• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/160

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

160 Cards in this Set

  • Front
  • Back
What is a unit of heredity?
A single gene
The scientific study of heredity, how are specific traits or predispositions are transmitted from parents to offspring?
genetics
What is a person’s unique genetic constitution that is made up of some 30,000 to 40,000 genes that a person inherits from his or her parents?
genotype
The observable characteristics of a person's genotype, that includes physical appearance, other biochemical, physiologic, and molecular traits is called your?
phenotype
What has helped us to understand how basic human genetics connects to human development, health, and disease?
The Human Genome Project
Most health conditions and birth defects are now believed to be the result of a combination of what two things?
genetic and environmental influences
What genetic condition caused by a small gene mutation that affects protein structure, produces hemoglobin S?
Sickle cell anemia
What addresses all of the genes of a given individual’s human genome working together as a whole?
Genomics
Why would you do prenatal screening?
this testing is used to identify whether a fetus is at risk for a birth defect such as Down’s syndrome or Spina Bifida (e.g. multiple marker maternal serum screening in pregnancy)
What do parents fear about Genetic Screening?
They are afraid the info will get out and/or it will be released to their Health Insurance company.
When doing a genetic history, how many generations do you look back on?
3 generations
What is the type of cell division involved in cell growth, differentiation, and repair and occurs in all cells of the body except oocytes and sperm?
Mitosis
During mitosis, the chromosomes of each cell duplicate, the result is two cells, called?
daughter cells
During mitosis, after duplication the two daughter cells contains the same number of chromosomes as the parent cell, how many?
46 chromosomes (23 pairs)
Cell division that occurs in reproductive cells and is the process by which oocytes and sperm are formed is called?
Meiosis
In Meiosis, when the paired chromosomes come together in preparation for cell division - portions cross over and an exchange of genetic material occurs before chromosomes separate. This is?
recombination
During meiosis, there is a reduction in the number of chromosomes that takes place that results in oocytes or sperm that contain how many chromosomes?
half the usual number, or 23 chromosomes
Sometimes during meiosis, a pair of chromosomes may fail to separate completely and it creates a sperm or oocyte that contains either two copies or no copy of a particular chromosome. This is called?
nondisjunction
The sporadic event, called nondisjunction can lead to? (e.g. Down's Syndrome or Turner's Syndrome)
monosomy or trisomy
What are some indications that chromosome studies may be needed?
suspected diagnosis of Down's syndrome and a history of two or more unexplained pregnancy losses
What chromosomal microscopic study is useful to detect small abnormalities in chromosomes and to characterize chromosomal rearrangements?
FISH - fluorescent in situ hybridization
A phenomenon observed in autosomal dominant inheritance, the percentage of people known to have a particular gene mutation who actually show the trait is called?

Ex: achondroplasia, 100% of pts display traits
Penetrance
The presence of a gene mutation doesn't mean the person has or will develop an autosomal condition; the probability that a given gene will produce disease is called?

Ex: BRCA1 hereditary breast cancer gene mutation w/ lifetime risk of breast cancer that can be as high as 80%
Incomplete penetrance
In incomplete penetrance a person may not have the condition but carries it and has a 50% chance of passing the gene to their children, what is one problem about this?
the gene appears to skip a generation leading to errors in interpreting family history and in genetic counseling
What are the tan to light brown, irregularly shaped spots called in the basal cell layer w/ well-defined borders often not visible in the very dark skinned person?
Café-au-lait spots
When does a gene mutation occur?
during cell division
What is consanguinity?
genetic relatedness
The three types of inherited mutations or conditions are called?
Autosomal dominant, Autosomal recessive and X-linked recessive
Characteristics of autosomal dominant inherited conditions?
Vertical transmission
Males and females equally affected
Variable expression
Reduced penetrance
Advanced paternal age
Characteristics of autosomal recessive inherited conditions?
Horizontal transmission
Males and females equally affected
Consanguinity (genetic relatedness)
Particular ethnic groups
Characteristics of X-linked recessive inherited conditions?
Vertical transmission in families
Males predominately affected
Characteristics of Multifactorial Inherited Conditions are?
Result of a combo of genetic & environmental factors
May recur in families
Does NOT demonstrate the characteristic pattern of inheritance seen w/ other mendalian conditions
When does a spontaneous mutation occur?
take place in individual oocytes or sperm at the time of conception
When does an acquired mutation occur?
take place in somatic cells and involve changes in DNA that occur after conception but develop as a result of changes in body cells
What is an example of an inherited mutation?
