Pathophysiology: a practical approach

537 Pages·2018·50.43 MB·English

by  Lachel Story

THIRD EDITION
PPAATTHHOOPPHHYYSSIIOOLLOOGGYY
A PRACTICAL APPROACH
Lachel Story, PhD, RN
Assistant Dean for Research and Evaluation
PhD Program Director
Associate Professor
College of Nursing
The University of Southern Mississippi
Hattiesburg, Mississippi
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Library of Congress Cataloging-in-Publication Data
Names: Story, Lachel, author.
Title: Pathophysiology : a practical approach / Lachel Story.
Description: Third edition. | Burlington, Massachusetts : Jones & Bartlett
Learning, [2018] | Includes bibliographical references and index.
Identifiers: LCCN 2016047299 | ISBN 9781284120196
Subjects: | MESH: Pathology | Physiology | Nurses’ Instruction
Classification: LCC RB113 | NLM QZ 140 | DDC 616.07–dc23
LC record available at https://lccn.loc.gov/2016047299
6048
Printed in the United States of America
21 20 19 18 17 10 9 8 7 6 5 4 3 2 1
Contents
Preface .................................................................. x
Acknowledgments ......................................................... xi
Reviewers ............................................................... xii
Introduction to Pathophysiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Chapter 1 Cellular Function .............................................. 1
Basic Cell Function ............................................. 2
Cellular Adaptation and Damage .................................. 9
Neoplasm .................................................... 14
Genetic and Congenital Alterations ................................ 21
Chapter Summary ............................................. 30
References ................................................... 30
Chapter 2 Immunity .................................................... 31
Stress ...................................................... 32
Immunity .................................................... 33
Innate and Adaptive Defenses .................................... 34
Transplant Reactions ........................................... 41
Autoimmune Disorders ......................................... 42
AIDS . ...................................................... 45
Developing a Strong Immune System .............................. 48
Chapter Summary ............................................. 50
References ................................................... 50
Chapter 3 Hematopoietic Function ......................................... 51
Normal Hematopoietic Function .................................. 52
Diseases of the White Blood Cells ................................. 53
Diseases of the Red Blood Cells ................................... 59
Diseases of the Platelets ......................................... 65
Chapter Summary ............................................. 69
References ................................................... 69
Chapter 4 Cardiovascular Function ......................................... 71
Anatomy and Physiology ........................................ 72
Understanding Conditions That Affect the Cardiovascular System ........ 80
Alterations Resulting in Decreased Cardiac Output ........................ 80
Conditions Resulting in Altered Tissue Perfusion ......................... 94
Conditions Resulting in Decreased Cardiac Output and Altered Perfusion ...... 107
Chapter Summary ............................................. 115
References ................................................... 115
vii
viii Contents
Chapter 5 Respiratory Function ........................................... 117
Anatomy and Physiology ........................................ 118
Understanding Conditions That Affect the Respiratory System .......... 127
Infectious Disorders ................................................ 128
Alterations in Ventilation ............................................ 141
Alterations in Ventilation and Perfusion ................................ 156
Chapter Summary ............................................. 159
References ................................................... 160
Chapter 6 Fluid, Electrolyte, and Acid–Base Homeostasis ....................... 161
Fluid Balance ................................................. 162
Electrolyte Balance ............................................. 167
Acid–Base Balance ............................................. 175
Chapter Summary ............................................. 185
References ................................................... 185
Chapter 7 Urinary Function .............................................. 187
Anatomy and Physiology ........................................ 188
Understanding Conditions That Affect the Urinary System ............. 194
Chapter Summary ............................................. 213
References ................................................... 213
Chapter 8 Reproductive Function .......................................... 215
Anatomy and Physiology ........................................ 216
Congenital Disorders ........................................... 226
Infertility Issues ............................................... 229
Disorders of the Testes and Scrotum ............................... 230
Menstrual Disorders ............................................ 233
Disorders of Pelvic Support ...................................... 235
Disorders of the Uterus ......................................... 236
Disorders of the Ovaries ......................................... 239
Disorders of the Breasts ......................................... 239
Miscellaneous Infections ........................................ 240
Sexually Transmitted Infections ................................... 243
Cancers ...................................................... 251
Chapter Summary ............................................. 257
References ................................................... 257
Chapter 9 Gastrointestinal Function ........................................ 259
Anatomy and Physiology ........................................ 260
Understanding Conditions That Affect the Gastrointestinal System ....... 268
Chapter Summary ............................................. 301
References ................................................... 301
Chapter 10 Endocrine Function ............................................ 303
Anatomy and Physiology ........................................ 305
Understanding Conditions That Affect the Endocrine System ........... 310
Chapter Summary ............................................. 324
References ................................................... 324
Contents ix
Chapter 11 Neural Function ............................................... 325
Anatomy and Physiology ........................................ 326
Understanding Conditions That Affect the Nervous System ............. 339
Chapter Summary ............................................. 374
References ................................................... 375
Chapter 12 Musculoskeletal Function ........................................ 377
Anatomy and Physiology ........................................ 378
Understanding Conditions That Affect the Musculoskeletal System ....... 388
Chapter Summary ............................................. 413
