NUR 410 exam 2 questions (solved)

NUR 410 exam 2 questions (solved)

1. shock: syndrome characterized by: -decreased tissue perfusion (hypo perfusion) -impaired cellular metabolism which results in an imbalance between supply and demand for oxygen and nutrient requirements at the cellular level 2. 1. adequate supply of oxygen being transported to the tissues 2. the cell's ability to use oxygen: what two things does adequate tissue perfusion depend on? 3. 1. pulmonary gas exchange 2. cardiac output/pump 3. hgb level (w/in volume): adequate supply of oxygen being transported to the tissues is reliant upon 3 things..... 4. metabolic, mitochondrial: the cell's ability to use oxygen is influenced by the internal environment (kidneys and lungs influence this environ- ment-acid base balance) and function 5. Krebs cycle: -want to function under aerobic metabolism -when have this we use O2 and get anywhere from 34-38 ATP (unit of energy) -if don't have enough ATP then Na/K pump fails causing the cell to swell, rupture, and die -need O2 and glucose to maximize ATP production -cells start to work under anaerobic conditions without O2 and then produce less ATP -Na/K pump works for a little but then stops working and cell dies -byproducts: H2O and CO2 -lactic acid produced 6. lactic acid: -shows hypo perfusion at cellular level when body is working under anaerobic conditions -acidotic: below 7.35 7. cariogenic, hypovolemic, distributive, and obstructive: what are the 4 types of shock 8. absolute and relative: what are the 2types of hypovolemic shock 9. neurogenic, anaphylactic, and septic: what are the 3 types of distributive shock 10. initial stage of shock: -stage of shock -no outward s/s -changes at cellular level -switch from aerobic metabolism to anaerobic metabolism -cells release lactic acid -lactic acid is removed by functioning liver (requires some O2 to do) 11. compensatory stage of shock: -stage of shock -mechanisms to compensate are activated -SNS response: narrowing pulse pressure and inc in HR -RAAS system: potent vasoconstrictors -aldosterone and ADH release -shunting of blood flow from non-vital organs -vasoconstriction -dec BF to lungs and ventilation/perfusion mismatch -inc amount of physiologic dead space -reversible! 12. ventilation perfusion mismatch: air goes into alveoli but not oxygenating blood stream well bc vasoconstriction in the lungs -no blood comes by to pick up the oxygen in the alveoli 13. compensatory shock stage: S&S: -inc in rate and depth of RR (first sign) -inc HR -dec in pulse pressure -dec in PaO2 -dec urine output -pale, cool, clammy skin -constipation (slowed peristalsis) -hypoactive bowel sounds