Huntington's Disease or Neuroblastoma
What is non-traditional inheritance?
variety of factors that influence genetic transformation
What is an example of non-traditional inheritance?
cystic fibrosis, alzheimer's disease, or angelman syndrome
What is a mono-genetic genetic disorder?
one gene is affected
Disorder where you only have to have a single copy of the defective gene?
Autosomal Dominant Inherited Condition
When or why would you do carrier screens?
Preconception screening for autosomal recessive inherited genetic conditions
Prenatal screening for diagnosis when a pregnancy is at risk
Newborn screening for genetic conditions that there is treatment
Why would you do a carrier screen on a newborn at 3 days?
to test for PKU a disease passed to children that affects digestion
Why might you get pre-symptomatic testing for Huntington's Disease, Alzheimer's Disease, or Cancer?
If you have a family history for these diseases and want to know ahead of time your prognosis or a confirmation diagnosis.
What is the most common genetic variations that occur frequently throughout the human genome?
Polymorphism and Single Nucleotide Polymorphisms (SNPs) or "snips"
SNPs or "snips" are becoming increasingly important for the discovery of DNA sequence variations that affect biologic function. Why is this knowledge important?
It allows clinicians to sub classify diseases and adapt therapies to individual patients.
How can a Polymorphisms or SNPs affect drug efficacy and safety?
If they alter protein or enzyme activity and that is the target of the medication regimen or is involved in drug transport or drug metabolism.
In autosomal recessive inheritance, each parent carries the gene on one chromosome of the pair and a normal gene on the other pair, parents are known as?
carriers
What is an example of Autosomal Recessive Inheritance?
Ex: sickle cell anemia, cystic fibrosis, & PKU
What condition is frequently seen among particular ethnic groups and usually occurs more often in children of parents who are relatedby blood, such as first cousins?
Autosomal Recessive conditions
What is the final check for compatibility between a donor’s blood and a recipient’s blood (the best antibody detection test available for avoiding lethal transfusion reactions)?
Crossmatching or compatibility testing
In the Cross-matching test, if there is agglutination when donor RBC and the recipients serum are correctly mixed and incubated is a?
positive crossmatch
A positive crossmatch indicates?
incompatibility between the donors blood and the recipients blood
The donor will have to be cross matched again to detect newly acquired incompatibilities if there is a testing delay of more than?
72 hours
Agglutination indicates?
an undesirable antigen-antibody reaction
What is it called when you have genetic trait but don't have symptoms?
carrier
When both parents are carriers, their child will have a ___% chance from EACH parent that their child will have the condition?
25%
Why is carrier testing done?
to determine if a person carries a recessive allele for an inherited condition such as CF, sickle cell, or tachy sachs dz.
What is one of the inherited antigens in human blood?
The Rh factor
There are five antigens in the Rh system, why is the one designated D a concern?
A person that has blood with a D antigen is called Rh positive or without it called Rh-negative.
An Rh-negative person must receive blood from another?
Rh-negative person
After the Rh typing test, you should give a pregnant person a card saying what?
identifying that she may need to receive Rh D injection
If an Rh-negative person gets a subsequent transfusion with Rh-positive blood it may cause?
serious reactions with clumping and hemolysis of red blood cells
What are some reasons you would you do Rh typing?
1) Establish blood type according to the Rh system
2) Determine the donor’s compatibility b4 transfusion
3) Determine if the pt will need an Rh (D) immune globulin injection
If an Rh-negative woman delivers a Rh-positive baby or aborts a fetus of unknown Rh type), why does she need an injection?
She must receive an Rh (D) immune globulin injection within 72 hours to prevent hemolytic disease of the neonate in future births
What do botulism, anthrax, hemorrhagic fever, Ebola virus, yellow fever, plague, smallpox have in common?
They are common infections associated with bioterrorism.
Why would you perform BIOTERRORISM INFECTIOUS AGENTS TESTING?
to isolate and identify the causative organism suspected
What Abnormal Findings are possible in BIOTERRORISM INFECTIOUS AGENTS TESTING?
Evidence of causative organism growth and guarnieri’s bodies present in the lesion scrapings and brick-shaped virions via electron microscope.
What is the process by which solutes move from an area of higher concentration to one of lower concentration and does not require expenditure of energy?
DIFFUSION
What exchange of gases happen between the pulmonary capillaries and alveoli (in the lungs) occurs by diffusion?
oxygen and carbon dioxide
There is a tendency of ______ to move from the ECF compartment, where the concentration is high, to the ICF, where its concentration is low?
sodium
What carries UNoxygenated blood back to lungs to for gas exchange?
