EXAM 2 - FUNDAMENTALS (NR 226) EXAM QUESTIONS WITH
COMPLETE SOLUTION
pH normal range
7.35-7.45
causes of respiratory acidosis
COPD, asthma, bronchitis, barbiturate or sedative overdose, acute airway obstruction,
weakness of the respiratory muscles
nursing interventions for respiratory acidosis
place semi-Fowler's position, maintain patent airway, turn cough, and deep breathe,
administer fluids to help liquefy, administer low oxygen, monitor ABG
causes of respiratory alkalosis
hyperventilation and mechanical overventilation, panic attack, anxiety, encephalitis
nursing interventions for respiratory alkalosis
encourage breathing into a paper bag or voluntary breath holding
causes of metabolic acidosis
diabetic ketoacidosis, dehydration, diarrhea, renal tubular
nursing interventions for metabolic acidosis
administer sodium bicarb as ordered, monitor for signs of hyperkalemia, measure intake
and output, monitor ABG
causes of metabolic alkalosis
nausea & vomiting, after chemotherapy, NG tube
nursing interventions for metabolic alkalosis
replace fluid and electrolyte losses (potassium chloride), measure intake and output,
monitor for hypokalemia, monitor ABG
pH = 7.31, PCO2 = 49, HCO3 = 24
respiratory acidosis
pH = 7.5, PCO2 = 37, HCO3 = 29
metabolic alkalosis
pH = 7.6, PCO2 = 21, HCO3 = 22
respiratory alkalosis
pH = 7.15, PCO2 = 44, HCO3 = 19
metabolic acidosis
pH = 7.45, PCO2 = 36, HCO3 = 25
normal
pH = 7.47, PCO2 = 26, HCO3 = 20
respiratory alkalosis
pH = 7.34, PCO2 = 30, HCO3 = 20
metabolic acidosis with partial compensation
pH = 7.23, PCO2 = 61, HCO3 = 40
respiratory acidosis with partial compensation
arterial blood gas
pH A 7.35 7.45 B
lungs
, PCO2 B 35 45 A
kidney
HCO3 A 22 26 B
main causes of electrolytes imbalance
changes in diet, GI malfunction, renal problems, medications, procedures or an entire
disease process (all of these can cause either hypo or hyper in elecctrolytes)
normal sodium (Na) levels
136-145 mEq/L
hypernatremia (hypertonic body fluids)
abnormally high sodium ion concentration in the blood
causes of hypernatremia
excessive/rapid IV administration of normal saline, inadequate water intake and kidney
disease
signs and symptoms of hypernatremia
confusion, dry mucous membranes, neck vein is flat, dry skin, furrows in tongue
(common in the older population), skin tenting, intense thirst, oliguria to anuria, dark
urine, orthostatic hypotension, tachycardia with thready pulse, tachypnea, hypoxia,
weight loss, specific gravity of urine is high, HCT is high
treatment for hypernatremia
weigh patient daily, monitor intake & output, monitor weight, and monitor vitals; assess
skin turgor, place patient on sodium-restricted diet, and administer hypotonic IV fluids or
isotonic IV fluids (NS)
hyponatremia (hypotonic body fluids)
abnormally low sodium ion concentration in the blood
causes of hyponatremia
decreased sodium intake, increased sodium excretion due to suctioning
signs and symptoms of hyponatremia
confusion, nausea and vomiting, abdominal cramping, weight gain, cold clammy skin,
sticky and moist mucous membrane, fatigue, dyspnea, shortness of breath, crackles,
periorbital edema, distended JVD, polyuria, restlessness, irritability, muscle weakness,
spasms or cramps, seizures, coma, specific gravity of urine is low, HCT is low
treatment for hyponatremia
provide high sodium foods, auscultate lungs (crackles), administer hypertonic IV fluids
or isotonic IV fluids (NS), monitor intake and output, monitor weight, and monitor vital
signs, note that body weight is the best indicator that shows if patient is losing or gaining
weight, monitor daily weight at the same time of the day, patient should should wear the
same gown, use the same weighing scale and use the same calibrations (use pounds
or kg be consistent)
normal value of potassium
3.5 - 5.0 mEq/L (think the heart, dysrhythmias in both hypo and hyperkalemia and use
12 leads ECG or EKG)
hyperkalemia
abnormally high potassium ion concentration in the blood
causes of hyperkalemia
increased potassium intake and absorption, shift of potassium from cells into the ECF,
and decreased potassium output; people who have renal issues such as oliguria
