CXA243 Pathophysiology For Health Care 2 Homework Answer

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Question :

Assessment Task 1 - Case Study 

Question 1 (1 point) 

Which pressure will be increased if there is a haemorrhage inside the skull?

a) Cerebrospinal fluid pressure

b) Intracranial Pressure 

c) Cerebral Perfusion Pressure 

d) Mean Arterial Pressure (Systemic)

Question 2 (1 point)

The Monroe Kellie doctrine describes 

a) pressure volume relationship within the intracranial cavity 

b) classification of traumatic brain injury 

c) physiological electrical function of the brain cells 

d) cerebral volume and pressure relationship

Question 3 (1 point)

Which Pressure, if it drops, can lead to brain ischaemia?

a) Mean Arterial Pressure (Systemic)

b) Intracranial Pressure 

c) Cerebrospinal fluid pressure

d) Cerebral Perfusion Pressure

Question 4 (1 point) 

Which pressure, if raised, can lead to compression of the vessels inside the skull?

a) Cerebrospinal fluid pressure

b) Cerebral Perfusion Pressure

c) Intracranial Pressure

d) Mean Arterial Pressure (Systemic)

Question 5 (1 point)
Which of the answers below would correctly complete the following statement?
The cerebro ischaemic response (Cushing's reflex) states that upon raised intracranial pressure, the   increases to overcome the  and ensure that the   is above 60mmHg.





Question 6 (1 point)
As Zac deteriorates, an accumulation of CO2 in the brain results in an increase in intracranial pressure due to which of the following?

a) Vascular compression 

b) Venous haemorrhage

c) Vasodilation

d) Arterial haemorrhage

Question 7 (1 point)
After head injury, ICP will increase quickly due to which of the following?

a) Vascular compression

b) Arterial haemorrhage

c) Venous haemorrhage

d) Vasodilation

Question 8 (1 point)
If Zac deteriorates, the may require a pain stimulus as part of his GCS assessment. In response to a pain stimulus, Zac may exhibit   if he has lost all brain function, excepting function of the brainstem.

a) withdrawn from pain

b) decorticate flexion

c) decerebrate extension

d) localised to pain

Question 9 (1 point) 

Zac hit his head, possibly experiencing a traumatic brain injury. Which of the following is a primary injury?

a) Neurogenic shock

b) Neural ischaemia

c)Subdural haematoma

d) Diffuse axonal injury

Question 10 (1 point) 

The most likely physical mechanism of Zac's traumatic brain injury was

a) static loading 

b) contact loading 

c) impact loading 

d) impulsive loading

Question 11 (1 point) 

Zac's cues prior to 0700 indicate

a) mild neurotrauma

b) severe neurotrauma 

c) minimal neurotrauma

d) moderate neurotrauma

Question 12 ( 1 point)

Zac hit his head, experiencing a traumatic brain injury (TBI). Which of the following is considered a tertiary presentation subsequent to a TBI?

a) subdural haematoma

b) hypoxaemia

c) neural ischaemia

d) contrecoup contusion

Question 13 (1 point) 

Which of the following is a direct result of the baroreceptor reflex towards end-stage elevation in ICP?

a) Widening pulse pressure

b) High blood pressure

c) Bradycardia

d) Reactive pupils

Question 14 (1 point) 

Zac hit his head, experiencing a traumatic brain injury (TB I). Which of the following is a consequence of secondary injury subsequent to TBI?

a) Concussion

b) Brain Herniation

c) Neurogenic Shock

d) Diffuse axonal Injury

Question 15 (1 point) 

Of Zac's 0700 cues, which of the following is a response to reduced cerebral perfusion pressure?

a) Bradycardia

b) Widening pulse pressure

c) Normally reactive pupils

d) High blood pressure

Question 16 (1 point) 

Cues for brain function deterioration due to rising ICP include all of the following except:

a) Widening pulse pressure

b) High blood pressure

c) Bradycardia

d) Reactive pupils

Question 17 (1 point) 

Which of the following cues from Zac's data is indicative of raised ICP?

a) elevated systolic blood pressure, widening pulse pressure, tachycardia

b) sluggish pupillary reflex

c) elevated systolic, lowered diastolic blood pressure, tachycardia

d) nausea and vomiting

Question 18 (1 point)

Haemorrhage into brain tissue is known as

a) intraventricular haemorrhage 

b) intracerebral haemorrhage

c) intralobe haemorrhage

d) intercerebral haemorrhage

Question 19 (1 point)

