Pathophysiology HESI ReviewIf a patient with a WBC count of 2,000/mm, is admitted to the unit. What signs should the nurse look out
... [Show More] for?
a. Bleeding
b. Embolism
c. MI
d. Infection
• WBC: 5-10 k WHITE has 5 letters, then double it.
• HIV/AIDS- CD4 T Cell count goes way down (<200 = diagnosis of AIDS)
• What is a patient at risk for if WBC are too low? What could you have if WBC too high?
• RBCs are measured in millions:
• RBC: 4-6 million
• Platelets: 150-400k- what happens if too low? Too high?
• Hgb: 12-18
• Hct: 40-50%- what happens if too high? Why would it be too low?
• Glucose 70-110- where will this # be in DKA+HHNKS (high or low)?
– DKA – 240; HHNKS - 600
• What hormones cause this to go up and down?
• Na: 135-145
• Potassium: 3.5-5 mEq/L (know this value and causes/manifestations of hypo/hyperkalemia- both S/S wise and on the EKG)
– HYPERkalemia: peaked T Wave
– HYPOkalemia: U wave
• Ca: 8.5-10.
• Know how fluid overload or dehydration could cause electrolyte imbalances.
Labs continued…
• Albumin and Potassium ranges are same: 3.5 -5
• AST and ALT- indicate liver function.
• aPTT is relevant to what drug? Heparin, think of TT looks like an H.
• PT/INR with warfarin
• Creatinine: 0.6-1.2- measures kidney function (too high=kidney dysfunction)
• Creatinine clearance- kidneys, again!
• BUN: 10-20- measures kidney function (too high=kidney dysfunction)
• Urine Specific Gravity: 1.010-1.025. What could high specific gravity indicate? Low?
• HbA1c: You’re only lucky if you’re below the lucky number 7%
• Normal urine output: 30 cc an hour
• Daily fluid intake: 2-3 L
• HDL: > 50 ; LDL: < 130
Know your ABG values and interpretation
pH: 7.35-7.45 PCO2: 35-45 mm Hg HCO3: 21-28 mEq/L
PO2: 80-100 mm Hg; O2 Sat: 95-100%
Practice Question…
A patient has a pH of 7.48, a PaCO2 of 50mmHg, and a HCO3 of 36mEq/L. What acid-base balance do they have?
• pH=alkalotic
• PaCO2=high
• HCO3= high
• The high pH can’t be coming from the high PaCO2 (an acid) so it is coming from the HCO3. This is a metabolic alkalosis that is partially compensated.
Green HESI Book
• Look at pg. 353-360 for more about lab values.
• Go over chapter 4 for brief descriptions of disease processes
– In Ch. 4, do NOT focus on nursing interventions/diagnoses/meds/care type questions.
Random facts that seem to show up on every
patho HESI…
• Vitamin K is important to make clotting factors- this is why babies get supplemental vitamin K after birth (reduce risk hemorrhagic events because they do not make vitamin K for a few days)
• Know that Hemophilia A (classic hemophilia) is a deficiency in Factor VIII (A = 8)
• Types of Hypersensitivity (I-IV) and players in each
• Big players in immunity- humoral vs. cell medicated immunity, what are the big players in each
• J2s seem to remember a lot of endocrine questions
• EKG basics- what is happening during each component of PQRS (U?)?
