NUR 425 Final Exam Questions With Correct Answers Latest Updated 2024 (GRADED A+)

Oxygen is ____ whereas CO2 is _____. - Answer - Alkaline. Acidic. Hydrogen is _____. - Answer - Acidic HCO3 is _____. - Answer - Alkaline HCl is _____. - Answer - Acidic Glucose is _____. - Answer - Acidic List the compensatory mechanisms (3) for acid-base balance. - Answer - 1. Buffer System -Very quick acting, but doesn't last long -Made up of proteins, ions, hydrogen, etc. -Strong acids are made to weaker acids, or vice versa 2. Respiratory System -Kicks in after a few minutes, lasts up to a day -Respiratory rate is altered to either increase O2 intake or increase CO2 retention. 3. Renal System -Kicks in after about a day, more sustainable than the others -Kidneys will either excrete hydrogen or retain it, and either excrete HCO3 or retain it, depending on the condition. -H + HCO3 --> H2CO3 (Carbonic acid) --> H20 + CO2 <--This process can be reversed What does PaO2 measure? - Answer - Partial pressure of oxygen in arterial blood Normal: 80-100 mmHg What does SaO2 measure? - Answer - The percentage of hemoglobin that is saturated with O2 Normal: 95-100% What does PaCO2 measure? - Answer - Partial pressure of CO2 in blood Normal: 35-45 mmHg Indicates lung function What does HCO3 measure? - Answer - It measures the bicarbonate concentration in the blood NUR 425 Final Exam Questions And Answers Latest Updated 2024 (GRADED A+) Normal: 22-26 mmHg Indicates kidney function Normal blood pH - Answer - 7.35-7.45, which represents the balance between hydrogen ions & bicarbonate ions Describe uncompensated acid-base imbalances. - Answer - -There is one problem but no one is helping. -The pH is abnormal and one other value is abnormal. -One value is normal. Identify this acid base imbalance as either mixed, uncompensated, partially compensated, or fully compensated. Also, identify the type of acid base balance. pH: 7.28 CO2: 58 mmHg HCO3: 25 mmHg - Answer - Uncompensated respiratory acidosis Describe mixed acid-base imbalances. - Answer - -There is a metabolic problem AND a respiratory problem. -No one is trying to compensate because they are BOTH causing the disturbance. -All values either indicate acidity, or all values indicate alkalinity. Identify this acid base imbalance as either mixed, uncompensated, partially compensated, or fully compensated. Also, identify the type of acid base balance. pH: 7.52 CO2: 28 mmHg HCO3: 32 mmHg - Answer - This can either be respiratory or metabolic alkalosis with mixed compensation. Because it is mixed, there are two problems causing an acid base balance. All of the values indicate an alkalinity problem. Describe partially compensated acid-base imbalance. - Answer - -One system is causing the disturbance, and the other system is TRYING to compensate. -All values are going be abnormal. The pH will help us determine which system is causing the disturbance. Identify this acid base imbalance as either mixed, uncompensated, partially compensated, or fully compensated. Also, identify the type of acid base balance. pH: 7.25 CO2: 53 mmHg HCO3: 35 mmHg - Answer - Partially compensated respiratory acidosis The pH is acidic, so the system causing the disturbance is the lungs. The kidneys are retaining bicarbonate to try to balance out the pH, but this is partially compensated because the pH is still acidic. Describe fully compensated acid-be imbalance. - Answer - -One system is causing the disturbance, the other system is compensating and it WORKED. -The pH is going to be normal, but it is going to be on the higher or lower end of a pH. -7.35-7.4 --> acidic -7.4-7.45 --> alkaline Identify this acid base imbalance as either mixed, uncompensated, partially compensated, or fully compensated. Also, identify the type of acid base balance. pH: 7.36 CO2: 50 mmHg HCO3: 35 mmHg - Answer - Fully compensated respiratory acidosis The pH is in the normal spectrum, but still less than 7.4 so we know the high CO2 level is causing the altered pH. The kidneys are retaining bicarbonate to compensate for the acidic pH, and it WORKED because the pH is now in the normal spectrum. List causes of respiratory acidosis. - Answer - -Hypoventilation -Drug overdose -Pulmonary edema, pneumonia, pulmonary embolism (later stage) -Chest trauma -Neuromuscular disease -COPD -Airway obstruction List treatment for respiratory acidosis. - Answer - We need to increase breathing, so... -Administer narcan for drug overdose -Reduce sedation -Intubate or change ventilator settings -Suction -Administer bronchodilators -Treat pneumonia, pneumothorax List causes of metabolic acidosis. - Answer - -DKA -Salicylate OD -Shock (Lactic acid increases during shock) -Sepsis -Diarrhea -Renal failure (Increased uric acid concentration) List treatment for metabolic