Venous blood flow
What do you do if tracheal suctioning does not produce enough sputum?
perform chest percussion to loosen & mobilize secretions
Why would you perform tracheal suctioning to get a Sputum Collection/Culture?
Generally used if expectoration fails to provide a sample
Why would you get a Sputum Collection/
Culture?
To identify respiratory pathogens
When you be the best time for collecting a Sputum Collection?
Plan to collect specimen early in the am, before breakfast
What are important teaching points for a Sputum Collection?
Ask pt to rinse mouth out with water before to reduce contamination and to produce at least 15mL of sputum (make sure it contains thick mucous)
Why would you do a Swab or Throat Specimen?
To identify pathogens or asymptomatic carriers of certain easily transmitted disease organisms
Why would you need a Blood Culture?
To detect bacterial invasion & the systemic spread of an infection through the bloodstream
When getting a blood culture, you wipe diaphragm tops of the culture bottles w/ a povidone-iodine pad, after that you do what?
Change the needle on the syringe used to draw blood
What should the nurse advise the pt to avoid before the Creatinine test?
Advise the patient that he should avoid strenuous physical exercise during the collection period.
What is the most common venipuncture complication?
Hematomas - if one develops, apply direct pressure til the bleeding stops
What is the body’s main buffer for ICF & ECF where the levels are regulated primarily in the kidneys?
BiCarbonate HCO3
Most common base in the body is BiCarbonate HCO3 and the normal levels range is ?
22-26 mEq/L
What is made by CO2 and water and the lungs regulate the production?
Carbonic Acid H2CO3
Carbonic Acid H2CO3 is the most common ____ in the human body.
acid
______ _____ __ must be maintained for optimal function, acid-base level of the blood, and hydrogen ion concentration.
Normal serum pH
What is the normal pH range?
7.35-7.45
What is the nonprotein end product that appears in serum in amounts proportional to the body’s muscle mass?
Creatinine
Why would you check the Creatinine level?
To assess & diagnose renal function primarily GFR and how efficiently the kidneys are clearing creatinine from blood
What interferes with a Creatinine test?
Diuretics, exceptionally large muscle mass, high protein diet or strenuous exercise
The nurse must tell the pt before the test to refrain from eating meat, fish, or drinking coffee prior to Creatinine test for __ hours?
6
Your Creatinine results might be abnormally high if?
If you have poor hydration, you exercise, or are preggo
Your Creatinine results might be abnormally low if?
If you have reduced blood flow, heart failure, or severe dehydration
What test is used to measure the partial pressure of arterial oxygen (PaO2), the partial pressure of arterial carbon dioxide (PaCO2), and the pH of an arterial sample?
ATERIAL BLOOD GAS ANALYSIS (ABG)
What is the purpose of the ABG test?
To evaluate the efficiency of pulmonary gas exchange and the acid-base level of the blood
What does pH measure?
the acid-base level of the blood or the hydrogen ion concentration
What three mechanisms work to maintain a normal blood pH?
Buffers, Respiration, & Urinary Excretion
What is the ration of bicarbonate and carbonic acid?
20:1
What possible things that may interfere with an ABG test?
1) Exposure sample to air
2) Venous blood in the sample
3) Fever
What acid base disorder has these values?
pH < 7.35 HCO3 > 26 PaCO2 > 45
Respiratory Acidosis
What acid base disorder has these values?
pH > 7.45 HCO3 < 22 PaCO2 < 35
Respiratory Alkalosis
What acid base disorder has these values?
pH < 7.35 HCO3 < 22 PaCO2 < 35
Metabolic Acidosis
What acid base disorder has these values?
pH > 7.45 HCO3 > 26 PaCO2 > 45
Metabolic Alkalosis
Fastest system to react in an acid-base imbalance is?
carbonic acid-sodium bicarb buffer
How do the lungs help with respirations to maintain the acid-base balance?
Depends on the amt of acid or bicarb in the blood.

If there is an increase in co2 in the blood then your rate and depth of resp increase to blow off the co2. If there is not enough acid or too much bicarb in the blood than the respirations will be just the opposite.
The third system to maintain the acid-base balance is?
the kidneys
The kidney performs two major functions to assist this balance depending on how acidic or alkaline the blood is?
to absorb bicarb and excretes acid (H+ ions) in the urine
When there is an acid-base imbalance, how long for the kidneys to kick in i?
