Chapters 23 and 24 Critical Thinking question and some of the answers...

Great answers, I needed help with #5 Island question.  Your responses were very helpful.  Thanks!
I am going to post what I have too, if it helps.  I am new to this site :-)

1.   You are a research assistant at a pharmaceutical company. Your group has been asked to develop an effective laxative that (1) provides bulk and (2) is non-irritating to the intestinal mucosa. Explain why these requests are important by describing what would happen if the opposite conditions were present. (4 points)
Answer:  Having a laxative that provides bulk is important for cases of constipation.  When an individual becomes constipated it can become hard to have a bowel movement.  Constipation is caused when food remains inside the colon for too long, causing stool to become hard and difficult to pass.  Sometimes laxatives are used when severe constipation occurs.  Bulk-forming laxatives draw water into the stool to create large soft stools.  The larger stools help trigger the bowel to contract and move the stools out.  It is also important to have a laxative that is non-irritating to the intestinal mucosa because the mucosa is very important for secreting mucus, digestive enzymes, and hormones, absorbing the end products of digestion into the blood, and protecting against infectious diseases.  The mucosa is the innermost layer, made of moist epithelial membranes that line the alimentary canal lumen from our mouth to our anus.  If this were to become irritated or destroyed it could cause a lot of GI tract issues, which would not be good for our body.  

2.   After a heavy meal rich with fried foods, Debby Collins, an over-weight 45 year-old-woman, was rushed to the emergency room with severe spasmodic pains in her epigastric region that radiated to the right side of her rib cage. She indicated that the attack came on suddenly, and her abdomen was found to be tender to the touch and somewhat rigid. What do you think is the patient’s problem and why is her pain discontinuous (colicky)? What are the treatment options and what might happen if the problem is not resolved? (4 points)
Answer:  Based on the information provided I believe Debby is having a gallbladder attack, which can be caused by gallstones.  (I had gallstones and had my gallbladder removed at 19 years old, I can relate to the pain)  After eating fried foods, an attack can come on suddenly and cause the pain she is experiencing.  Gallstones, depending on the severity, can cause pain off and on, sometimes for years.  The following symptoms are typical of a gallbladder attack:
Moderate to severe pain under the right side of the rib cage
Pain may radiate through to the back or to the right shoulder
Severe upper abdominal pain (biliary colic)
Nausea
Queasiness
Vomiting
Gas
Burping or belching
Attacks are often at night
Attacks often occur after overeating
Pain will often but not always follow a meal with fats or grease
Pain may be worse with deep inhalation
Attacks can last from 15 minutes to 15 hours
The treatment options for gallstones/gallbladder problems include dissolving the crystals with drugs, lithotripsy, vaporizing them with lasers, and surgically removing the gallbladder.  If the gallstones aren’t removed attacks will persist and become more painful (cholecystitis), blockage of the common bile duct, blockage of the pancreatic duct, gallbladder cancer, obstructive jaundice, and possible liver disease.

3.   A baby is admitted to the hospital with a history of diarrhea and watery feces occurring over the last three days. The baby has sunken fontanels, indicating extreme dehydration. Tests indicate that the baby has a bacterium-induced colitis, and antibiotics are prescribed. Because of the baby’s loss of intestinal juices, do you think that the blood ph would indicate an acidosis or an alkalosis? Explain your reasoning. (4 points). Answer:  Prolonged diarrhea can cause an electrolyte imbalance, which results in acidosis.  Hyperchloremic or non-AG metabolic acidosis is caused when there is a loss of too much HCO3 (bicarbonate ion).  Bicarbonate ions are the most important buffer in the blood; bicarbonate is regulated by the kidney, which excretes it in excess and retains it when needed.  

4.   Gary Francis, a middle-aged salesman, complains of burning pain in the “pit of his stomach,” usually beginning about two hours after eating and abating after drinking a glass of milk. When asked to indicate the site, he points to his epigastric region. The GI tract is examined by X-ray fluoroscopy. A gastric ulcer is visualized, and drug therapy using an antibiotic-bismuth approach is recommended. (a) Why is this treatment suggested? (b) What are the possible consequences of no treatment? (4 points)
Answer:  In this case I believe Gary has a peptic ulcer.  Peptic ulcers can improve with bismuth subsalicylate (Pepto-Bismol), which coats ulcers, protecting them from stomach acid.  Normally a two-week course of antibiotics can also promote healing and prevent recurrence of ulcers along with taking bismuth for symptoms.  The goal is to kill (Helicobacter pylori) H. pylori bacterium and other medications to reduce the level of acid in your digestive system to relieve pain and encourage healing.  If Gary doesn’t receive treatment for his ulcer he could have internal bleeding, infections in the wall of the stomach and/or small intestine, and develop scar tissue that can block the passage of food through the digestive tract.

