Complete Solutions
Pulmonary Assessment correct answer: - history
- physical exam
- breath sounds and their meaning
Breath sounds correct answer: - Rales/Crackles (fluid)
- Rhonchi (congestion)
- Wheezes (airway)
- Pleural Rub (irritated pleural space)
- Diminished
- Absence
Diagnostics: ABG correct answer: - pH: 7.35-7.45 (acid/base
evaluator)
- PaCO2: 35-45 mm Hg
- HCO3: 22-26 mm Hg (metabolic evaluator)
- PaO2: 80-100 mm Hg (more accurate than SaO2)
- SaO2: 92-100%
Steps for interpreting ABG correct answer:
Respiratory Acidosis correct answer: - decreased pH
- increased PaCO2
Respiratory Acidosis causes correct answer: - Hypoventilation
- COPD
- over sedation
,- head trauma
- drug OD
- neuromuscular disease
Respiratory Acidosis interventions correct answer: - Need to
↑ventilation
- C&DB
- Suction
- Oxygen
- Meds = Bronchodilators
- Ambulate
- Increase frequency rate on mech. vent
Respiratory Alkalosis correct answer: - increased pH
- decreased PaCO2
Respiratory Alkalosis causes correct answer: - Hyperventilation
- Hypoxia
- Anxiety
- PE
- Pg
- hypervent with Mech. Vent.
- compensation for Met. Acidosis
Respiratory Alkalosis interventions correct answer: - Need to
↓ventilation
- Breath into a bag
- Hold breath
- Calm patient
- Decrease Frequency rate on mech. Vent.
, metabolic acidosis correct answer: - decreased pH
- decreased HC03
metabolic acidosis causes correct answer: High Anion Gap:
+ Lactic Acidosis
+ Ketoacidosis
+ RF
+ acid ingestion
+ Rhabdomyolosis
Non-Anion Gap:
+ Diarrhea
+ renal tube acidosis
+ Ileostomy
+ pancreatic fistula
Metabolic acidosis interventions correct answer: - Need to ↑
Base
- Sodium Bicarb IV & Fluids
- Treat underlying cause (Metabolic or Resp.)
Metabolic Alkalosis correct answer: - increased pH
- Increased HCO3
Metabolic Alkalosis causes correct answer: - Steroid Tx
- Vomiting
- GI suction
- Diuretic tx
- hypokalemia
- hypovolemia
- hypochloremia
- Na Bicarb ingestion