This mechanism takes at least 2-3 days to kick in but when it does it’s a long term mechanism.
What test evaluates the ability of the kidneys to concentrate solutes in the urine (measures the density of a solution compared to the density of water)?
Specific Gravity
Specific Gravity test is altered by the presence of?
blood protein and casts
What are three methods for testing Specific Gravity?
1) Multiple-test dipstick
2) Urinometer
3) Refractometer
Specific gravity depends largely on?
hydration status
When _____ _________ decreases specific gravity increases.

When _____ _________ increases specific gravity decreases.
fluid intake
Disorders that cause decreased specific gravity are?
severe renal damage, diabetes inspidus, and glomerulonephritis
Disorders that cause increased specific gravity are?
fluid deficit, diabetes mellitus, and nephritis
What precautions should you institute if there is a possibility of bioterrorism infectious?
1) Institute airborne precautions
2) Use negative pressure rooms for pts with suspected infection of Hemorrhagic Fever, Hantaan Virus, Ebola Virus, and yellow fever
3) Clean contaminated surfaces and spills with appropriate solution.
RESPIRATORY ALKALOSIS (excess CO2 excretion) is caused by?
Hyperventilation d/t anxiety, pain or improper ventilator setting;
Respiratory stimulation caused by drugs, disease, hypoxia, fever, or high room temp;
Gram - bacteremia;
Compensation for metabolic acidosis (chronic renal failure)
What are the S/S of RESPIRATORY ALKALOSIS?
Rapid, deep breathing, paresthesia, lightheadedness, twitching, anxiety, fear
How do you treat RESPIRATORY ALKALOSIS?
If the cause is anxiety, the patient is instructed to breathe more slowly to allow CO2 to accumulate. Treatment of other causes of respiratory alkalosis is directed at correcting the underlying problem.
METABOLIC ALKALOSIS is caused by?
vomiting or gastric suction, hypokalemia, potassium wasting diuretic (eg, thiazides, furosemide), excessive adrenocorticoid hormones, Alkali ingestion, Renal loss of H+
What are the S/S of METABOLIC ALKALOSIS?
dizziness, tingling of the fingers and toes, hypertonic muscles, depressed respirations, atrial tachycardia, hypoventilation, hypoxemia
How do you treat METABOLIC ALKALOSIS?
1) correcting the underlying acid–base disorder.
2) I&O must be monitored carefully
3) chloride must be supplied for the kidney to absorb sodium with chloride
4) restoring normal fluid volume by administering sodium chloride fluids
What is the major intracellular electrolyte?
Potassium
The normal serum potassium concentration ranges from?
3.5 to 5.0 mEq/L
What is the condition called where Potassium Serum K below 3.5 mEq/L and is commonly associated with various diseases, injuries, medications (eg, NSAIDs and ACE inhibitors), and acid–base imbalances?
Hypokalemia
What are the risk factors for Hypokalemia?
Diarrhea, Vomiting or gastric suction, Potassium-wasting diuretics, Poor intake as in anorexia nervosa, alcoholism
What are the S/S of Hypokalemia?
fatigue, anorexia, nausea & vomiting, muscle weakness, decreased bowel motility, cardiac arrhythmias, increased sensitivity to digitalis, polyuria, nocturia, dilute urine, postural hypertension, ECG changes, leg cramps, paresthesias
How do you manage Hypokalemia?
Careful monitoring of fluid I&O, ECG is monitored for changes, and arterial blood gas values are checked for elevated bicarbonate and pH levels. Potassium loss must be corrected daily; administration of 40to 80 mEq/day of potassium is adequate in the adult if there are no abnormal losses of potassium.
What should you check for in patients at risk for Hypokalemia?
Check for abuse of laxatives or diuretics and if they have a diet containing sufficient potassium.
What are some dietary sources of potassium?
fruit juices and bananas, melon, citrus fruits, fresh and frozen vegetables, fresh meats, milk, and processed foods
What is the condition where Potassium Serum K above 5 mEq/L called that is dangerous, and can include cardiac arrest?
Hyperkalemia
What are the risk factors for Hyperkalemia?
Decreased potassium excretion, Renal failure, potassium-sparing diuretics, hypoaldosteronism
What are the S/S of Hyperkalemia?
Vague muscle weakness, cardiac arrhythmias, paresthesias of face, tongue, feet, and hands, flaccid muscle paralysis, nausea, intermittent intestinal colic, or diarrhea, effect on the myocardium, skeletal muscle weakness and even paralysis, including paralysis of respiratory and speech muscles
How do you manage Hyperkalemia?
