NRS 440 Exam 2 Questions with Correct Answer Graded A+

Ventilator breath stacking - Occurs when a mandatory breath is delivered during the inspiratory phase of a spontaneous breath Can cause high tidal volumes which can lead to lung injury, decreased venous return, and decreased cardiac output Decrease venous return/CO Increase tidal volume Lung injury Acid-Base Balance - Homeostasis Buffer solutions keep pH at constant Problems that lead to imbalances: Diabetes Mellitus, Vomiting and diarrhea, and respiratory conditions Not a disease but a manifestation of underlying health problem Diabetes Mellitus - Can lead to increase of H+ in blood DKA Vomiting - Loss of chloride and hydrogen ions Leads to alkalosis Diarrhea - Loss of Bicarb Acidosis Respiratory Conditions - Too much CO2 Acidosis pH - Measure of H+ ion concentrations 7.35-7.45 Acidosis - pH less than 7.35 Alkalosis - pH greater than 7.45 Regulatory Mechanisms - Buffers Respiratory System Renal System Buffers - React immediately Act chemically to neutralize acids or change strong acids to weak acids Primary regulators Cannot maintain pH without adequate respiratory and renal function Carbonic acid-bicarbonate, Phosphate, Protein, Hemoglobin Cell cam shift hydrogen in and out of the cell Better - Body buffers and acid load _______ than it neutralizes base excess Hypokalemia - Caused by alkalosis because in H+ in ECF are increased, H+ enters the cells in exchange for potassium Carbonic Acid-Bicarbonate - Major buffer system in ECF Strong acid + strong base is buffered into salt and weak acid Prevents acid from making a large decrease in the blood's pH 20:1 - Ration between bicarbonate and carbonic acid and the normal pH Carbonic Acid - Broken down into H2O and CO2 Weak acid Dissociates to form bicarbonate and hydrogen Less effect on pH than H+ Increase Bicarb - More CO2 will convert to carbonic acid to replace the lost H+ ions CO2 - excreted by the lungs either combine with insensible H2O as carbonic acid or alone Respiratory System - Responds in minutes and reaches maximum effectiveness in hours Eliminates CO2 Increased respirations leads to increased CO2 elimination and decreased CO2 in blood Impaired - Older adult has an _______ compensatory ability because of decreased respiratory function Renal System - Takes 2-3 days to respond maximally but kidneys can maintain balance indefinitely in chronic imbalances Eliminates H+ and reabsorbs HCO3 Secrete free hydrogen Combine H+ with ammonia Excrete weak acids Reabsorption and secretion of electrolytes Less - Older adults are _______ able to compensate for an acid load Acidosis - Kidneys can generate additional bicarbonate and eliminate excess H+ to compensate for this Increases blood pH and decreases urine pH Respiratory - Affect carbonic acid concentration