Lab Values- arteriol blood
- PH
- PACO3
- HC03
What kind of PH will you find with Acidosis & Alklosis |
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Definition
- 7.35-7.45
- 35-45
- 22-26
Low Ph=acidosis nothing to do with 02
High Ph= Alkalosis |
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Term
Rep Acidosis
Resp Alk
Met Acid
Mer Alk |
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Definition
- Low Ph- High C02
- High Ph- low C02
- Low PH- Low Hc03
- High PH- High HCO3
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Term
When does compensatin occure?
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Definition
| When Ph returns to normal. The opposite system is trying ti fix imbalance |
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Term
| What is the process of creating RBC? |
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Definition
| Erythopoiesis- tissue Hypoxia/decreased blood 02 causes kidneys to secrete erythopoietin this stimulates bone marrow and a new RBC is created |
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Term
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Definition
| Immature RBC & RETICulocyte= no 02, bone marrow creates new RBC these are now mature 02. Your tetic gets high when you do not have enough 02, this causes tissue hypoxia and then causes the process of RBC production |
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Term
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Definition
| Live for 120 days, become damamged, break in cap in spleen, engulfed by WBC creating unconjugated bilirubin= toxic liver can't keep up causes jaundice, connects it to gluconuride now it is conjugated bilirubin and is excreted in bile. |
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Term
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Definition
| Blood loss- deficient RBC production- hemolysis |
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Term
What does Defiecient RBC look like what does it do?
- megablastic anemia
- Pernisious Anemia
- Aplastic Anemia
- Chronic disease
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Definition
We don't have enough cells or we do and they are not working well.
- Increase MCV- you have really big RBC that are not working correctly caused by vit b12 and folic acid deficiency- b12 & folic acid make RBC
- lack intrinsic factor, which is needed to absorb b12 to make RBC
- Abnormal stem cells replace bonemarrow can't make good cells
- Use up resources d/t chronic illness
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Term
| Explain Sickle Cell anemia |
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Definition
| Causes blocked capilarries bed- hemoglobin is deoxygenated caused by tissue ischemia this causes beta chains to link together forming "sickel" |
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Term
Regulates vaso constricting substances |
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Definition
| Brdaykinin, angiotension 2, heparin |
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Term
| Where does gas exchange occure |
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Definition
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Term
How does breathing work in regaurds to pressure?
- Inspiration
- Exspiration
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Definition
1. Chest exspands first air goes in ,ovement of muscle is what causes uou to breath. Use introcostol to open chest exspand diaphram moving it down. This opens up the air causing MORE SPACE LESS PRESSURE, increase space is what pulls 02 in
2. Let muscles lose chest collapse in, diaphram rise pushes air out INCREASE PRESSURE /DECREASE AIR |
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Term
| Compliance stretch vs recoil |
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Definition
| Normal lungs have to be able to stretch and recoil. Emphysema there is a problem with recoil this keeps the chest exspanded you trap air and then gas exchange can't occure. Fibrosis lung can't stretch |
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Term
| What does compliance depend on? |
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Definition
| Elastic /collogen fiber, water content & surface tension |
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Term
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Definition
| Decrease surface tension in alveoli allows me to exspand, prevents alveoli from collapsing during exspiration |
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Term
Explain Dead space
- Anatomic dead space
- Physiologic dead space
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Definition
- normal air does not reach exchange level should be 30% tidal volume
- abnormal air gets to alveolus but no exchange takes place and shunting occurs
- Anatomic- obstuctive alveoli
- Physiologic Alveolus dysfunction edema, excessive secretion
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Term
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Definition
| movement of air in and out of lung |
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Term
Perfusion
Vent <perf=
Per >vent = |
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Definition
Blood flow- cant have good respiration if you have bad blood flow
- Dead space air goes in does not exchange=pulm embolism/infraction
- Blood pass by no place to exchange=tumor/mucous plug
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Term
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Definition
| Have to Have normal alveolus and cap= no edema or secretions |
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Term
Oxyhemoglobin dissociation curve what is it all about?
