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NURS 4390 Adult Health Theory > Week Two Modules > Flashcards

Week Two Modules Flashcards

1
Q

what two components are involved in acid-base balance?

A

the respiratory system and the renal system

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2
Q

the respiratory system:

the lungs help maintain a normal pH by excreting ___ and ____ through ____

the amount of CO2 in the blood directly relates to _____ concentration

A

CO2; water; expiration; carbonic acid concentration

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3
Q

with decreased respirations, more ____ remains in the blood

A

CO2

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4
Q

the renal system:

the body depends on the ____ to reabsorb and conserve all the _____ they filter

the kidneys will absorb more ____ to compensate for acidosis

A

kidneys; HCO3-; HCO3-

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5
Q

NORMAL ARTERIAL BLOOD GAS VALUES

what are the normal ranges for pH?

A

7.35-7.45

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6
Q

NORMAL ARTERIAL BLOOD GAS VALUES

what are the normal ranges for PACO2 (acid)?

A

35-45 mmHg

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7
Q

NORMAL ARTERIAL BLOOD GAS VALUES

what are the normal ranges for HCO3- (base)?

A

22-26

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8
Q

NORMAL ARTERIAL BLOOD GAS VALUES

what are the normal ranges for PaO2?

A

80-100 mmHg

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9
Q

why does respiratory acidosis happen?

A

when there is carbonic acid excess due to the person hypoventilating

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10
Q

what are some other causes of respiratory acidosis?

A

copd, sedative overdose, pneumonia, and pulmonary edema

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11
Q

why does respiratory alkalosis happen?

A

when there is a carbonic acid deficit which occurs with hyperventilation

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12
Q

what is the PRIMARY cause of respiratory alkalosis?

A

hypoxemia from acute pulmonary disorders

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13
Q

respiratory alkalosis can also occur due to ___, ____, and neurological disorders

A

pain; anxiety

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14
Q

why does metabolic acidosis happen?

A

this is due to base bicarbonate deficit

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15
Q

what are the two types of metabolic acidosis?

A

diabetic ketoacidosis; lactic acidosis

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16
Q

what are some issues that can lead to metabolic acidosis?

A

diarrhea, starvation, and shock

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17
Q

______: bicarbonate (base) excess

A

metabolic alkalosis

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18
Q

metabolic alkalosis occurs when there is a loss of acid due to ____ or _____ or a gain in HCO3- (ingesting ____)

A

vomiting; hypokalemia; baking soda

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19
Q

in RESPIRATORY CONDITIONS, the pH and CO2 go in _____ directions

in respiratory alkalosis, the pH is ___ and the PaCO2 is ____

in respiratory acidosis, the pH is ____ and the PaCO2 is ______

A

opposite; high; low; low; high

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20
Q

in METABOLIC CONDITIONS, the pH and HCO3- go in the ____ direction

in metabolic alkalosis, both the pH and HCO3- are ___

in metabolic acidosis, both the pH and HCO3- are ___

A

same; high; low

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21
Q

obstructive respiratory disorders cause an _____ or airway _____

A

airway obstruction; narrowing

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22
Q

what are some examples of obstructive respiratory disorders?

A

asthma, chronic bronchitis, copd, and emphysema

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23
Q

restrictive respiratory disorders ____ the ability of the ___ to move

A

impair; chest wall

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24
Q

what are some examples of restrictive respiratory disorders?

A

pneumonia; pneumothorax

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25
Q

what are some examples of vascular respiratory disorders?

A

pulmonary embolus; pulmonary edema

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26
Q

pneumonia is an acute infection of the ______

A

lung parenchyma

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27
Q

what are risk factors pneumonia?