References ................................................... 413
Chapter 13 Integumentary Function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415
Anatomy and Physiology ........................................ 416
Understanding Conditions That Affect the Integumentary System ........ 417
Chapter Summary ............................................. 438
References ................................................... 438
Chapter 14 Sensory Function .............................................. 439
Anatomy and Physiology ........................................ 440
Understanding Conditions That Affect the Senses ..................... 449
Chapter Summary ............................................. 461
References ................................................... 461
Appendix A Normal Lab Values ............................................. 463
Appendix B Root Words and Combining Forms ................................ 467
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509
Preface
While teaching pathophysiology for more than 13 years (Committee on the Robert Wood Johnson Foundation
and nursing for more than 21 years, I noticed a lack of Initiative on the Future of Nursing at the Institute of
pathophysiology books that students could relate to, Medicine, 2010), and nursing leaders (Benner, Sutphen,
and high student frustration in learning the convoluted Leonard, & Day, 2010), among others, who have sought
material. Pathophysiology—while being the foundation to change how nurses are educated to meet the chang-
of much of nursing education, from medical–surgical to ing landscape of health care and needs of new
pharmacology—is often an insurmountable barrier for generations.
students. They are faced with a copious amount of com- The third edition of this text organizes content in a
plicated information to weed through. While some stu- conceptual manner to provide students with an under-
dents become bogged down in an information marsh, standable and practical resource for learning pathophys-
others seek more information than is provided in a iology. New and updated material has been added to
skeleton book that has been cut to the bone. Nursing every chapter. An increased focus on pediatric content
faculty join the students on this frustrating, Goldilocks and considerations has been threaded throughout. New
journey by trying to make the available resources fit. and updated case studies add to students’ understand-
Unfortunately, nursing students and faculty often have ing and ability to apply their learning on a practical
pathophysiology books available that provide either far level. Instructor resources have been expanded to in-
too much information or far too little. clude active learning activities that support the “flipped”
This text provides the right fit: it is a practical guide classroom approach. Faculty will appreciate having a
to pathophysiology that presents information in a resource that speaks to and engages students. Health
student-friendly, understandable way. Here, extraneous professionals will also be able to refer the text to refresh
information is omitted, leaving only necessary informa- their memory on concepts in a pragmatic way.
tion. The information in this text is also presented in a
more accessible manner by considering readability, pro- References
viding colorful graphics, and giving the content context
and meaning. Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Edu-
This ground-breaking text will provide a spring- cating nurses: A call for radical transformation. San Francisco,
CA: Jossey-Bass.
board for faculty and students to come together as co-
Committee on the Robert Wood Johnson Foundation Initia-
learners to explore this fascinating content. When such
tive on the Future of Nursing at the Institute of Medicine.
co-learning is stimulated, pathophysiology is no longer
(2010). A summary of the February 2010 forum on the
just mindlessly deposited into the students in a stifling
future of nursing: Education [Chapter 2: What to teach].
manner; rather, learning for the students and the fac-
Retrieved from http://www.nap.edu/catalog/12894.html
ulty becomes an empowerment pedagogy. This ap- Institute of Medicine. (2011). The future of nursing education:
proach has been supported by experts at the Institute of Leading change, advancing health. Washington, DC: National
Medicine (2011), the Robert Wood Johnson Foundation Academies Press.
x
Acknowledgments
First, I would like to thank my husband, Tom, and chil- past, present, and future for constantly teaching me
dren, Clayton and Mason, for their never-ending love more than I could ever teach them and for all their
and encouragement. I would also like to express my feedback—I heard it and I hope this is more what you
deepest gratitude to my mom, Carolyn, and dad, had in mind. Finally, I would like to convey my appre-
Tommy, because I would not be who I am today without ciation to my colleagues for their gracious mentoring
them. I would also like to acknowledge all my students and support.
xi
Reviewers
Judy Anderson, PhD, RN, CNE Christine Henshaw, EdD, RN, CNE
Associate Professor Associate Dean, Undergraduate Program
School of Nursing School of Health Sciences
Viterbo University Seattle Pacific University
La Crosse, Wisconsin Seattle, Washington
Margaret Hamilton Birney, PhD, RN Patricia R . Keene, DNP, ACNP, CS, BC
Associate Professor Associate Professor of Nursing
School of Nursing School of Nursing
University of Delaware Union University
Newark, Delaware Germantown, Tennessee
Linda Keilman, DNP(c), MSN, GNP-BC
Patsy E . Crihfield, DNP, APRN, FNP-BC
Assistant Professor
Associate Professor of Nursing and Director of Nurse
College of Nursing
Practitioner Program
Michigan State University
School of Nursing
East Lansing, Michigan
Union University
Germantown, Tennessee Barbara McClaskey, PhD, MN, ARNP-CNS
Associate Professor
Jennifer Donwerth, MSN, RN, ANP-BC, Department of Nursing
GNP-BC Pittsburg State University
Instructor Pittsburg, Kansas
Department of Nursing
Tarleton State University Joan Niederriter, PhD, RN
Stephenville, Texas Assistant Professor
Department of Nursing
Julie Eggert, PhD Cleveland State University
Associate Professor and Healthcare Genetics Doctoral Cleveland, Ohio
Program Coordinator
Tanya L . Rogers, APRN, BC, MSN, EdD
School of Nursing
Associate Professor of Nursing
Clemson University
School of Nursing and Allied Health Administration
Clemson, South Carolina
Fairmont State University
Fairmont, West Virginia
Masoud Ghaffari, MSN/RN, MEd,
MT (ASCP), CMA Jennifer K . Sofie, MSN, ANP, FNP
Associate Professor Adjunct Assistant Professor
College of Nursing College of Nursing
East Tennessee State University Montana State University
Johnson City, Tennessee Bozeman, Montana
Kathleen A . Goei, PhD, RN, MSN Joan Stokowski, MSN
Assistant Professor Assistant Professor
School of Nursing and Health Professions Department of Health Careers
University of the Incarnate Word Illinois Central College
San Antonio, Texas Peoria, Illinois
xii
Reviewers xiii
Brenda D . Tilton, RN, MSN, FNP-BC Vickie Walker, DNP, RN
Assistant Professor of Nursing Assistant Professor of Nursing
School of Nursing School of Nursing
Southern State Community College Gardner-Webb University
Hillsboro, Ohio Boiling Springs, North Carolina