PN 4006 MT - Questions And Accurate Answers
Neurological Assessment Right Ans - PERRLA & GCS
inspect palpate head for bruises bumps etc
resp assessment Right Ans - WOB
nasal flarring
accessory muscle us
hx
allergies
cough sputum
chest rising
tactile fremitus
breath sounds
o2 therapy
color of skin nail beds lips
CV assessment Right Ans - hx
meds
chest pain?
pulse points - temporal carotid brachial radial femoral popliteal dorsalis pedis
posterior tibialis
heart sounds S1,2
extra heart sounds S3,4
Vitals
arrythmias
CO
EF
Auscultation: Aortic area Right Ans - 2nd intercostal space, right sternal
border
Auscultation of pulmonary valve Right Ans - 2nd intercostal space to the
left of the sternum
Auscultation: Erb's point Right Ans - 3rd left intercostal space
Auscultation of tricuspid valve Right Ans - 4th left intercostal space at the
sternal border
,Auscultation of mitral valve Right Ans - 5th intercostal space, mid-
clavicular line
ABG normal values Right Ans - pH 7.35 - 7.45 decreased is acidic
PaCO2 35 - 45 mmHg decreased is basic
HCO3 22-26 mEq/L decreased is acidic
ABG compensation Right Ans - FULL COMP if pH is back to normal
PARTIAL COMP if all values are abnormal
UNCOMP if PaCO2 or HCO3 is normal while the other is abnormal
resp acidosis Right Ans - Build-up of carbon dioxide in the lungs that
causes acid-base imbalances and the body becomes acidic
Can be acute or chronic
Caused by excess carbonic acid which causes the blood pH to drop
resp acidosis causes Right Ans - Post op abdominal surgery
Mechanical ventilation
Analgesics or sedation
Pneumothorax
Hemothorax
Pulmonary edema
Acute bronchial asthma
Atelectasis
Pneumonia
Some drug overdoses and head injuries
Emphysema
Bronchiectasis
Bronchial asthma
CF
resp acidosis s/s Right Ans - Extreme resp insufficiency
Frantic efforts to breath
Breathe slowly irregularly or stop breathing
Expiratory volume is decreased
Lung sounds may be moist or absent
Tachycardia and other cardiac arrhythmias
Cyanosis in later stages
,Confusion
Disorientation
Hallucinations
Tremors
Muscle twitching
Flushed skin
Headache
Weakness
Stupor
Coma
Chronic resp acidosis s/s are less prominent and include increased breathing
effort, lack of energy, reduced activity, dull headache, weakness
resp acidosis management Right Ans - Depending on the cause and
whether its acute or chronic
Mechanical ventilation may be necessary
IV sodium bicarb may be administered when ventilation efforts do not
adequately restore a balanced pH
HR and rhythm are monitored to detect sudden cardiac changes
In less acute situations tx may include bronchodilators, abx, airway suctioning
if pt is too weak to cough
resp alkalosis Right Ans - hyperventilation
resp alkalosis causes Right Ans - acute anxiety
High fever
Overactive thyroid
Aspirin poisoning
Hypoxia
Mechanical ventilation
use of nicotine or aminophylline
resp alkalosis s/s Right Ans - Increased RR
Lightheadedness
Anxiety
restlessness
Diaphoresis
Dyspnea (⇑ rate and depth)
EKG changes
, Hyperreflexia
paresthesia
Tachycardia
Tetany
Dry mouth
Convulsions
resp alkalosis management Right Ans - Breathe into paper bag
Make them calmer decrease anxiety
met acidosis Right Ans - Results in decreased plasma pH b/c of increased
organic acids (acids other than H2CO3) or decreased bicarb organic acids
increase in periods of anaerobic metabolism when cells attempt to produce
ATP without o2
Anaerobic metabolism is much less efficient than aerobic metabolism and
produces by-products such as lactic acid
Occurs during shock and cardiac arrest
Acids also increase in cases of starvation and DKA as fatty acids accumulate
b/c body can't use glucose for energy
Accumulation of acids may also follow renal failure b/c the kidneys can't
reabsorb bicarb to buffer the blood
They also accumulate with aspirin overdose or profuse diarrhea
Another cause is loss of intestinal fluid through wound drainage in which
bicarb can be lost in disproportionate amounts
Other causes include
Diabetes mellitus
Alcoholism
Hyperthyroidism
Lactic acidosis secondary to shock, heart failure, pulmonary disease, hepatic
disease, seizures, strenuous exercise
met acidosis s/s Right Ans - Kussmaul respiration
Anorexia
n/v
Headache
Confusion
Flushing
Lethargy
Malaise
Neurological Assessment Right Ans - PERRLA & GCS
inspect palpate head for bruises bumps etc
resp assessment Right Ans - WOB
nasal flarring
accessory muscle us
hx
allergies
cough sputum
chest rising
tactile fremitus
breath sounds
o2 therapy
color of skin nail beds lips
CV assessment Right Ans - hx
meds
chest pain?
