Unit 3 Flashcards
What are s/s of respiratory acidosis?
Increased HR and cardiac output
Hyperkalemia
Shallow, rapid respiration
Skin/mucous membranes pale and cyanotic
Muscle weakness
What are s/s of metabolic acidosis?
Increased HR and cardiac output
Hyperkalemia
Kussmauls respiration
Vasodilation (skin warm, red, dry)
Muscle weakness
What are s/s of alkalosis?
Agitation
Dizziness
Tetany (continuous contractions)
Chvosteks and trousseaus
Tachycardia
HTN
Muscle weakness
Tingling/numbness
What are causes of metabolic acidosis?
DKA
Shock
Sepsis
Diarrhea
Renal failure
Intermittent fasting
Dehydration
Aspirin
What are causes of metabolic alkalosis?
Loss of gastric juices (NG suctioning, vomiting)
K+ wasting diuretics
Overuse of antacids (TUMS)
What are causes of respiratory acidosis?
Hypoventilation
Opioid overdose
Pulmonary edema
Chest trauma
COPD and other diseases affecting muscle
Airway obstruction
What are causes of respiratory alkalosis?
Hyperventilation
Initial stages of pulmonary emboli
Anxiety
High altitudes
Hypoxia
Pregnancy
Fever - increases metabolic demand, increasing respiratory rate
What are normal HCO3, PaCO2, and pH lvls?
pH: 7.35-7.45 (anything about 7.8 or below 6.8 leads to death)
PaCO2: 35-45
HCO3: 22-26
What are risk factors for DKA?
Insulin deficiency
Infection is #1
Stress
What are s/s of DKA?
Ketones
High blood sugar (>250)
Polydipsia
Polyuria
Polyphagia
N/V
Dehydration
Coma
Weight loss
pH <7.35
What are treatment for DKA?
IV bolus 15-20mL/kg/hr for 1st hour
Give a hypotonic solution (4-14mL/kg/hr) over the next couple of hours
Once blood glucose is 250 give D5 in 1/2NS
Give insulin to decrease glucose - monitor for hypoglycemia and hypokalemia
What are risk factors for HHS?
Hyperglycemia
Dehydration
MI
Sepsis
Pancreatitis
Stroke
Drugs
What are s/s of HHS?
pH>7.4
BG >600
No ketones
Polyuria
Polydipsia
Weight loss
Dry skin
Sunken eyes
Soft eyeballs
Lethargy
Coma
Blood osmolarity >320
What is the treatment for HHS?
Replace fluids with NS (for shock and hypotension) or 1/2 NS to restore blood volume at 1L/hr until BP and urine output are adequate.
Decrease to 100-200mL/hr after
Assess for cerebral edema!! - don’t drop glucose more than 100/hr
What is normal fasting glucose? DM2? Prediabetic?
Normal: 70-100
DM2 >125
Prediabetic: 100-125
What is normal A1c?
<6.5%
What should the patients and families know about DKA and HHS?
How to manage insulin
How to check sugars
What to do on sick days
