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Nerve and muscle firing is a difficult concept for students, involving as it doe

ID: 276030 • Letter: N

Question

Nerve and muscle firing is a difficult concept for students, involving as it does the rather abstract concepts of ion channels and electric potentials. Once they have memorized the basics, however, a horde of fascinating clinical applications open up. Perhaps the most important of these is potassium's control of resting potential and the consequences for cell firing. The case goes further to introduce a second ion that affects excitable tissues Ca2+ , which the doctor uses as emergency treatment for the patient's hyperkalemia. While K+ affected resting potential, Ca2+ affects Na+ channels and therefore threshold potential. Between them, they provide a review of some of the sticky concepts in nerve firing.

Mr. M is a Type 2 diabetic with diagnoses of (poorly controlled) hypertension and chronic renal failure. He has come in for a routine checkup and claims to be feeling fine, just a little tired. He presents as an overweight 58-year-old man with a sunburn on his cheeks and ears and a BAND-AID® on one cheek (where he says he nicked himself shaving that morning), a heart rate of 66 bpm, blood pressure of 124/80 mm Hg, normal breath and heart sounds, and slightly puffy ankles, face, and hands. His weight has increased by 1.5 lbs since he was last seen eight months ago.

Do you see anything to concern you in Mr. M's description?

There are several worrying signs in Mr. M's presentation. Can you pick them out?

Nurses Need Physiolo gy: Hyperkalemia and Excitable Tissues 16 of 18 Constants Periodic Table Nerve and muscle firing is a difficult concept for students, involving as it does the rather abstract concepts of ion channels and electric potentials. Once they have memorized the basics, however, a horde of fascinating clinical applications open up. Perhaps the most important of these is potassium's control of resting potential and the consequences for cell firing. The case goes further to introduce a second ion that affects excitable tissues Ca2+, which the doctor uses as emergency treatment for the patient's hyperkalemia. While Kt affected resting potential, Ca2+ affects Na* channels and therefore threshold potential Between them, they provide a review of some of the sticky concepts in nerve firing Part A A Type I Diabetic Mr. M is a Type 2 diabetic with diagnoses of (poorly controlled) hypertension and chronic renal failure. He has come in for a routine checkup and claims to be feeling fine, just a little tired. He presents as an overweight 58-year-old man with a sunburn on his cheeks and ears and a BAND-AID on one cheek (where he says he nicked himself shaving that morning), a heart rate of 66 bpm, blood pressure of 124/80 mm Hg, normal breath and heart sounds, and slightly puffy ankles, face, and hands. His weight has increased by 1.5 lbs since he was last seen eight months ago. Do you see anything to concen you in Mr. Ms description? There are several worrying signs in Mr. M's presentation. Can you pick them out? View Available Hint(s) His sunbum may cause skin cancer. His heart rate is lower than expected. The cut on his cheek may be infected. His tiredness might indicate worsening of his diseases. His puffy ankles, face, and hands could indicate fluid retention His blood pressure is prehypertensive. His blood pressure is low for someone with hypertension. His obesity is likely to make his diabetes worse Submit X Incorrect: Try Again, 2 attempts remaining

Explanation / Answer

Answer. His sunburn may cause skin cancer, should not be opted because he might be taking oral diabetes medication which must be containing sulphonyl urea and has the tendency of causing the sun burns on over exposure to sun. Thus, this option should be avoided.

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