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26 Apr 2019

Sunstroke was a common danger in biblical days (2 Kings 4:18-20). Comment on the role the kidneys play in adjusting electrolyte and fluid balance as a result of sunstroke.​ ​PLEASE DONT COPY WORD FROM WORD FROM A SOURCE!!! THANK YOU

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Irving Heathcote
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28 Apr 2019

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Read Ps 31:10. This verse describes how despair and other negative feelings take a toll on our physical well being. There are many hypothalamic disorders that result in physical maladies such as wasting away (cachexia), obesity, sleep disturbances, dehydration, as well as a wide range of emotional disorders which over time causes the body great harm. Similarly, in Eccl 8:1, Solomon describes how anxiety, anger, sorrow and frustration can harden one’s face, but enjoyment of life and attaining wisdom will reverse these conditions. Discuss how stress can causes excessive and prolonged cortisol release and the disease state that may result from this. (PLEASE DO NOT COPY WORD FROM WORD FROM A SOURCE! THANK YOU :)

ST, a 64-year-old patient, has heart failure (HF), which is being controlled with digoxin (Lanoxin), furosemide (Lasix), and a low-sodium diet. She is taking potassium chloride (KCl) 20╯mEq per day orally. Three days ago, ST had flulike symptoms such as anorexia, lethargy, and diarrhea. Her fluid and food intake was diminished. She refused to take the KCl and stated that the drug makes her sick. She has been taking the digoxin and furosemide daily. The nurse’s assessment during the home visit includes poor skin turgor, poor muscle tone, irregular pulse rate, and decreased bowel sounds. The nurse obtained a blood sample for serum electrolytes; results indicated potassium (K) 2.9╯mEq/L, sodium (Na) 137╯mEq/L, and chloride (Cl) 96╯mEq/L.

1. List reference values for serum potassium (K), serum sodium (Na), and serum chloride (Cl). Are ST’s electrolyte levels within normal range? Explain your answer.

2. Match ST’s physical findings with the corresponding electrolyte imbalance.

3. What are the reasons for the electrolyte imbalance?

4. ST said she was not taking KCl because the drug makes her sick. What information can you give her concerning the administration of potassium?

5. What is the effect of furosemide on digoxin when there is a potassium deficit? Explain your answer.

6. Why should the nurse assess ST for digitalis toxicity? List the signs and symptoms of digitalis toxicity. ST was referred to the health care provider because of her serum potassium deficit and its effect on digoxin. A repeat serum potassium determination was taken, and the result was 2.8╯mEq/L. A liter of 5% dextrose in water with KCl 40╯mEq/L was administered over 4 hours.

7. How many milliequivalents of KCl per hour would ST receive? Does this amount constitute an acceptable?

dosage?

8. Why is it important that the nurse monitor the rate of intravenous fluids containing potassium, the hourly

urine output, and vital signs?

9. Because of the low serum potassium level, what other electrolyte value should be checked? Explain your answer. After ST’s serum electrolytes returned to normal, the health care provider instructed her to continue taking the prescribed KCl dosage daily with her other medications.

10. ST asks why she has to continue taking these drugs. What is the nurse’s best response?

11. The nurse instructs ST to eat foods rich in potassium.

Which foods are the richest sources of potassium?

1. Assume you could “look” into the musculature of an animal andwatch neurosecetion as an animal moved. What would you see?

a. dynamic neurosecretionb. dynamic patterns ofneurosecretion

2. The word organ denotes adistinct set of tissues performing one or more specificfunctions. Therefore, this termcan be used to refer to large visceral organs, e.g. the liver, or much smaller structuressuch as otolith organs. In regard to the otolith organs, whatcauses the cilia of their vestibular cells to bend?

a, shear force b.inertia of endolymph

3. Recall that thevestibulo-ocular reflex enables the eyes to remain fixed on targetand that extrinsic eye muscles are innervated by brainstem α-motorneurons. What role does the medial longitudinal fasciculus play inthe vestibulo-ocular reflex?

a. central integration b. links the vestibular nuclei with brainstem motornuclei

4. Descending projections fromthe vestibular nuclei enable postural adjustments of the head andbody. Any stereotypical change in head position that promotes balance is mediated by thevestibulo-cervical reflex. This name stems from the fact that mostof the α-motor neurons that control the position of the head arelocated in the motor nuclei of the

a. brainstem b.cervical cord

5. Any stereotypical changein bodyposition that promotesbalance is mediated by the vestibulo-spinal reflex. Does thisreflex implement the γ-loop?

a. yes b. no

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