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Med and Surge Adult 2 > AGB > Flashcards

AGB Flashcards

1
Q
A
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2
Q

a) pH
b) PaCO2
c) HCO3
d) PaO2
e) SaO2

A

a) 7.35-7.45
b) 35-45
c) 22-26
d) 80-100
e) 95-100%

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3
Q

Acid? base?
a) HCO3
b) CO2
c) H+

A

a) base
b) acid
c) acid

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4
Q

Weak Buffers
a) what is it?
b) waht are they?
c) what is the most abundant buffering system in the body?

A

a) Weaker in affecting the pH balance but faster in correcting
b) Ammonia Buffering System
Phosphate Buffering System
Protein/Hemoglobin Buffering System
Potassium Regulation
c) Protein/Hemoglobin Buffering System

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5
Q

Strong Buffers
a) what is it?
b) waht are they?

A

a) stronger in affecting the pH balance for severe imbalances but takes more time
b) Carbonic Acid-Bicarbonate System

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6
Q

Respiratory Acidosis Causes
a) low or rapid RR?
b) what’s causes? pulmonary
c) what’s causes? non pulmonary

A

a) slow RR
Hypoventilation
b) Respiratory disease
-COPD, pneumonia, asthma attack,pulmonary edema
Resp. muscle weakness (hypokalemia, obesity, neurological dysfunction)
Mechanical hypoventilation
Post-ope
c) apnea
Sepsis
opioid(molphine)
head trauma
benzodiazepines

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7
Q

Respiratory Acidosis Diagnosis Labs
K and ca level?

A

ABGs, chemistry, CBC
Hyperkalemia
Hypercalcemia

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8
Q

Respiratory Acidosis
Manifestations

A

Anxiety,Fatigue
Headache
Dysrhythmias, Tachycardia, and Hypotension
Warm and flushed skin
Muscular twitching
Hypoventilation with Hypoxia

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9
Q

Respiratory Acidosis
Nursing Interventions

A

Oxygen therapy for hypoxemia
Maintain patent airway
Position HOB
Suction
Seizure precautions

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10
Q

Respiratory Alkalosis Causes
a) low or rapid RR?
b) what’s causes? pulmonary
c) what’s causes? non pulmonary

A

a) fast
b) Hyperventilation due to Hypoxemia
b) Acute pain
Anxiety/sobbing
Panic attack
Exercise
Pregnancy

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11
Q

Respiratory Alkalosis
Manifestations

A

Increased rate and depth respirations
Anxiety, confusion followed by decreased LOC
Paresthesias, muscle cramps, seizures
Nausea, vomiting, diarrhea
Dysrhythmias, palpations, tachycardia
Positive Chvostek sign
Positive Trousseau sign

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12
Q

Respiratory Alkalosis
Nursing Interventions

A

Oxygen therapy for hypoxemia
Anxiety reducing techniques
Pain med
Rebreathing techniques
-Breathe into a paper bag
Seizure precautions

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13
Q

a) A nurse is assessing a patient who is experiencing a panic attack, assuming the patient is exhibiting signs of respiratory alkalosis. What about the panic attack is causing the respiratory alkalosis?
b) A 45-year-old male patient who has COPD reports having a headache, hypotension, and muscle weakness. During your assessment you find dysrhythmias and hyperkalemia. What acid-base balance disorder is this patient presenting with?

A

a) Excess exhalation of CO2
b) Respiratory acidosis

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14
Q

Metabolic Acidosis Causes
a) cause inc acid
b) cause dec base

A

a) renal failur (retain H+)
DKA
Tissue hypoxia (sepsis, MI)
burns
b) diarrhea
severe dehydration
renal failur(failu to reabosr base)

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15
Q

Metabolic Acidosis
Manifestations

A

Weakness, Lethargy
Fatigue, twitching
Nausea, vomiting, diarrhea, abdominal pain
Kussmaul’s respirations and dyspnea
hypotension, bradycardia, decreased cardiac output, weak pulses
Warm, flushed skin

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16
Q

Metabolic Acidosis
Nursing Interventions

A

DKA
-administer insulin and fluids
GI losses
-antidiarrheals and hydration
Bicarb losses
-IV sodium bicarbonate 1 mEq/kg
Assess anion gap

17
Q

a) T or F
The anion gap helps determine if a patient has metabolic or respiratory acidosis”
b) A patient with a history of uncontrolled diabetes presents with headaches, hyperkalemia, and vasodilation. What type of acid base imbalance is the patient experiencing?
c) Crohn’s disease is which imbalamce?