A subdural haematoma occurs when the

a) cortical bridging veins are ruptured

b) subependymal veins are damaged 

c) superficial arterial and venous vessels are ruptured

d) intracerebral vessels are torn

Question 20 (2 points) 

Identify the injury types in which the primary injury involves/affects the entire brain. Select only TWO (2) options
a) haematoma 

b) concussion 

c) diffuse axonal injury 

d) open skull fracture 

 e) contusion 

 f) intracerebral haemorrhage

Question 21 (4 points)

If Zac were to remain untreated, which of the following would be evidence of life-threatening deterioration due to raised intra-cranial pressure? Select only FOUR (4) options

a) widening pulse pressure

b) decreased blood pressure

c) decorticate posturing

d) fixed pupils

e) tachycardia

f) rhinitis

g) exopthalmus

h) hyporeflexia

i) neurogenic shock

j) bradycardia

k) altered respiratory pattern

l) GCS 12

Question 22 

A very important intervention for any deteriorating patient is to increase in the frequency of observations undertaken. If Zac were to significantly deteriorate, what trend in his blood pressure might be observed? Explain the pathophysiological mechanisms which would cause these changes.
Word limit: 200 words excluding in-text references. Use the School of Nursing guidelines for UTas Harvard referencing. These can be found in the "Assessment help and resources" section on MyLO.

Question 23 (0.0001 points) 

If Zac deteriorates further, mannitol may be administered. Explain the rationale if this therapy were to be used in Zac's care, and the changes in parameters (or lack thereof) that would be evidence that the intervention is having the desired effect. You should also explain why administration to Zac should proceed with caution.
Word limit: 200 words excluding in-text references. Use the School of Nursing guidelines for UTas Harvard referencing. These can be found in the "Assessment help and resources" section on MyLO.

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Answer :

CXA243 Pathophysiology for Health Care 2

Multiple Choice Questions

  1. Answer: b) 
  2. Answer: a)
  3. Answer: b)
  4. Answer: c)
  5. Answer: d)
  6. Answer: a)
  7. Answer: c)
  8. Answer: c)
  9. Answer: c)
  10. Answer: c)
  11. Answer: d)
  12. Answer: b)
  13. Answer: b)
  14. Answer: c)
  15. Answer: d)
  16. Answer: a)
  17. Answer: b)
  18. Answer: b)
  19. Answer: a)
  20. Answer: a) and f)
  21. Answer: a) i) j) and l)
  22. If Zac were to deteriorate significantly, the blood pressure might encounter collaborative interventions. In this regard, the pathophysiological basis for Zac’s health condition includes damages associated with TBI in regards to the neuronal tissues. This can be categorized into two forms, namely primary injury and secondary injury. While the prejudice of primary injury is caused by mechanical forces, the secondary injury replicates the damages that occurred in tissues and cells. In this regard, the clinical decision states that the blood pressure might remain higher during the intervention but might decrease comparatively while undergoing the control group (Carteret al., 2010). The most effective strategy in controlling the blood pressure includes team-based health assessments that highly focus on collaborative care by the pharmacist. The physiological and pathophysiological mechanisms to control the blood pressure for such cases as Zac’s health condition include impairment of the feedback system and the renal pressure natriuresis (Vaneckova et al., 2014). The mechanism also states that high blood pressure induces an increase in the level of sodium and water excretion which mainly relates to the excretion from the human kidney that might reduce the blood pressure of the patient. While the causes are including an increase in vascular stiffness or an increase in vascular responsiveness, the right target organ (Anatomical Structures) assessment might help the pathophysiological mechanisms control the blood pressure (Ricklin and Lambris, 2013). 
  23. If Zac deteriorates any further, Mannitol can be administrated. Mannitol is considered as a sugar alcohol that helps in reducing the intracranial pressure of the patient and helps to decrease the brain mass as well (Anderegg, Plavcova, Anderegg, Hacke, Berry and Field, 2013). The rationale for therapeutic approaches can be categorized under two forms, namely behavioural and psychodynamic mechanisms. For Zac’s health condition, the cognitive behavioural mechanism fits the best as the rationale. This might include certain psychological mechanism and effective clinical guidelines as well. The rationale for this therapeutic approach helps to reduce the intraocular pressure that cannot be minimized by any other method. In this regard, mannitol also helps to promote the diuresis regarding acute renal failure and processes prevention of the oliguric phase before it is too late. At the same time, Neuss and team in 2017 publication have echoed loud that there remains a question about the elevation of serum osmolality to reduce brain volume, as a result of which the parameter changes from 132 to 146 per 40g of Mannitol (Neuss et al., 2017).