NR 324-exam 1 fluid and electrolytes
and respiratory
paO2 - answer80-100 mm Hg
pH - answer7.35-7.45
low pH - answer acidic
high pH - answeralkalosis
pa CO2 - answer35-45 mm Hg
HCO3 - answer22-26 mEq/L
respiratory acidosis - answerlow pH, high co2, normal bicarbonate
causes of respiratory acidosis - answerrespiratory depression from anesthesia,
overdose, increased intracranial pressure, airway obstruction from decreased alveolar
capillary diffusion like pneumonia, COPD, ARDS, AND PE
signs/symptoms of respiratory acidosis - answerhypoventilation (hypoxia), rapid,
shallow respirations, decrease in BP, skin/mucous pale to cyanotic, headache,
hyperkalemia, dysrhythmias, drowsiness, dizziness, disorientation, muscle weakness,
hyperreflexia
Nursing management of respiratory acidosis - answerventilator, arterial blood gas, low-
dose oxygen in chronic conditions, high-dose oxygen in acute hypoxia with acidosis,
I/O, promote the release of CO2, turn/cough/deep breathe, assume semi-high fowlers
position, clear respiratory secretions, colors of skin, mucous membranes
respiratory alkalosis - answerhigh pH, low co2 and normal bicarbonate
causes of respiratory alkalosis - answerhigh pH, low co2 and hyperventilation, initial
stages of pulmonary emboli, hypoxia, fever, pregnancy, high altitudes, and anxiety
signs/symptoms of respiratory alkalosis - answerseizures, deep/rapid breathing,
hyperventilation, tachycardia, decrease BP, hypokalemia, numbness/tingling in
extremities, lethargy/confusion, light headedness, N/V
, nursing management of respiratory alkalosis - answerkidneys retain H+ ions, use a
rebreather mask or paper bag, sedatives, monitor respiratory rate/depth, tachycardia,
low BP, serum K+ levels/ECG levels, hydration status I/O, check for toxicities
metabolic acidosis - answerlow ph, normal co2 and low bicarbonate
metabolic acidosis signs/symptoms - answercompensatory hyperventilation (kussmaul
respirations), headache, decreased BP, hyperkalemia, muscle twitching, warm/flushed
skin, N/D/V, changes in LOC,
causes of metabolic acidosis - answerlow ph/low bicarbonate, diabetic ketoacidosis,
shock, sepsis, severe diarrhea, and renal failure
what goes up in acidosis - answerpotassium
metabolic acidosis nursing management - answerBUN, creatinine,
hemoglobin/hematocrit levels, monitor hydration, turn/cough/deep breathe, ABG's,
check K, Ca usually goes down, weights, vitals
metabolic alkalosis - answerhigh ph, normal co2, and high hco3
causes of metabolic alkalosis - answerhigh ph, high bicarb and severe vomiting,
excessive GI suctioning, diuretics, and excessive NaHCO3
metabolic alkalosis signs/symptoms - answerrestlessness (lethargy), confusion, dizzy,
irritable, dysrhythmias, compensatory hypoventilation, N/V/D, tremors, muscle cramps,
tingling of fingers and toes, dehydration
metabolic alkalosis nursing management - answermonitor ECG's, ABG's for pH, K, Ca
levels, LOC checks for tetany, tremors, muscle cramps, tingling,
what is hyperkalemia frequently associated with - answermetabolic acidosis
what is a compensatory mechanism for metabolic alkalosis - answerdecreased
respiratory rate and depth to retain CO2 and kidney excretion of bicarbonate
excessive intake causes - answerrapid oral ingestion of water, infusions of D5%W
hypotonic fluid at excess, massive replacement of water without NA
decreased output causes - answerrenal failure
fluid volume excess causes - answerheart failure, water intoxication, liver cirrhosis,
SIADH, lung cancer, renal failure, primary polydipsia, long term use of cortiosteroids
fluid volume excess clinical manifestations - answerheadache, JVD, increased weight,
edema, ascites, elevated blood pressure, crackles in lungs, confusion, decreased urine
