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2120 Health and Illness Concepts II > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Acid-Base Balance definition

A

The process of regulating the pH, bicarbonate concentration, and partial pressure of carbon dioxide of body fluids

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2
Q

Acid

A

a substance that releases hydrogen ions

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3
Q

Base

A

a substance that takes up hydrogen ions

Bicarbonate is the most important base in the body

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4
Q

pH of a solution

A

a measure of its degree of acidity

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5
Q

Low pH

A

solution is acidic (<7.35)

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6
Q

High pH

A

solution is alkaline (>7.45)

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7
Q

Buffers

A

pairs of chemicals that take up hydrogen or release it to keep the pH in the normal range

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8
Q

Metabolic acidosis is caused by…

A
  1. noncarbonic acids increase
  2. bicarbonate is lost from the extracellular fluid
  3. cannot be regenerated by the kidney
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9
Q

Clinical manifestations of metabolic acidosis

A

Kussmaul respirations (deep, rapid respirations), anorexia, nausea, vomiting, diarrhea, abdominal pain

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10
Q

Early symptoms of metabolic acidosis

A

headache and lethargy

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11
Q

Severe symptoms of metabolic acidosis

A

life threatening arrhythmias and hypotension

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12
Q

Treatment of metabolic acidosis

A

treat underlying cause; if severe, administer bicarbonate IVP

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13
Q

Metabolic alkalosis is caused by…

A

increased bicarbonate due to excessive loss of metabolic acids

  • prolonged vomiting
  • GI suctioning
  • excessive bicarbonate intake (antacids(
  • diuretic therapy
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14
Q

Clinical manifestations of metabolic alkalosis

A

weakness, muscle cramps, hyperactive reflexes r/t volume depletion and electrolyte loss; respirations are slow and shallow;

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15
Q

Severe symptoms of metabolic alkalosis

A

confusion and seizures, tachycardia, arrhythmias

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16
Q

Treatment of metabolic alkalosis

A

treat underlying cause, sodium chloride for volume depletion, and potassium replacement

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17
Q

Respiratory acidosis can be caused by…

A
  1. alveolar hypoventilation
  2. airway obstruction
  3. COPD
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18
Q

Clinical manifestations of respiratory acidosis

A

headache, restlessness, blurred vision, apprehension, lethargy, muscle twitching, tremors, seizures, coma

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19
Q

Treatment of respiratory acidosis

A

treat underlying cause, possible mechanical ventilation, bronchodilators, oxygen

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20
Q

Respiratory alkalosis can be caused by:

A
  1. alveolar hyperventilation and decreased plasma CO2

2. pulmonary disease, congestive HF

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21
Q

Clinical manifestations of respiratory alkalosis

A

dizziness, confusion, tingling of extremities, seizures, coma

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22
Q

Treatment of respiratory alkalosis

A

treat underlying cause, possible mechanical ventilation

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23
Q

Interventions for neurologic changes

A

reorient x3, safety, work with family or other loved ones

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24
Q

Interventions for respiratory changes

A

bipap mask, ventilator

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25
Q

Interventions for GI changes

A

reglan (metoclopramide), H2 antagonists to control stomach acid, prevent stress ulcers

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26
Q

Interventions for arrhythmias

A

antiarrhythmics (amiodarone), Ca channel blockers (verapamil, diltiazem), beta blockers (metropolol)

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27
Q

Interventions for hypotension

A

vasopressor agents, dopamine, Ca channel blockers, levophed as last result

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28
Q

Base excess: (-2 to +2 mmol/L) measures

A

how well are the buffers managing metabolic acid

29
Q

BE < -2 mmol/L

A

too much metabolic acid

30
Q

BE > +2 mmol/L

A

too little metabolic acid

31
Q

Infiltrate

A

alveoli filled with fluid

32
Q

Consolidation

A

Lung tissue filled with fluid causing swelling/hardening of normally soft tissue

33
Q

Pulmonary edema

A

a life threatening condition associated with left ventricular failure that severely impairs gas exchange