A

a) F
because the anion gap helps determine the cause of metabolic acidosis.
b) metabolic acidosis
c) metabolic acidosis

18
Q

Metabolic Alkalosis Causes
a) inc biocarb
b) dec biocarb

A

a) antacids
b) vomiting
too much NG suctioning
K wasting diuretic

19
Q

Metabolic Alkalosis
Manifestations

A

Mental confusion
Weakness,spasms, paresthesias
increased deep tendon reflexes
Nausea, vomiting, anorexia
Tachycardia, dysrhythmias
Hypoventilation

20
Q
A
21
Q

4 day hx weakness, lethargy, fever, N/V, abd pain, confused, extreme thirst, polyuria. DM1, HTN. Glucose 500.
pH 7.20
PaCO2 27
HCO3 18
PaO2 60
SaO2 90%
a) Identify imbalance?
b) What caused imbalance?
c) Identify s/sx the pt would exhibit?
d) What nursing interventions would you implement?

A

a) Metabolic acidosis partial compensation
b) DKA
c) Weakness, lethargy, fever, N/V, abd pain, extreme thirst, confused, polyuria, kussmal respirations
d) Fluids, draw labs, then insulin IV push or insulin drip, bicarb, need O2 to bring up PaO2

22
Q

A 44 year old admitted to the ER following ingestion of a bottle of her son’s Phenobarbital. She is non-responsive and breathing at 6-8 shallow breaths per minute. Room air ABG’s are:
pH 7.30
PaCO2 54
HCO3 24
PaO2 56
Sa02 88%
a) Imbalance?
b) What caused the imbalance?
c) Identify S/S? S
d) What nursing diagnosis?
e) What nursing interventions?

A

a) Respiratory acidosis with absent compensation
b) hypoventilating
c) Slow, shallow breaths
d) Ineffective breathing pattern; inadequate tissue perfusion; impaired gas exchange
e) Intubate (ambu bag until you can intubate)

23
Q

68 yr old male with a history of AMI and CHF. He was admitted to the telemetry unit in mild pulmonary edema 3 days ago and has been treated with digoxin, furosemide, a low sodium diet, and oxygen therapy.He refused breakfast saying he was not hungry.
pH 7.50
PaCO2 49
HCO3 34
PaO2 88
Sa02 92%
a) Imbalance?
b) What caused the imbalance?
c) Identify S/S?
d) What interventions?

A

a) Metabolic alkalosis with partial compensation (PaCO2 is increased)
b) Prolonged diuretic therapy to tx HF
c) Digoxin toxicity (not hungry, n/v, abdominal pain,low hypokalemia and low mag)
d) Adjust electrolytes, K replacement

24
Q

72 yr old male diarrhea for several days. Tried over the counter meds and has been careful with his diet. However, diarrhea has worsened, and he is too nauseated to continue oral intake.
pH 7.32
PaCO2 29
HCO3 15
PaO2 92
SaO2 96%
a) Imbalance?
b) What caused?
c) Identify s/s?
d) nursing interventions?

A

a) Metabolic acidosis with partial compensation
b) Diarrhea
c) Dehydration,vitals low, orthostatic hypotension
d) Fluids, electrolyte replacement

25
Q

62-year-old female, moderately obese, post-op abdominal hysterectomy 2 days ago. Uncomplicated post op course has ambulated several times. Resting in bed, sudden onset chest pain, shallow RR 28-32, extremely anxious, c/o “breathlessness.” B/P 140/80, HR 124.
Tachypnea is quick, shallow breathing
pH 7.49
PaCO2 29
HCO3 22
PaO2 62
Sa02 90%
a) ABG analysis?
b) What caused?
c) What nursing interventions?

A

a) Respiratory alkalosis with no compensation
b) Hyperventilating
c) Elevate HOB, 100% NRB

26
Q

PACU RN has a client recovering from surgery. The client has been receiving IV morphine sulfate 4 mg for pain. RN notices a RR 8.
pH 7.15
PaCO2 64
HCO3 22
PaO2 50
SaO2 87%
a) Imbalance?
b) What caused the imbalance?
c) Identify S/S
d) What nursing interventions?

a) Respiratory acidosis with no compensation
b) Respiratory depression from opioid
c) Decreased RR
d) Give O2, Bag valve mask, give Narcan

A

a) Respiratory acidosis with no compensation
b) Respiratory depression from opioid
c) Decreased RR
d) Give O2, Bag valve mask, give Narcan

Med and Surge Adult 2 (21 decks)

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