5.   Dr. Dolan used an endoscope to view Mr. Habib’s colon. He noted the presence of several polyps and removed them during the same procedure. What is an endoscope? Why did Dr. Dolan opt to remove the polyps immediately? (4 points)
Answer:  An endoscope is flexible tubelike device that contains a light source and a lens, which is used to visually examine a ventral body cavity or the interior of a visceral organ.  Dr. Dolan would want to remove the polyps in Mr. Habib’s colon immediately because they can become cancerous over time, especially in individuals who are 50 or older, overweight or a smoker, eat a high-fat, low-fiber diet, or have a personal or family history of colon polyps or colon cancer.  

6.   Mr. Holden has had severe diarrhea all day and is severely weakened. Explain why his nurse is concerned about his present condition. (4 points) Answer:  Fluids and ions are lost from the body in prolonged diarrhea and can cause dehydration and an electrolyte imbalance.  If dehydration and/or loss of electrolytes become severe enough it can be fatal.  Electrolytes play a critical role in almost every metabolic reaction in the body.  They help control water balance and fluid distribution in the body, create an electrical gradient across cell membranes that are necessary for muscle contraction and nerve transmission, regulate the acidity (pH) of the blood, help regulate the level of oxygen in the blood, and are involved in moving nutrients into cells and waste products out of cells.  Malabsorption of needed nutrients, vitamins, etc. can also occur with prolonged diarrhea.

2.Every year dozens of elderly people are found dead in their unheated apartments and are listed as victims of hypothermia. What is hypothermia and how does it kill? Why are elderly more susceptible to hypothermia than the young? (4 points)
Answer:  Hypothermia is low body temperature resulting from prolonged uncontrolled exposure to cold temperatures.  Hypothermia is very dangerous; it causes vital signs to decrease and lowers the body’s core temperature.  This causes drowsiness and the body becomes too exhausted to generate heat.  Hypothermia can cause a coma and death if left untreated.  The elderly are more susceptible to hypothermia because they can fall or slip on ice in the winter and become stuck in cold temperatures.  They can also suffer from hypothermia because they aren’t as active as younger individuals and don’t have as much fat under their skin to help protect and keep their body warm.  Other reasons include taking medications that can increase the risk of hypothermia and they can have illnesses that affect the ability to feel that they are starting to feel cold.  

3. Frank Moro has been diagnosed as having severe atherosclerosis and high blood cholesterol levels. He is told that he is at risk for a stroke or a heart attack. Frist, what foods would you suggest that he avoid like the plague? What foods would you suggest he add or substitute? What activities would you recommend? (4 points)
Answer:  With a diagnosis of atherosclerosis and high blood pressure Frank should avoid foods that contain high trans fats and saturated fatty acids.  Trans fat is found in many processed foods, such as cookies, crackers, snack foods, and other processed foods made with shortening, partially hydrogenated vegetable oils, or hydrogenated vegetable oils, including some margarines and salad dressings.  He should add fruits and vegetables (including dark green vegetables, beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk, dairy products, nuts, and seeds.  I would suggest that he add Vitamin E and also include foods low in sodium (salt), added sugar, solid fats, and refined grains.  Adding any kind of physical activity and/or an exercise program can reduce the chances of getting atherosclerosis and high blood pressure.

5. While attempting to sail solo from Los Angeles to Tahiti, Simon encountered a storm that marooned him on an uninhabited island. He was able using his ingenuity and a pocket knife, to obtain plenty of fish to eat, and roots were plentiful. However, the island was barren of fruits and soon his gums began to bleed and he started to develop several infections. Analyze his problem. (4 points)
Answer:  Since there is a lack of fruit on the island Simon’s body is being deprived of Vitamin C, which is used in collagen synthesis for bone, cartilage, and gums.  Lack of iron absorption and collagen synthesis could cause his teeth and gums to degenerate, which would account for the bleeding and infections.  

thanks