NUR390 ALL UPDATED EXAMS SCRIPT
QUESTIONS AND ANSWERS SURE A+
✔✔Hypokalemia: Causes and protocol - ✔✔Cause: Excessive diuresis with loop
diuretic; clients who are receiving IV insulin for treatment of DKA and alkalosis.
Protocol:
Potassium replacement.
SAFETY CONSIDERATIONS
1. Never give Potassium IM or SQ (causes tissue necrosis).
2. Never give Potassium IV push (causes cardiac arrest)
3. Potassium IV piggyback should be given no faster than 10meq/hr.
✔✔EKG findings for electrolyte disturbance - ✔✔Hypokalemia: Flattened T wave,
depressed ST segment, heart block and fatal arrhythmias.
Hyperkalemia: Tall, peaked T waves and fatal arrhythmias like ventricular fibrillation or
cardiac standstill.
✔✔What is Metabolic Acidosis? - ✔✔Cause: DKA, Renal Failure, lactic acidosis from
sepsis, excessive diarrhea or liver failure (aspirin overdose)
S/S: COMA; hypovolemic shock, hyperkalemia
, ✔✔What is Metabolic Alkalosis? - ✔✔Cause: V/D, NG suction - loss of hydrogen; too
many antacids; Potassium depletion (thiazide diuretics)
S/S: 1. Electrolyte imbalances & fluid volume deficit (hypovolemic shock)
✔✔What is Respiratory Acidosis? - ✔✔Cause: 1. COPD, resp depression (think
opioids/narcotics), inadequate chest expansion (penumothorax, atelectasis), PE, brain
injury
S/S: Lethargy, confusion, headache, dizziness, coma, hypotension, ventricular
fibrillation related to hyperkalemia, warm, flushed skin, and seizures
✔✔What is Respiratory Alkalosis? - ✔✔Cause: Any process that causes prolonged
tachypnea or hypoxemia (panic attacks, hyperventilation, liver failure)
S/S: Assess for circumoral numbness and tingling or numbness and tingling of the
fingers
✔✔Respiratory Acidosis Compensation - ✔✔Problem: The lungs are retaining too much
CO2
Compensation: The kidneys excrete excess H+and retain BICARB (HCO3)
✔✔Respiratory Alkalosis Compensation - ✔✔Problem: The lungs are losing too much
CO2
Compensation: The kidneys excrete excess BICARB (HCO3) and retain H+
✔✔Metabolic Acidosis Compensation - ✔✔Problem: Too much H+, too little BICARB
(HCO3)
Compensation: Lungs blow off CO2 (increased resp)
✔✔Metabolic Alkalosis Compensation - ✔✔Problem: Too much BICARB (HCO3), loo
little H+
Compensation: Lungs will retain CO2 (decreased resp)
✔✔Anticipated lab causing identified ABG - ✔✔Respiratory Alkalosis: pH over 7.45,
paCO2 under, normal or low HCO3
Metabolic Alkalosis: pH over 7.45, high HCO3 (over 28), increased or normal paCO2
Metabolic Acidosis: pH < 7.35, low HCO3, paCO2 low or normal
QUESTIONS AND ANSWERS SURE A+
✔✔Hypokalemia: Causes and protocol - ✔✔Cause: Excessive diuresis with loop
diuretic; clients who are receiving IV insulin for treatment of DKA and alkalosis.
Protocol:
Potassium replacement.
SAFETY CONSIDERATIONS
1. Never give Potassium IM or SQ (causes tissue necrosis).
2. Never give Potassium IV push (causes cardiac arrest)
3. Potassium IV piggyback should be given no faster than 10meq/hr.
✔✔EKG findings for electrolyte disturbance - ✔✔Hypokalemia: Flattened T wave,
depressed ST segment, heart block and fatal arrhythmias.
Hyperkalemia: Tall, peaked T waves and fatal arrhythmias like ventricular fibrillation or
cardiac standstill.
✔✔What is Metabolic Acidosis? - ✔✔Cause: DKA, Renal Failure, lactic acidosis from
sepsis, excessive diarrhea or liver failure (aspirin overdose)
S/S: COMA; hypovolemic shock, hyperkalemia
, ✔✔What is Metabolic Alkalosis? - ✔✔Cause: V/D, NG suction - loss of hydrogen; too
many antacids; Potassium depletion (thiazide diuretics)
S/S: 1. Electrolyte imbalances & fluid volume deficit (hypovolemic shock)
✔✔What is Respiratory Acidosis? - ✔✔Cause: 1. COPD, resp depression (think
opioids/narcotics), inadequate chest expansion (penumothorax, atelectasis), PE, brain
injury
S/S: Lethargy, confusion, headache, dizziness, coma, hypotension, ventricular
fibrillation related to hyperkalemia, warm, flushed skin, and seizures
✔✔What is Respiratory Alkalosis? - ✔✔Cause: Any process that causes prolonged
tachypnea or hypoxemia (panic attacks, hyperventilation, liver failure)
S/S: Assess for circumoral numbness and tingling or numbness and tingling of the
fingers
✔✔Respiratory Acidosis Compensation - ✔✔Problem: The lungs are retaining too much
CO2
Compensation: The kidneys excrete excess H+and retain BICARB (HCO3)
✔✔Respiratory Alkalosis Compensation - ✔✔Problem: The lungs are losing too much
CO2
Compensation: The kidneys excrete excess BICARB (HCO3) and retain H+
✔✔Metabolic Acidosis Compensation - ✔✔Problem: Too much H+, too little BICARB
(HCO3)
Compensation: Lungs blow off CO2 (increased resp)
✔✔Metabolic Alkalosis Compensation - ✔✔Problem: Too much BICARB (HCO3), loo
little H+
Compensation: Lungs will retain CO2 (decreased resp)
✔✔Anticipated lab causing identified ABG - ✔✔Respiratory Alkalosis: pH over 7.45,
paCO2 under, normal or low HCO3
Metabolic Alkalosis: pH over 7.45, high HCO3 (over 28), increased or normal paCO2
Metabolic Acidosis: pH < 7.35, low HCO3, paCO2 low or normal
