Test 2 Acide/base fluid/electrolytes

Question 1

Respiratory acidosis labs and caused by

Answer 1

low pH, Hi pCO2 and normal bicarb. anything that causes hypoventilation: asthma, copd, pneumonia, pulmonary edema. CNS depression due to meds, brain injury, neuromuscular diseases. gillian barr syndrome (ineffective resp. pump)

Question 2

normal bicarb range

Answer 2

22-26

Question 3

resp alkalosis labs and causes

Answer 3

high pH, low pCO2, normal bicarb. anything that causes hyperventilation- anxiety, fear, acute pain, increase metabolic demand (fever, sepsis, pregnancy), head injury meningitis

Question 4

metabolic acidosis labs and causes

Answer 4

low pH, norm CO2, low bicarb. loss of bicarb (diarrhea) or increase acid- produce ketones faster than kidneys can excrete. diabetic ketoacid, renal failure, anaerobic respirs, starvation, asa overdose. lactic acid (hypoxemia), thyroid storm

Question 5

metabolic alkalosis labs and causes

Answer 5

high pH, norm CO2, hi bicarb. excess base (antacid, lactate in dialysis. or loss of acid (vomiting, GI sxn, hypochloremia, excess diuretic, excess aldosterone. Shift of H into cells (out of blood) from hypokalemia.

Question 6

fully compensated

Answer 6

pH normal, other numbers out of whack. end of pH spectrum closer to gives primary imbalance and other figure that follows that primary tells if it is metabolic or resp- youtube on bb.

Question 7

At risk for Acid base imbalance have at least 1 of these 4

Answer 7

1. excessive production or intake of met. acid
2. altered acid buffering due to loss or gain of bicarb
3. Altered Acid exertion
4. abnormal shift of h into cells

Question 8

hypokalemia causes what acid base imbalance

Answer 8

k shifts out of cells and into blood in response to low level, but has to exchange with H. H shifts out of blood- reducing the acid causing metabolic alkalosis.

Question 9

Nursing DXs for hypernatremia

Answer 9

Risk for injury, potential complication: seizures and coma leading to irreversible death (neuro decline), risk for fluid vol deficit (water loss), risk for electrolyte imbalance (excess na intake)

Question 10

nursing dxs for hyperkalemia

Answer 10

risk for activity intolerance and risk for injury (lower extremity muscle weakness), risk for electrolyte imbalance, potential complication- dysrhythmias

Question 11

nursing dx for hyponatremia

Answer 11

acute confusion, risk for injury and electrolyte imbalance, potential complication: severe neurologic changes

Question 12

hyponatremia tx

Answer 12

hyertonic fluid to replace the sodium (3% or 5% Saline careful and controlled to avoid vascular overload- monitor lung sounds, neuro. seizure precautions, restrict fluid, heart failure- give loop and ACEI, monitor I&O, daily weight, change pos slowly

Question 13

hypernatremia tx

Answer 13

Hypo or iso fluid to dilute blood, loop diuretics, monitor LOC, safety, heart rhythm, lung sounds, oral hygiene/comfort, I&O. seizure precautions. notify of inadequate renal output.

Question 14

hypokalemia tx

Answer 14

slow IV diluted KCl to replaceK (no bolus or push), monitor urine output, cardiac rhythm, dig (inc risk dig tox), LOC, bowl sounds, abd distention, kidney fun, other electrolytes, assist with ADLs

Question 15

Hyperkalemia tx

Answer 15

IV infusion insulin or sodiumBicarb to move K from cells to blood. Loop diuretic or kayexalate to excrete K. If extreme- hemodialysis, clacium gluconate IV (protects heart by reversed membrane effect).monitor cardiac rhythm, asses resp and neuro status.

Question 16

poor skin turger

Answer 16

fvd

Question 17

cold clammy skin

Answer 17

na deficit, shift of plasma to interstitial fluid

Question 18

pitting edema

Answer 18

fluid vol excess

Question 19

flushed dry skin

Answer 19

na excess

Question 20

bounding pulse

Answer 20

fluid vol excess, shift of interstitial fluid to plasma

Question 21

rapid, weak thready pulse

Answer 21

shift of plasma to interstitial fluid, na deficit fluid vol deficit

Question 22

rapid weak irregular pulse

Answer 22

severe k deficit

Question 23

slow weak irregular pulse

Answer 23

severe k excess

Question 24

hypotension

Answer 24

fvd, shift of plasma to interstitial fluid, na deficit

Question 25

hypertension

Answer 25

fve, shift of interstitial fluid to plasma

Question 26

deep, rapid breathing

Answer 26

compensation for met acidosis

Question 27

shallow slow irregular breathing

Answer 27

compensation for met alkalosis (or cause of rest acidosis)

Question 28

sob

Answer 28

fluid vol excess- listed to lungs for crackles

Question 29

moist crackles

Answer 29

fluid vol excess, shift of interstitial fluid to plasma

Question 30

restricted airway

Answer 30

calcium deficit

Question 31

cramping of exercised muscle

Answer 31

calcium or mg deficit, alkalosis

Question 32

carpa spasm (trousseaus sign)

Answer 32

ca deficit, mg deficit or alkalosis

Question 33

flabby muscles

Answer 33

k deficit

Question 34

pos chvosteks sign

Answer 34

ca deficit, mg deficit, alkalosis

Question 35

picking at bedclothes

Answer 35

k or mg deficit

Question 36

indifference

Answer 36

fvd, na deficit

Question 37

apprehension

Answer 37

shift of plasma to interstitial

Question 38

extreme restlessness

Answer 38

k or na excess, fluid vol defecit

Question 39

confusion and irritability

Answer 39

k deficit, fve, ca mg or h2o excess, na deficit

Question 40

decreased LOC

Answer 40

na deficit, H2O excess