COMPLETE SOLUTION
pH normal range
7.35-7.45
causes of respiratory acidosis
COPD, asthma, bronchitis, barbiturate or sedative overdose, acute airway obstruction,
weakness of the respiratory muscles
nursing interventions for respiratory acidosis
place semi-Fowler's position, maintain patent airway, turn cough, and deep breathe,
administer fluids to help liquefy, administer low oxygen, monitor ABG
causes of respiratory alkalosis
hyperventilation and mechanical overventilation, panic attack, anxiety, encephalitis
nursing interventions for respiratory alkalosis
encourage breathing into a paper bag or voluntary breath holding
causes of metabolic acidosis
diabetic ketoacidosis, dehydration, diarrhea, renal tubular
nursing interventions for metabolic acidosis
administer sodium bicarb as ordered, monitor for signs of hyperkalemia, measure intake
and output, monitor ABG
causes of metabolic alkalosis
nausea & vomiting, after chemotherapy, NG tube
nursing interventions for metabolic alkalosis
replace fluid and electrolyte losses (potassium chloride), measure intake and output,
monitor for hypokalemia, monitor ABG
pH = 7.31, PCO2 = 49, HCO3 = 24
respiratory acidosis
pH = 7.5, PCO2 = 37, HCO3 = 29
metabolic alkalosis
pH = 7.6, PCO2 = 21, HCO3 = 22
respiratory alkalosis
pH = 7.15, PCO2 = 44, HCO3 = 19
metabolic acidosis
pH = 7.45, PCO2 = 36, HCO3 = 25
normal
pH = 7.47, PCO2 = 26, HCO3 = 20
respiratory alkalosis
pH = 7.34, PCO2 = 30, HCO3 = 20
metabolic acidosis with partial compensation
pH = 7.23, PCO2 = 61, HCO3 = 40
respiratory acidosis with partial compensation
arterial blood gas
pH A 7.35 7.45 B
lungs
, PCO2 B 35 45 A
kidney
HCO3 A 22 26 B
main causes of electrolytes imbalance
changes in diet, GI malfunction, renal problems, medications, procedures or an entire
disease process (all of these can cause either hypo or hyper in elecctrolytes)
normal sodium (Na) levels
136-145 mEq/L
hypernatremia (hypertonic body fluids)
abnormally high sodium ion concentration in the blood
causes of hypernatremia
excessive/rapid IV administration of normal saline, inadequate water intake and kidney
disease
signs and symptoms of hypernatremia
confusion, dry mucous membranes, neck vein is flat, dry skin, furrows in tongue
(common in the older population), skin tenting, intense thirst, oliguria to anuria, dark
urine, orthostatic hypotension, tachycardia with thready pulse, tachypnea, hypoxia,
weight loss, specific gravity of urine is high, HCT is high
treatment for hypernatremia
weigh patient daily, monitor intake & output, monitor weight, and monitor vitals; assess
skin turgor, place patient on sodium-restricted diet, and administer hypotonic IV fluids or
isotonic IV fluids (NS)
hyponatremia (hypotonic body fluids)
abnormally low sodium ion concentration in the blood
causes of hyponatremia
decreased sodium intake, increased sodium excretion due to suctioning
signs and symptoms of hyponatremia
confusion, nausea and vomiting, abdominal cramping, weight gain, cold clammy skin,
sticky and moist mucous membrane, fatigue, dyspnea, shortness of breath, crackles,
periorbital edema, distended JVD, polyuria, restlessness, irritability, muscle weakness,
spasms or cramps, seizures, coma, specific gravity of urine is low, HCT is low
treatment for hyponatremia
provide high sodium foods, auscultate lungs (crackles), administer hypertonic IV fluids
or isotonic IV fluids (NS), monitor intake and output, monitor weight, and monitor vital
signs, note that body weight is the best indicator that shows if patient is losing or gaining
weight, monitor daily weight at the same time of the day, patient should should wear the
same gown, use the same weighing scale and use the same calibrations (use pounds
or kg be consistent)
normal value of potassium
3.5 - 5.0 mEq/L (think the heart, dysrhythmias in both hypo and hyperkalemia and use
12 leads ECG or EKG)
hyperkalemia
abnormally high potassium ion concentration in the blood
causes of hyperkalemia
increased potassium intake and absorption, shift of potassium from cells into the ECF,
and decreased potassium output; people who have renal issues such as oliguria