pulse points - temporal carotid brachial radial femoral popliteal dorsalis pedis
posterior tibialis
heart sounds S1,2
extra heart sounds S3,4
Vitals
arrythmias
CO
EF
Auscultation: Aortic area Right Ans - 2nd intercostal space, right sternal
border
Auscultation of pulmonary valve Right Ans - 2nd intercostal space to the
left of the sternum
Auscultation: Erb's point Right Ans - 3rd left intercostal space
Auscultation of tricuspid valve Right Ans - 4th left intercostal space at the
sternal border
,Auscultation of mitral valve Right Ans - 5th intercostal space, mid-
clavicular line
ABG normal values Right Ans - pH 7.35 - 7.45 decreased is acidic
PaCO2 35 - 45 mmHg decreased is basic
HCO3 22-26 mEq/L decreased is acidic
ABG compensation Right Ans - FULL COMP if pH is back to normal
PARTIAL COMP if all values are abnormal
UNCOMP if PaCO2 or HCO3 is normal while the other is abnormal
resp acidosis Right Ans - Build-up of carbon dioxide in the lungs that
causes acid-base imbalances and the body becomes acidic
Can be acute or chronic
Caused by excess carbonic acid which causes the blood pH to drop
resp acidosis causes Right Ans - Post op abdominal surgery
Mechanical ventilation
Analgesics or sedation
Pneumothorax
Hemothorax
Pulmonary edema
Acute bronchial asthma
Atelectasis
Pneumonia
Some drug overdoses and head injuries
Emphysema
Bronchiectasis
Bronchial asthma
CF
resp acidosis s/s Right Ans - Extreme resp insufficiency
Frantic efforts to breath
Breathe slowly irregularly or stop breathing
Expiratory volume is decreased
Lung sounds may be moist or absent
Tachycardia and other cardiac arrhythmias
Cyanosis in later stages
,Confusion
Disorientation
Hallucinations
Tremors
Muscle twitching
Flushed skin
Headache
Weakness
Stupor
Coma
Chronic resp acidosis s/s are less prominent and include increased breathing
effort, lack of energy, reduced activity, dull headache, weakness
resp acidosis management Right Ans - Depending on the cause and
whether its acute or chronic
Mechanical ventilation may be necessary
IV sodium bicarb may be administered when ventilation efforts do not
adequately restore a balanced pH
HR and rhythm are monitored to detect sudden cardiac changes
In less acute situations tx may include bronchodilators, abx, airway suctioning
if pt is too weak to cough
resp alkalosis Right Ans - hyperventilation
resp alkalosis causes Right Ans - acute anxiety
High fever
Overactive thyroid
Aspirin poisoning
Hypoxia
Mechanical ventilation
use of nicotine or aminophylline
resp alkalosis s/s Right Ans - Increased RR
Lightheadedness
Anxiety
restlessness
Diaphoresis
Dyspnea (⇑ rate and depth)
EKG changes
, Hyperreflexia
paresthesia
Tachycardia
Tetany
Dry mouth
Convulsions
resp alkalosis management Right Ans - Breathe into paper bag
Make them calmer decrease anxiety
met acidosis Right Ans - Results in decreased plasma pH b/c of increased
organic acids (acids other than H2CO3) or decreased bicarb organic acids
increase in periods of anaerobic metabolism when cells attempt to produce
ATP without o2
Anaerobic metabolism is much less efficient than aerobic metabolism and
produces by-products such as lactic acid
Occurs during shock and cardiac arrest
Acids also increase in cases of starvation and DKA as fatty acids accumulate
b/c body can't use glucose for energy
Accumulation of acids may also follow renal failure b/c the kidneys can't
reabsorb bicarb to buffer the blood
They also accumulate with aspirin overdose or profuse diarrhea
Another cause is loss of intestinal fluid through wound drainage in which
bicarb can be lost in disproportionate amounts
Other causes include
Diabetes mellitus
Alcoholism
Hyperthyroidism
Lactic acidosis secondary to shock, heart failure, pulmonary disease, hepatic
disease, seizures, strenuous exercise
met acidosis s/s Right Ans - Kussmaul respiration
Anorexia
n/v
Headache
Confusion
Flushing
Lethargy
Malaise
