Really need help with critical thinking questions!!

Hattie has a renal calculus, or kidney stone, in her ureter. Predisposing conditions are frequent bacterial infections of the urinary tract, urinary retention, high concentrations of calcium in the blood, and alkaline urine. Her pain comes in waves because waves of peristalsis pass along the ureter at intervals. The pain results when the ureter walls close in on the sharp kidney stone during this peristalsis.

Hope this helps!

Thanks Robertling!!  Thaat really helped alot!!

Cystitis is bladder inflammation. Women are more frequent cystitis sufferers than men because the female urethra is very short and its external orifice is closer to the anal opening. Improper toilet habits can carry fecal bacteria into the urethra.


A fracture at the lumbar region will stop the impulses to the brain, so there will be no voluntary control of micturition and he will never again feel the urge to void. There will be no dribbling of urine between voidings as long as the internal sphincter is undamaged. Micturition will be triggered in response to bladder stretch by a reflex arc at the sacral region of the spinal cord as it is in an infant.

Thanks for the help you guys!!  The paper was due yesterday so I turned in what I had, but I will upload the paper here for others to use!!  Thanks again...


Critical thinking Questions: 1-6, Pg. 994 in Marieb text
1.   Mrs. Bigida, a 60-year-old woman, was brought to the hospital by the police after falling to the pavement. She is found to have alcoholic hepatitis. She is put on a salt and protein restricted diet. Diuretics are prescribed to manage her ascites (accumulated fluid in the peritoneal cavity). How will diuretics reduce this excess fluid? Name and describe the mechanisms of the action of three types of diuretics. Why is her diet salt restricted? (4 points). Answer: The diuretics will prompt the kidneys to excrete more water, reducing the excessive fluid.  Three types of diuretics and their mechanism of action are, (1). Alcohol – essentially a sedative, encourages diuresis by inhibiting release of ADH.  (2). Loop diuretics – increases urine flow by inhibiting formation of the medullary gradient by acting at the ascending limb of Henle’s loop.  (3). Caffeine – increases urine flow by inhibiting sodium reabsorption and the obligatory water reabsorption that normally follows.  Her diet salt is restricted because salt will give her to urge to drink more fluids (pg. 999 in Marieb).
2.   While repairing a frayed utility wire, Herbert, an experienced lineman, slips and falls to the ground. Medical examination reveals a fracture of his lower spine and transection of the lumbar region of the spinal cord. How will Herbert’s micturition be controlled from this point on? Will he ever again feel the need to void? Will he experience dribbling? Please explain all of your answers. (4 points) Answer:
3.   What is cystitis? Why do women experience cystitis more frequently than men? (4 points) Answer:  Cystitis is an infection of the bladder.  Women experience cystitis more frequently because the urethra is closer to the opening of the anus where bowel collects.  This makes it easier for bacteria to get transferred from the surrounding skin to the urethra (Pg. 998 in Marieb).
4.   Hattie, aged 55, is awakened by excruciating pain that radiates from her right abdomen to the loin and groin regions on the same side. The pain is not continuous but recurs at intervals of 3 to 4 minutes. Diagnose her problem, and cite factors that might favor its occurrence. Also, explain why Hattie’s pain comes in “waves.” (4 points). Answer:  Hattie has kidney stones in her ureter.  Predisposing conditions are frequent bacterial infections of the urinary tract, urinary retention, high concentration of calcium in the blood, and alkaline urine.  He pain comes in waves because waves of peristalsis pass along the ureter in intervals (pg.986 in Marieb).
5.   Why does the use of a spermicide increase a woman’s risk for urinary tract infections ?(4 points) Answer: Because the spermicide kills helpful bacteria, allowing infectious fecal bacterial to colonize the vagina (pg. 988 in Marieb).
6.   Why are renal failure patients undergoing dialysis at risk for anemia and osteoporosis? What medications or supplements could you give them to prevent these problems? (4 points) Answer: They are at risk for anemia because, their diseased kidney isn’t making enough EPOs, resulting in fewer red blood cells.  And they are at risk for osteoporosis because, the body is pulling calcium out of the bone to make up for its calcium loss, and that’s causing their bones to become brittle.  Iron supplements can be taken for anemia and calcium supplements can be taken for osteoporosis.  Pub Med Health (2012).  Anemia.  Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001586/, on February 19, 2012 
Pub Med Health (2012).  Osteoporosis.  Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001400/, on February 19, 2012
 
Critical thinking questions: 1, 3, 4,  Pg. 1022 in Marieb text
1. Mr. Jessup, a 55 year old man, is operated on for a cerebral tumor. About a month later, he appears at his physician’s office complaining of excessive thirst. He claims to have been drinking about 20 liters of water daily for the past week and he has been voiding nearly continuously. A urine sample is collected and its specific gravity is 1.001. What is your diagnosis of Mr. Jessup’s problem? What connection might exist between the previous surgery and his present problem? (4 points). Answer: My diagnosis of Mr. Jessup would be that he has diabetes insipidus, due to a failure of ADH production, which resulted in him voiding large volumes of diluted urine.  The connection between the previous surgery and his present problem is, the surgery might have damaged the structure of his posterior pituitary gland by accident, which was the cause of his failure of ADH production (pg. 991 in Marieb).
3. Explain how emphysema and congestive heart failure can lead to acid-base imbalance. (4 points) Answer: Emphysema patients are unable to expel carbon dioxide correctly, so they have to work very hard just to exhale.  Since they can’t expel the carbon dioxide correctly, their blood acid rises, lowering the blood pH value.  And congestive heart failure patients, has a reduction of circulation to the lungs, which can lead to retention of carbon dioxide, and a drop in the bloods pH (pg. 1114-1115 in Marieb).
4. Mrs. Bush, a 70 year old woman is admitted to the hospital. Her history states that she has been suffering from diarrhea for three weeks. On admission, she complains of severe fatigue and muscle weakness. A blood chemistry reveals the following lab values: Sodium is 142 mEq/L, potassium is 1.5mEq/L; chloride: 92 mEq/L; PC02 is 32 mmHg. Which electrolytes are within normal limits? Which are so abnormal that the patient has a medical emergency? Which of the following represents the greatest danger to Mrs. Bush (a) fall due to her muscular weakness (b) edema, (c) cardiac arrhythmias (8 points) Answer: Electrolytes that are in normal limits are sodium and PC02.  Her potassium and chloride levels are what caused her to have a medical emergency. And (A.) a fall due to her muscular weakness represents the greatest danger to Mrs. Bush.  (Digital Pharmacy (n.d.).  Electrolytes.  Retrieved from http://www.digitalpharmacist.net/electrolytes.pdf, on February 19, 2012)