- High affinity
- Low Affinity
- Acidotic
- Alkalosis
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Definition
Based on blood Ph, represents relationship b/t 02 discolved and 02 bound. Affinity refers to capacity of HGB to combine with 02.
1. HGB bind easy does not let go
2.HGB release 02 more easy.. off you go
3. Ph Low, affinity low, HGB let loose shit to right shift to right
4. High PH, High affinity, hold till it is really needed shift to left |
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Term
| What allows c02 to remain within the buffer system |
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Definition
| cabonic anydrase allows to stay in buffer system to keep ph under control |
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Term
Respiratory control central vs peripheral
- Central chemoreptors (medulla/pons)
- Peripheral Chemoreceptros (carotid & aortic bodies)
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Definition
- Measure Ph increase resp when ph decreases. Acidosis high C02 is the stimulus, will only do this for awhile
- Measure PO2 in arterial blood look for 02 when decreases increases resp rate. Stimulus Hypoxia
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Term
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Definition
Aerosol/direct contact
ifectious 1 day b4 symptoms
Upper phinotracheitis- malaise develp viral pne followed by bacterial infection, rapid onset 3-10days bacterial infection begins as pt starts to feel better |
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Term
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Definition
| Inflammation of parchynmal structure of lung effect alveoli & bronchials, can be infectious or non start to see mucous-serous exudate |
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Term
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Definition
| serous exudate, blood/rust colored exudate causes consolidation causing vent problem and can lead to resp failure |
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Term
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Definition
| Non productive- lowgrade fever- normal wbc- no atb |
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Term
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Definition
| Productive- fever- high wbc- infiltrates antibiotics |
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Term
- Hydrothorax
- Empysema
- Chylothorax
- Hemothorax
How can you get this fluid out? |
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Definition
- Serous Fluid
- Pus-purlent
- lymph fatty fluid
- blood
They have to use a tube to drain fluid out...THis is not a chest tube |
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Term
Pnomothorax
- Spontaneous
- Tramatice
- Tension
- Open
Treatment? |
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Definition
- Air that enters the pleural cavity and gets trapped can have partial or complete
- Air filled blister
- injury caused
- Patient on vent to much air gets put into lung and it pops. Posistive pressure instead of neg in pleural space. Trachea will shift
- Air enters chest through wall d/t injury
Chest tube to such air out |
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Term
Atelectasis?
What causes? |
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Definition
| Incomplete exspansion of lung or portion of the lung, causes most times by an obstruction |
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Term
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Definition
| Paradoxial chest exspansion d/t mulitple rib fracture, chest will fall in on self |
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Term
| Extrinsic (Atopic) Asthma |
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Definition
| Type 1 hypersensitivitiy, mast cells inflamm mediators acute responce w/i 10-20 minutes causes branchospasm, |
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Term
| 2 main characteristics of asthma |
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Definition
D/t mast cell break down
- Bronchospasm
- increase muscuous w/i Broncho lumen= inflammation
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Term
COPD what is cause and 2 types explain
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Definition
Smoking
- emphysema- enlargement of airspace and destruction of lung tissure- lost of alevoli tissue
- Chronist obstructive bronchititi- Loss of elastic lung fiber= small airways d/t secretion/ imflammmation
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Term
| When you have emphysema you have an increase in your neutrphil d/t to inhaled irritants that cause damage alveoili what is activated to help protect alveoli? |
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Definition
| Alpha-anitrypsin inactives the trypsin before it can damamge the alveoli |
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Term
| Pink Puffers vs Blue Bloaters |
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Definition
- PP= Emphysema, in RR to maintain 02 level really SOB, use accessory muscles, pursed -lip breathing
- BB-Bronchitis, Cannot increase resp enough to maintain 02 level, cop pulm
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Term
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Definition
Decreased vent
Tissue hypoxemia
HF d/t pulm disease d/t increase wrk load
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