test one patho 2373

• adh


  posterior pituitary, activated by increased osmolality and decreased ecf volume, results in reabsorption of h2o from kidneys
• raas


  Activated by decreased renal blood flow (Renin, Angiotensin I, Angiotensin II, Aldosterone). Results in vasoconstriction and retention of sodium and fluids.
• sns


  hypothalamus, activated by baroreceptors, results in constriction of vessels and increased heart rate
• baroreceptors


  senses pressure changes in arterial vasculature (decreases in volume), activates other regulatory mechanisms
• thirst


  hypothalamus, cellular dehydration (increase ECF osmolality), decrease in ECF volume, no change in cell size
• mechanisms of fluid regulation

  - circulating volume, thirst (hypothalamus), baroreceptors, SNS, RAAS, antidiuretic hormone (ADH), and ANP
• transcellular spaces

  pericardial sac, peritoneal cavity, pleural cavity
• third space accumulation


  Accumulation of fluids outside the vascular compartment that is NOT the interstitial space, called "EFFUSION"
• manifestations of edema

  swelling, pitting, impaired oxygen delivery to affected area, increase risk of tissue damage, may compress blood vessels
• edema


  increase in interstitial volume, caused by: increased capillary filtration pressure and permeability, decreased capillary colloidal pressure and obstruction of lymph flow
• what changes in capillary causes fluids to leak out of capillary and into surrounding tissue?

  increase in capillary filtration pressure, decrease in capillary colloidal osmotic pressure
• tissue colloidal osmotic pressure

  pulls water out of the capillary into the interstitial spaces
• capillary colloid osmotic pressure


  pulls water back into the capillary
• interstitial hydrostatic pressure


  opposes the movement of water out of the capillary
• capillary filtration pressure


  pushes water out of the capillary into the interstitial spaces
• tonicty


  movement of water that affects cell size: isotonic, hypotonic, hypertonic
• LOW=


  OVERFLOW
• HIGH=


  DRY
• osmolality


  A measure of the number of particles per kilogram of water, used interchangeably with osmolarity
• osmosis


  diffusion of water across a selectively permeable membrane, movement from lower concentration of particles to higher concentration of particles
• diffusion


  Movement of molecules from an area of higher concentration to an area of lower concentration.
• Suspected Deep Tissue Injury—Depth Unknown.

  Purple or maroon localized area of discolored intact skin or blood-filled blister caused by damage of underlying soft tissue from pressure and/or shear
• unstageable pressure injury

  Full-thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar
• stage four pressure injury

  Full-thickness tissue loss with exposed bone, muscle, or tendon
• stage three pressure injury

  full-thickness skin loss, can see fat, no bone, possible undermining and tunneling
• stage two pressure injury

  Skin is open; epidermis and possible dermis involvement; appears as a shallow crater, without slough
• stage one pressure injury

  Localized area of intact skin with nonblanchable redness, usually over a bony prominence but not maroon or purple discoloration.
• complications of pressure injuries

  necrosis, infection, tunneling, undermining
• pressure injury prevention


  frequent turning (every 2 hours), get person out of bed and into chair, keep vulnerable areas clean and dry, keep bed coverings off feet (use pillows to "float heels")
• contributing factors of pressure injury

  impaired sensory perception, urinary incontrence, impaired nutrition, hydration status, moisture, immobility, and circulatory status
• mechanisms of development for pressure injury

  pressure, shearing, friction, moisture
• rule of nines

  a method used in calculating body surface area affected by burns
• 3rd degree burn full thickness

  subcutaneous tissue and possible muscle/bone, white/waxy,/yellow/tan/brown/deep red/black in color, hard/dry, leathery, no pain, skin grafts possible, heals in several weeks-months
• 2nd degree burn full thickness

  entire epidermis and dermis, painful, mottles pink/red, waxy white areas, blisters (resemble tissue paper), scar formation likely, heals in 1 month
• 2nd degree burn partial thickness

  epidermis and various degrees of dermis, painful, moist, red, blistered, heals in 1-2 weeks
• 1st degree superficial

  outer layer of epidermis, pink, painful, no blisters, sunburn, heals in 3-10 days
• ABCDE

  asymmetry, border, color, diameter, evolving
• keratinocytes

  deals with basal cell and squamous cell
• melanocytes


  deal with melanoma
• malignant melanoma


  least common, most fatal, progresses rapidly, starts in epidermis then spreads to dermis, arises normally from pre-existing nevi. irregular borders, red, inflammed, tender, may ulcerate or bleed