A

abdominal surgery, age greater than 65, altered consciousness, chronic diseases

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28
Q

community acquired pneumonia is an acute infection of the lung occuring in patients who live in the community, such as a _____ or _____ within ___ days of onset of symptoms

A

long term care facility; skilled nursing facility; 14

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29
Q

community acquired pneumonia is the leading cause of ___ from ____

A

death; infection

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30
Q

hospital acquired pneumonia occurs in a ____, _____ patient 48 hours after admission and is not present at time of admission

A

hospitalized, non-intubated

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31
Q

ventilator acquired pneumonia occurs in patients who are _____ and happens ___ hours or longer after the patient was intubated

A

intubated; 48

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32
Q

both hospital acquired pneumonia and ventilator acquired pneumonia are associated with _____ stays

A

longer hospital

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33
Q

aspiration pneumonia occurs when a patient ____ protect their airway from ___ and _____

A

cannot; secretions; tube feedings

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34
Q

what are some risk factors that may cause a patient to not be able to protect the airway?

A

head injury, stroke, or anesthesia

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35
Q

what are some signs and symptoms of aspiration pneumonia?

A

fever, cough, chills, dyspnea, tachycardia, and WBC increase

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36
Q

when a patient has pneumonia, you can expect to hear what kinds of sounds in the lungs?

A

crackles, bronchial breath sounds, and wheezes

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37
Q

if the pneumonia patient is suffering from a fever what are some nursing interventions you can perform?

A

apply a cold cloth to forehead, administer acetaminophen prn

38
Q

if the pneumonia patient is suffering from chills what are some nursing interventions you can perform?

A

apply warm blankets, put socks on the feet

39
Q

patients with pneumonia are often times _____ due to increased work of breathing so what is encouraged?

A

dehydrated; oral fluids are encouraged and IVFs are often administered

40
Q

patients with pneumonia may require a _____ and more frequent, smaller meals

A

high calorie diet

41
Q

what causes a pneumothorax?

A

air entering the pleural space

42
Q

if a patient has a “small” pneumothorax what are some s/s we could expect to see?

A

mild tachycardia and dyspnea

43
Q

if a patient has a “large” pneumothorax what are some s/s we could expect to see?

A

respiratory distress, shallow breathing, and oxygen desaturation

44
Q

spontaneous pneumothorax happens when a _____, which is an air filled sac on the surface of the lung _____

A

small bleb; ruptures

45
Q

what kind of characteristics make an individual “high risk” for developing blebs?

A

smokers, people who are tall, males, and thin

46
Q

a spontaneous pneumothorax is considered a ______ pneumothorax

A

closed

47
Q

what can cause a traumatic pneumothorax to occur?

A

stab wound or fence post penetration

48
Q

a traumatic pneumothorax is considered ______ because there is air ____ into the pleural space

A

open; moving

49
Q

what type of pneumothorax is considered a medical emergency?

A

tension pneumothorax

50
Q

why is a tension pneumothorax considered an emergency?

A

because air puts pressure on the heart and the vessels making the cardiovascular system compromised

51
Q

what are some s/s of a tension pneumothorax?

A

tachycardia, severe dyspnea, and diaphoresis

52
Q

what is the purpose of a chest tube?

A

chest tubes help re-establish negative pressure by pulling out the air in the pleural space via suction

53
Q

chest tubes typically have ___ chambers

A

3

54
Q

the air collects in the _______ as it drains from the pleural space

A

collection chamber

55
Q

the ________ prevents backflow of air into the patient

A

water seal chamber

56
Q

the ______ applies suction to the chest drainage unit

A

suction control chamber

57
Q

what are some tips for nursing management of chest tube drainage systems?

A

never elevate the drainage system to the level of the chest because fluid can drain back into the lungs; do not clamp the chest tube during transport of the patient

58
Q

when should dressing changes for tube drainage systems be done?

A

changes should be done once a day or every 24 hours

59
Q

CHEST DRAINAGE TUBES

drainage of greater than 200mls in the first hour, can indicate _______ or any respiratory distress

A

subcutaneous emphysema

60
Q

if an individual has PACO2 levels > _____ this could be a sign of respiratory failure

A

45 mmHg

61
Q

what are some treatments for respiratory failure?