34
Q

Clinical manifestations of pulmonary edema

A

crackles, dyspnea at rest, disorientation, tachycardia, hypertension or hypotension, reduced urinary output, cough, pink tinged sputum, PVs and other dysrhythmias, anxiety, restlessness

35
Q

Crackles

A

opening of alveoli which has collapsed from fluids

36
Q

Classic sign of pulmonary edema

A

pink, tinged sputum

37
Q

Nitroglycerin

A

Give every 5 minutes, up to 3 times

It decreases preload and afterload

38
Q

Emphysema

A

loss of lung elasticity, and hyperinflation of the lung

“pink bloaters”

39
Q

Chronic bronchitis

A

inflammation of the bronchi and brochioles

40
Q

Risk factors for COPD

A

active & passive smoking is greatest

41
Q

Complications of COPD

A

hypoxemia and acidosis, respiratory infection, and cardiac failure

42
Q

Medications for COPD

A

corticosteroids for inflammation, inhalors, mucolytics, nebulizor treatments

43
Q

Guillain-Barre Syndrome

A

an acute inflammatory demyelinating disease that affects the peripheral nervous system causing motor weakness and sensory abnormalities

44
Q

Clinical manifestations of Guillain-Barre Syndrome

A

ascending weakness, partial or total immobility, paralyzed respiratory muscles

45
Q

Three stages of Guillain-Barre Syndrome

A
  1. acute or initial period (1-4 weeks): begins with onset of symptom and ends with no further symptoms
  2. plateau period (several days to 2 weeks): ascending weakness stops
  3. recovery phase (4-6 months, maybe 2 years): descending weakness until there is recovery
46
Q

Drug for Guillain-Barre Syndrome

A

IgA: effective in ambulatory patients early on in disease
Plasmapheresis: for paralysis, it removes circulating antibodies

47
Q

Clotting

A

a physiologic process in which blood is converted from a liquid to a semi-solid gel

48
Q

Risk factors for clotting

A

Age, genetics, immobility, and smoking

49
Q

Thrombocytopenia

A

a reduction in the number of platelets

50
Q

Platelet count <30,000

A

susceptible to uncontrolled bleeding with injury

51
Q

Platelet count <6,000

A

susceptible to spontaneous bleeding in the brain

52
Q

Polycythemia

A

production and presence of too many RBCs

53
Q

Prothrombin time (PT)

A

11-12.5 seconds
Extrinsic pathway
for cumadin (warfarin)

54
Q

INR

A

1.1-1.2
therapeutic: 2.5-3.5
for cumadin (warfarin)

55
Q

Partial thromboplastin time (PTT)

A

30-40 seconds
therapeutic: 1.5-2.5
Intrinsic
for heparin

56
Q

Clopidogrel (plavix)

A

Antiplatelet

adverse effect: brain hemorrhage

57
Q

Streptokinase t-PA

A

given in ER for stroke unless there is active bleeding in the brain (need CT scan)
3hr window from when symptoms started

58
Q

DIC

A

widespread clotting uses up existing clotting factors and platelets

59
Q

clinical manifestations of DIC

A

pain, stroke like symptoms, dyspnea, tachycardia, decreased kidney function, bowel necrosis

60
Q

medication therapy for DIC

A

ampheteracin B

61
Q

Sickle cell disease

A

a genetic disorder that results in chronic anemia, pain, disability, organ damage, risk for infection and early death

62
Q

How many alpha and beta chains of amino acids does a healthy adult have?

A

2 alpha chains, and 2 beta chains

63
Q

What percentage of hemoglobin A does a healthy adult have?

A

98-99%

64
Q

What percentage of hemoglobin S does a person with sickle cell disease have?

A

40%

65
Q

Clinical manifestations of sickle cell disease

A

Pain (due to block of blood flow), pallor or cyanosis, jaundice from RBC destruction, hepatomegay, splenomegaly, kidney damage

66
Q

Number one nursing intervention for sickle cell disease

A

Pain management

67
Q

Hemophilia

A

Hemophilia A is more common
-deficiency of facto VII
Hemophilia B
-deficiency of factor IX

68
Q

Clinical manifestations of hemophilia

A

abnormal bleeding, bruising easily

2120 Health and Illness Concepts II (3 decks)

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