final exam review 305

• Teaching family about care of a child with PKU (phenylketonuria)


  1. Avoid high protein foods

  2. Limited amount of starched

  3. Phenylalanine lowering agents

  4. Gene therapy
• Monosomy X (Turner's syndrome)


  • Coarctation of the aorta
  • Vision issues and hearting loss
  • Renal abnormalities
  • Infertility
  • Increased risk for infections
• Monosomy X (Turner's syndrome)


  • Cardiovascular complications
• Hypertrophic Cardiomyopathy and cardiovascular assessment

  1. Result of hypertension= pathological hypertrophy

  2. During CV assessment, left chest palpation location the PMI

  3. Usually located under the left nipple, with left ventricular hypertrophy, PMI is displaced to the left
• Lines of defense against infection (immunity lecture) and invasive procedures

  • Non-specific physical and chemical defenses (barriers and expulsions)=primary
  • Innate immunity (macrophages, neutrophils, eosinophils, basophils, monocytes/complement system)=secondary
  • Adaptive immunity (cellular and humoral)=tertiary
• Physiological benefits of a low-grade fever/ mildly elevated temperature

  Create an unpleasant environment for bacterial growth
• Clinical manifestations of systemic infection

  • Nonspecific signs and symptoms- fever, chills, multi organ involvement, edema
• Factors that interfere with gas exchange


  • Bed rest
  • Surface tensions
  • Microbes
  • Temperature
  • Dryness
• Metabolic alkalosis


  • Excess bicarb=antacids, bicarb-contating fluids, cardiac resuscitation
  • Deficient acids- GI loss(vomiting/suctioning
• Metabolic alkalosis


  • Neuro:confusion, dizziness, agitation, seizures
  • GI: vomiting, diarrhea
  • Systemic: weakness
• Fluid overload


  Excess fluid in the intravascular compartment
• Water intoxication


  Fluid excess in the intracellular space, can lead to rupture of cells
• Hypocalcemia


  • Increases all cell membrane excitability
  • CV= fast, irregular heartbeat
  • Neurological: fatigue, mental changes, muscle spasms, seizures, increased deep tendon reflex, increased bowel sounds
  • Blood: increased bleeding tendencies-calcium is necessary in the clotting cascade
• Hypomagnesemia


  • Similar to those of hypocalcemia
• Plasma osmolality


  • Glucose and sodium are important in determining plasma osmolality
  • 275 to 295 milliosmoles per kilogram
• Anti-diuretic hormone


  Released by posterior pituitary, controls water losses, promotes reabsorption of water
• Conductive hearing loss


  Occurs when the sound has problems transmitting through outer and middle ear to the inner ear
• Sensorineural hearing loss


  Damage to inner ear, auditory nerve or brain
• Causes of conductive hearing loss

  • Impacted cerumen
• Cellulitis


  • Acute infection involving the dermis and subcutaneous tissue
  • Redness, pain, swelling, heat
• Changes in the respiratory system of older adults

  • Decreased response to hypoxia and hypercapnia
  • Not exhibit the early warning signs of tachypnea and dyspnea
  • Switch to anaerobic respiration earlier in illness to make energy, develop acid-base imbalances earlier in illness
  • Less effective ventilation and gas exchange
• Changes in the renal system of older adults

  • Decrease nephrons
  • Decreased activity, number and length of proximal tubules
  • Decreased ability to respond to fluid overload and concentrate urine
• Age-related changes in the cardiac system

  • Blood vessels become stiffer with age
  • The heart of an older adult is less compliant
  • Increased fibrous and calcified tissues infiltrate myocardium
  • Calcified tissues infiltrate SA/AV node, bundle of his
  • Increased risk of arrythmias
  • Diastolic dysfunction
  • Less able to adapt to workload and demand
  • Increased risk of orthostatic hypotension
• Frailty syndrome


  • Weakness, weight loss, decreased balance and physical activity, slowness, social withdrawal, cognitive impairment and fatigue
  • Increased vulnerability to stressors
• Vertebral compression fractures


  • Secondary to osteoporosis, cancer, ostenocrosis, osteolmyelitis
• Vertebral compression fractures


  • Incontinence: medical emergency
• Pancreatitis complications


  • Damage to cells, edema, vascular insufficiency, ischemia
• Complications of renal failure


  • Don't concentrate urine, maintain bp, or secrete erythropoietin
  • Unable to maintain homeostasis while waste products, fluid, and electrolytes accumulate
• Cerebrospinal fluid, where is it produced and pathway of circulation

  1. Made in choroid plexusus (roof of ventricles)

  2. Lateral ventricle>intraventricular foramen> third ventricle> cerbeal aqueduct>fourth ventricle
• Cerebral aneurysm


  Subarachnoid hemmorrgae
• Protein doesn't pass the blood-brain barrier
• Glasgow coma scale severity categories


  • 3-8 severe
  • 9-12 moderate
  • 13-15 mild
• Hypokalemia

  • cardiac arrest
  • leg cramps
  • hyporeflexia
  • decreased bowel sounds
• Hyperkalemia


  • Bradycardia
  • cardiac arrest
  • flaccid paralysis, respiratory depression
• Normal range of potassium and sodium


  • Na-135-145
  • K-3.5-5.0
• Diabetes Inspidius

  High Urinary output, low levels of ADH, hypernatremia, dehydrated
• SIADH

  low urinary output, high levels of ADH, hyponatremia, over hydrated