A

oxygen therapy, positioning, mobilization, and bronchodilators

62
Q

what are some types of noninvasive ventilatory supports?

A

CPAP and BiPAP

63
Q

what are some good candidates for noninvasive ventilatory supports?

A

hypercapnic respiratory failure and COPD

64
Q

what are some benefits of using noninvasive ventilatory support systems?

A

reduced work of breathing; improved gas exchange; shorter stays of ICU; decreased infection rates

65
Q

what are some complications of CPAP or BIPAP?

A

gastric detention; risk of aspiration; nasal congestion

66
Q

what are some ways to manage pneumothorax?

A

oxygen therapy, ongoing monitoring, and chest tube placement

67
Q

what is the defining characteristic of COPD?

A

airflow limitation that is not completely reversible during exhalation

68
Q

what causes airflow limitation in COPD?

A

its caused by loss of elastic recoil and airflow obstruction due to large amounts of mucus

69
Q

during the later stage of COPD the patient may develop problems with ______ as evidenced by lower PaO2

A

hypoxemia

70
Q

the major risk factor for developing COPD is _______

A

cigarette smoking

71
Q

cigarette smoking causes ______ of cells which increases _____

A

hyperplasia; mucus production

72
Q

alpha-1 antitrypsin deficiency is also known to cause what?

A

copd

73
Q

what are some signs and symptoms of COPD?

A

chronic cough, dyspnea, pursed lip breathing, barrel chest, tripod position (leaning forward) fatigue, and weight loss

74
Q

what are some potential problems of a patient with COPD?

A

hypoxemia with hypercapnia, anxiety, and weight loss related to increased wob

75
Q

what is a nursing priority for a patient who has COPD?

A

improve gas exchange - if the patient has a low O2 level you’ll want to increase the oxygen that the patient is receiving

76
Q

if a patient has COPD, on average their O2 sat will be between 88-92% so you’ll want to shoot for ____% O2 sat

A

90

77
Q

another treatment option for a patient with COPD would be to teach the patient ______ breathing

A

pursed lip breathing

78
Q

the purpose of pursed lip breathing is to ______, which prevents _____ and air-trapping

A

prolong exhalation; bronchiolar collapse

79
Q

patients with COPD will also require _____, high protein diet

A

high calorie

80
Q

it’s important to remember that a patient with COPD is using a lot of calories for breathing, so it’s important to remember to _______ at meal times

A

limit liquids

81
Q

what are some complications that can occur due to COPD?

A

acute exacerbations; respiratory failure; pulmonary hypertension; cor pulmonale

82
Q

what are acute exacerbations?

A

exacerbations are a worsening of baseline symptoms of dyspnea, cough, and sputum

83
Q

often times, during COPD, the nurses will give the patient an _____ to help increase the O2 sat

A

albuterol nebulizer

84
Q

with COPD, if the patient’s O2 sat continues to drop to less than 88% the patient will be placed on a ______

A

non rebreather mask

85
Q

what is respiratory failure?

A

occurs when oxygenation, ventilation, or both are inadequate

86
Q

when is a person considered to be in hypoxemic respiratory failure?

A

when the PaO2 is less than or equal to 60 mmHg with an FiO2 of 60% or more

87
Q

what causes pulmonary hypertension?

A

caused by the constriction of the pulmonary vessels from hypoxia

88
Q

alpha 1 antitrypsin deficiency can cause COPD because…

A

alpha 1 helps protect the lungs and breaks down inhaled pollutants so without it there is no protection

89
Q

what are signs and symptoms of metabolic alkalosis?

A

tachycardia, dysrhythmias, confusion, nausea, and vomiting

90
Q

what are signs and symptoms of respiratory alkalosis?

A

hyperventilation, tachycardia, dysrhythmias, vomiting, diarrhea, and confusion

NURS 4390 Adult Health Theory (9 decks)

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