Monitor for hyperkalemia, follow rules for safe administration of K, encourage the patient to adhere to the prescribed potassium restriction.
What should you teach in patients at risk for Hyperkalemia?
Labels of cola beverages must be checked carefully because some are high in potassium and some are not.
What are some dietary sources of potassium to be avoided?
many fruits and vegetables, legumes, whole-grain breads, meat, milk, eggs, coffee, tea, and cocoa
The most abundant electrolyte in the body and_______ levels are inversely related to phosphorus levels.
calcium
Calcium plays a major role in?
1) transmitting nerve impulses
2) regulate muscle contraction and relaxation
3) role in blood coagulation
4) activating enzymes that stimulate essential chemical reactions in the body
Calcium is absorbed from foods in the presence of?
normal gastric acidity and vitamin D
What disorder is common in patients with renal failure w/ elevated serum phosphate, inadequate vitamin D consumption, magnesium deficiency, medullary thyroid carcinoma, low serum albumin levels, alkalosis, and alcohol abuse?
Hypocalcemia
What are the risk factors for Hypocalcemia?
Surgical hypoparathyroidism, malabsorption, Vitamin D deficiency, acute pancreatitis, excessive admin of citrated blood, & alkalotic states.
These Symptoms are for? Trousseau’s and Chvostek’s signs, Numbness and tingling of fingers & toes, depression, impaired memory, confusion, delirium, and hallucinations, Seizures, Spasm of laryngeal muscles, ECG changes, Cramps in muscles of extremities
Hypocalcemia
How do you treat Hypocalcemia?
Take seizure precautions when hypocalcemia is severe. Monitor condition of airway. Take safety precautions if confusion is present.
What should your Hypocalcemia pt be cautioned to avoid?
1) overuse of laxatives and antacids that contain phosphorus, because their use decreases calcium absorption.
2) Discuss calcium-losing aspects of nicotine and alcohol use.
What dangerous imbalance has a mortality rate as high as 50% if not treated promptly?
hypercalcemia
The most common causes of hypercalcemia?
malignancies and hyperparathyroidism
The excessive PTH secretion associated with hyperparathyroidism & bone mineral is lost during immobilization causes increased release of ________ from the bones?
calcium
What are the risk factors for hypercalcemia?
Hyperparathyroidism, Malignant neoplastic disease, Prolonged immobilization, Large doses of vitamin D, Overuse of calcium supplements, Thiazide diuretics
What are the S/S of Hypercalcemia?
Muscular weakness, Tiredness, lethargy, Constipation, Anorexia, nausea, and vomiting, Dehydration, Decreased memory and attention span, Polyuria and polydipsia, Renal stones, Neurotic behavior including confusion, impaired memory, slurred speech, acute psychotic behavior, or coma may occur, Cardiac arrest, ECG changes, Serum calcium > 10.5 mg/dL
How do you manage Hyperkalemia?
Increase mobilization when feasible. Increase oral intake (3 to 4 quarts of fluid daily). Force fluids to prevent formation of renal stones. Fluids containing sodium should be admin unless contraindicated, because sodium assists with calcium excretion. Discourage excessive consumption of milk products. Encourage bulk & adequate fiber in the diet to offset the tendency for constipation. Take safety precautions if confusion or mental symptoms is present. Be alert for signs of digitalis toxicity in hypercalcemic patients.
What test provides a more sensitive measure of renal damage than do BUN levels?
Creatinine Serum
What test aids in the assessment of hydration and evals kidney function & aid in d/d of renal disease?
BUN
What does the Blood Urea Nitrogen (BUN) test measure?
Test is used to measure the nitrogen fraction of urea
What should you teach your pt that is going to have a BUN test?
Explain to the pt that they should limit their meat intake (protein intake affects BUN levels).
What issue will increase or decrease the levels of the BUN test?
Overhydration & underhydration will affect BUN levels
There is an inverse relationship between K+ Potassium and __ _______ (if one goes up the other goes down)?
Na Sodium
If your patient is going to get a Calcium Serum test they must fast for __ hrs prior to testing?
6
These are interfering factors for which test?

1) Excess dietary K+ (increase)
2) Contamination of specimen w/ toilet tissue or stool
3) Potassium-wasting medications (increase)
4) Excessive vomiting or stomach suctioning
Potassium, Serum (K+)
What causes diffusion?
The concentration gradient
What test would you do before drawing an ABG?
Allen's Test
What genetic test would you do while a women is in her 1st trimester?
Amniocentesis