and respiratory
paO2 - answer80-100 mm Hg
pH - answer7.35-7.45
low pH - answer acidic
high pH - answeralkalosis
pa CO2 - answer35-45 mm Hg
HCO3 - answer22-26 mEq/L
respiratory acidosis - answerlow pH, high co2, normal bicarbonate
causes of respiratory acidosis - answerrespiratory depression from anesthesia,
overdose, increased intracranial pressure, airway obstruction from decreased alveolar
capillary diffusion like pneumonia, COPD, ARDS, AND PE
signs/symptoms of respiratory acidosis - answerhypoventilation (hypoxia), rapid,
shallow respirations, decrease in BP, skin/mucous pale to cyanotic, headache,
hyperkalemia, dysrhythmias, drowsiness, dizziness, disorientation, muscle weakness,
hyperreflexia
Nursing management of respiratory acidosis - answerventilator, arterial blood gas, low-
dose oxygen in chronic conditions, high-dose oxygen in acute hypoxia with acidosis,
I/O, promote the release of CO2, turn/cough/deep breathe, assume semi-high fowlers
position, clear respiratory secretions, colors of skin, mucous membranes
respiratory alkalosis - answerhigh pH, low co2 and normal bicarbonate
causes of respiratory alkalosis - answerhigh pH, low co2 and hyperventilation, initial
stages of pulmonary emboli, hypoxia, fever, pregnancy, high altitudes, and anxiety
signs/symptoms of respiratory alkalosis - answerseizures, deep/rapid breathing,
hyperventilation, tachycardia, decrease BP, hypokalemia, numbness/tingling in
extremities, lethargy/confusion, light headedness, N/V
, nursing management of respiratory alkalosis - answerkidneys retain H+ ions, use a
rebreather mask or paper bag, sedatives, monitor respiratory rate/depth, tachycardia,
low BP, serum K+ levels/ECG levels, hydration status I/O, check for toxicities
metabolic acidosis - answerlow ph, normal co2 and low bicarbonate
metabolic acidosis signs/symptoms - answercompensatory hyperventilation (kussmaul
respirations), headache, decreased BP, hyperkalemia, muscle twitching, warm/flushed
skin, N/D/V, changes in LOC,
causes of metabolic acidosis - answerlow ph/low bicarbonate, diabetic ketoacidosis,
shock, sepsis, severe diarrhea, and renal failure
what goes up in acidosis - answerpotassium
metabolic acidosis nursing management - answerBUN, creatinine,
hemoglobin/hematocrit levels, monitor hydration, turn/cough/deep breathe, ABG's,
check K, Ca usually goes down, weights, vitals
metabolic alkalosis - answerhigh ph, normal co2, and high hco3
causes of metabolic alkalosis - answerhigh ph, high bicarb and severe vomiting,
excessive GI suctioning, diuretics, and excessive NaHCO3
metabolic alkalosis signs/symptoms - answerrestlessness (lethargy), confusion, dizzy,
irritable, dysrhythmias, compensatory hypoventilation, N/V/D, tremors, muscle cramps,
tingling of fingers and toes, dehydration
metabolic alkalosis nursing management - answermonitor ECG's, ABG's for pH, K, Ca
levels, LOC checks for tetany, tremors, muscle cramps, tingling,
what is hyperkalemia frequently associated with - answermetabolic acidosis
what is a compensatory mechanism for metabolic alkalosis - answerdecreased
respiratory rate and depth to retain CO2 and kidney excretion of bicarbonate
excessive intake causes - answerrapid oral ingestion of water, infusions of D5%W
hypotonic fluid at excess, massive replacement of water without NA
decreased output causes - answerrenal failure
fluid volume excess causes - answerheart failure, water intoxication, liver cirrhosis,
SIADH, lung cancer, renal failure, primary polydipsia, long term use of cortiosteroids
fluid volume excess clinical manifestations - answerheadache, JVD, increased weight,
edema, ascites, elevated blood pressure, crackles in lungs, confusion, decreased urine