• Know your ABGs
Hypersensitivity Reactions
1- A - Anaphylaxis / Allergies
• IgE
• Ex: Allergies, anaphylaxis
2 - C - Cytotoxic / Complement system
• IgG, IgM
• Ex: Blood transfusions/ABO mismatch
3 - I - Immune complex
• IgG, IgM
• Ex: Lupus
4 - D - Delayed response
• Cell-mediated
• Ex: Graft vs Host (transplants), TB Test
Inflammation
• Immunity
• Edema
• Hypersensitivities 1-4
Neuro
• Parkinson’s disease
• Multiple sclerosis
• Alzheimer’s disease
• ALS
• Subarachnoid hemorrhage
• Changes in ICP
Pulmonary
• ARDS
• Pulmonary emboli
• TB
• COPD (Emphysema & Chronic Bronchitis)
CV
• Frank-Starling Law of the Heart
• Aortic aneurysm
• Atherosclerosis steps
• Deep vein thrombosis
• Intermittent claudication
• Right vs Left-Sided Heart Failure
Endocrine
• Diabetes 1, 2
• DKA vs HHNKs
• Diabetes capillary changes
• Diabetes insipidus
• SIADH
• Cushing’s Disease
• Addison’s Disease
• Hyper/hypothyroidism
• Pregnancy Hormone (Hcg)
• Insulin’s relationship with glucose and potassium
Renal
• Pyelonephritis
• Glomerulonephritis
• Cholelithiasis
• Manifestations of Kidney Disease
GI
• Pancreatitis
• Liver cirrhosis
• Hepatic encephalopathy
• Jaundice
• Vomiting
• Zofran
Hematology
• DIC
• Types of Anemia
• Lymphoma
Musculoskeletal
• Rheumatoid vs Osteoporosis
• Compartment syndrome
• Rhabdomyolysis
Other
• Ulcers
• BUN levels
• Stress: physiologic and psychological signs
• HIV
• ABGs
• Vitamin K: purpose and why we give it to babies
• BUN levels
• Platelet count
• Hemoglobin A1C
Which of the following is a force favoring
reabsorption?
a) Capillary hydrostatic pressure
b) Decreased albumin in plasma
c) Interstitial oncotic pressure
d) Capillary oncotic pressure
Answer: D
Why? HydroStatic= Shoving pressure, pushes fluid away… so capillary hydrostatic pressure pushes water OUT of the vessel into the interstitial space-“filtration,” interstitial hydrostatic pressure shoves water away from the interstitial space back into the vessel.
Capillary onContic pressure= Come back (pulling)! So capillary oncotic pressure asks the fluid to come back into the vessel. Interstitial oncotic pressure asks the fluid to come back into the interstitial space.
A patient presents with Trousseau’s sign, what
laboratory abnormality would you expect to see?
a) Low calcium
b) Low platelets
c) Elevated ALT
d) Elevated Calcium
Answer: A
Trousseau’s sign (T-Rex sign) and Chvostek’s (chopsticks; C for cheek and calcium) sign are a sign of hypocalcemia.
Which of the following would be the first to
respond in the event of an acute infection?
a) Macrophages
b) Neutrophils
c) Monocytes
d) Reticulocytes
Answer: B
Which ones in particular? BANDS!!!! And what is that called?? Left shift!
Which is NOT a characteristic of adaptive
immunity?
a) Nonspecific
b) Specific
c) Slower onset
d) Long-lived
Answer: A
Adaptive immune responses are slower onset, specific, long-lived (memory cells).
Innate immunity is the opposite- it is fast onset, non-specific, and shorter-lived.
Which is an example of passive natural
immunity?
a) Getting the chicken pox
b) Getting a flu shot
c) Getting antibodies from a blood transfusion
d) Baby getting antibodies from mom via placenta or breastmilk
Answer: D
Getting the chicken pox is a type of natural active immunity because your body has to ACTIVELY make antibodies against the virus. Getting a flu shot is artificial active immunity. Getting antibodies from a blood transfusion is a form of passive artificial immunity.
Which of the following is the immunoglobulin
associated with Type I hypersensitivity reactions?
a) IgG
b) IgA
c) IgE
d) IgM
….. If you don’t know the answer…. You may
want to go back over every single page of your notes Haha. Kidding…. You guys ALL know that it’s IgE!!!
Which of the following are characteristics of
benign tumors? Select all that apply
a) Grow Slowly
b) Well differentiated
c) Divide rapidly
d) Not encapsulated
e) Do not metastasize
Answer: A, B, E
The rest describe characteristics of malignant tumors.
Which of the following is TRUE about
Alzheimer’s Disease?
a) Everyone gets it just at different ages
b) It is caused by too much CSF
c) It can be officially diagnosed by PET scan
d) It is diagnosed by neuritic plaques and neurofibrillary tangles post mortem
Answer: D
It is a disease of aging BUT not everyone will get it. It has not been correlated with the amount of CSF present. It cannot be officially diagnosed until after death
Which of the [Show Less]