PN 4006 Midterm Exam - Questions With In-Depth
Solutions
Why are older people at risk of fluid imbalances? Right Ans - less fluid due
to decline in muscle and increase in fat (fat is hydrophobic)
If the extracellular space is hypertonic compared to intracellular what
happens? Right Ans - fluid exits the cells
what’s a clinical manifestation of GI bleed and fluid volume deficit? Right
Ans - dry mouth (dry oral mucosae)
Intervention for hyponatremia? Right Ans - limit water intake
Monitoring of loop diuretics Right Ans - monitor pulse regularity
(potassium)
Which patients would have a higher risk to develop hypermagnesemia
Right Ans - renal failure, old age (worse kidney function), hypothyroidism
(worse kidney function), etc
(think of anything that affects the kidneys!)
What is the Chvostek sign? Right Ans - The Chvostek sign is a clinical
finding associated with hypocalcemia, or low levels of calcium in the blood.
This clinical sign refers to a twitch of the facial muscles that occurs when
gently tapping an individual's cheek, in front of the ear.
what to watch for after a total thyroidectomy? Right Ans - positive
chvostek sign (due to hypocalcemia)
how do the lungs act as an acid base buffer? Right Ans - by increasing
respiratory rate and depth when CO2 levels in the blood are high, thereby
reducing acid load
normal blood pH Right Ans - 7.35-7.45
lower = acidic
, Normal PaO2 levels Right Ans - 75-100 mmHg
Normal PaCO2 range Right Ans - 35-45 mmHg
higher = acidic
Normal HCO3 range (bicarbonate) Right Ans - 22-26 mEq/L
lower = acidic
compensated vs uncompensated ABGs Right Ans - if the pH is in range
despite other factors being out of range, it means it is compensated (body is
compensating to make the pH normal)
if fully compensated, check whether it is leaning high or low to determine if it
is acidosis or alkalosis
try:
pH = 7.30
PaCO2 = 50
HCO3- = 30 Right Ans - partially compensated respiratory acidosis
1. the pH is 7.30. This is lower than normal, so we have an acidosis.
2. What else is acidotic? The CO2 is 50, which is high. So, we have respiratory
acidosis.
3. normal HCO3- is between 22-28. So, the body is trying to fix this problem.
Has the body done a good job of fixing the problem? No, the pH is still not
within normal ranges, so there is only partial compensation occurring
try:
pH = 7.50
PaCO2 = 47
HCO3- = 32 Right Ans - partially compensated metabolic alkalosis
1. The pH is 7.50. so we have an alkalosis.
Solutions
Why are older people at risk of fluid imbalances? Right Ans - less fluid due
to decline in muscle and increase in fat (fat is hydrophobic)
If the extracellular space is hypertonic compared to intracellular what
happens? Right Ans - fluid exits the cells
what’s a clinical manifestation of GI bleed and fluid volume deficit? Right
Ans - dry mouth (dry oral mucosae)
Intervention for hyponatremia? Right Ans - limit water intake
Monitoring of loop diuretics Right Ans - monitor pulse regularity
(potassium)
Which patients would have a higher risk to develop hypermagnesemia
Right Ans - renal failure, old age (worse kidney function), hypothyroidism
(worse kidney function), etc
(think of anything that affects the kidneys!)
What is the Chvostek sign? Right Ans - The Chvostek sign is a clinical
finding associated with hypocalcemia, or low levels of calcium in the blood.
This clinical sign refers to a twitch of the facial muscles that occurs when
gently tapping an individual's cheek, in front of the ear.
what to watch for after a total thyroidectomy? Right Ans - positive
chvostek sign (due to hypocalcemia)
how do the lungs act as an acid base buffer? Right Ans - by increasing
respiratory rate and depth when CO2 levels in the blood are high, thereby
reducing acid load
normal blood pH Right Ans - 7.35-7.45
lower = acidic
, Normal PaO2 levels Right Ans - 75-100 mmHg
Normal PaCO2 range Right Ans - 35-45 mmHg
higher = acidic
Normal HCO3 range (bicarbonate) Right Ans - 22-26 mEq/L
lower = acidic
compensated vs uncompensated ABGs Right Ans - if the pH is in range
despite other factors being out of range, it means it is compensated (body is
compensating to make the pH normal)
if fully compensated, check whether it is leaning high or low to determine if it
is acidosis or alkalosis
try:
pH = 7.30
PaCO2 = 50
HCO3- = 30 Right Ans - partially compensated respiratory acidosis
1. the pH is 7.30. This is lower than normal, so we have an acidosis.
2. What else is acidotic? The CO2 is 50, which is high. So, we have respiratory
acidosis.
3. normal HCO3- is between 22-28. So, the body is trying to fix this problem.
Has the body done a good job of fixing the problem? No, the pH is still not
within normal ranges, so there is only partial compensation occurring
try:
pH = 7.50
PaCO2 = 47
HCO3- = 32 Right Ans - partially compensated metabolic alkalosis
1. The pH is 7.50. so we have an alkalosis.