acidosis. - Answer - We need to excrete acid or retain HCO3, so... -Administer sodium bicarbonate -Encourage Kussmaul respirations or set ventilator settings to do this -Antidiarrheal medications -Dialysis -Insulin List causes of respiratory alkalosis. - Answer - -Hyperventilation -Initial stages of pulmonary embolism -Hypoxia -Fever -Pregnancy -High altitudes -Anxiety -Pain -Mechanical ventilator causing hyperventilation List treatment for respiratory alkalosis. - Answer - We need to decrease RR, so... -Administer analgesics, anxiolytics, antipyretics -Stop or reverse drug that is causing increased CNS activation -Breathe into a paper bag -Change existing ventilator settings List causes of metabolic alkalosis. - Answer - -Vomiting -K-wasting diuretics -Overuse of antacids -NG tubes suctioning -Overadministration of NaHCO3 Potassium is _____. - Answer - Acidic (For the sake of simplicity, know that high potassium is gonna cause more of an acidic pH and low potassium is going to cause more of an alkaline pH) List treatment for metabolic alkalosis. - Answer - We need to excrete bicarbonate and retain acids, so... -Discontinue dugs causing imbalance (Such as diuretic, antacid, sodium bicarbonate, etc.) -Discontinue NG tube suction -Administer anti-emetics -Admnister acetazolamide (Treats altitude sickness) George Kent is a 54 year old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty in communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has a tachycardia and a bounding pulse. Measurement EMAIL ME: EMAIL ME: of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg. How would you interpret this? A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially, Compensated - Answer - B (The patient has respiratory acidosis (raised carbon dioxide) resulting from an acute exacerbation of chronic obstructive pulmonary disease, with partial compensation.) Carl, an elementary student, was rushed to the hospital due to vomiting and a decreased level of consciousness. The patient displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. He appears to be dehydrated—his eyes are sunken and mucous membranes are dry—and he has a two week history of polydipsia, polyuria, and weight loss. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 23 mm Hg, and HCO3 12 mmol/L; other results are Na+ 126 mmol/L, K+ 5 mmol/L, and Cl- 95 mmol/L. What is your assessment? A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated - Answer - D (The student was diagnosed having diabetes mellitus. The results show that he has metabolic acidosis (low HCO3 -) with respiratory compensation (low CO2).) A cigarette vendor was brought to the emergency department of a hospital after she fell into the ground and hurt her left leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she started complaining that she is still in pain and now experiencing muscle cramps, tingling, and paraesthesia. Measurement of arterial blood gas reveals pH 7.6, PaO2 120 mm Hg, PaCO2 31 mm Hg, and HCO3 25 mmol/L. What does this mean? A. Respiratory Alkalosis, Uncompensated B. Respiratory Acidosis, Partially Compensated C. Metabolic Alkalosis, Uncompensated D. Metabolic Alkalosis, Partially Compensated - Answer - A (The primary disorder is acute respiratory alkalosis (low CO2) due to the pain and anxiety causing her to hyperventilate. There has not been time for metabolic compensation.) Ricky's grandmother is suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid-base disorder is shown? A. Respiratory Alkalosis, Uncompensated B. Respiratory Acidosis, Partially Compensated C. Metabolic Alkalosis, Uncompensated D. Metabolic Alkalosis, Partially Compensated - Answer - C (The primary disorder is uncompensated metabolic alkalosis (high HCO3 -). As CO2 is the strongest driver of respiration, it generally will not allow hypoventilation as compensation for metabolic alkalosis.) A nurse is caring for a client admitted with confusion and lethargy. The clients was found at home unresponsive with an empty bottle of aspirin lying next to her bed. VS reveal BP 104/72, HR 116 with regular rhythm, and respiratory rate 42/min and deep. Which of the following arterial blood gas findings should the nurse expect? a. ph 7.68 PaO2 96 mmHg PaCO2 38 mmHg HCO3 28 mEq/L b. pH 7.48 PaO2 100 mmHg PaCO2 28 mmHg HCO3 23 mEq/L c. pH 6.98 PaO2 100 mmHg PaCO2 30 mmHg HCO3 18 mEq/L d. pH 7.58 PaO2 96 mmHg PaCO2 38 mmHg HCO3 29 mEq/L - Answer - C A nurse is caring for a client who was in a motor-vehicle accident. The client reports chest pain and difficulty breathing. A chest x-ray reveals the client has a pneumothorax. Which of the following arterial blood gas findings should the nurse expect? a. pH 7.06 PaO2 86 mmHg PaCO2 52 mmHg HCO3 24 mEq/L b. pH 7.42 PaO2 100 mmHg PaCO2 38 mmHg HCO3 23 mEq/L c. pH 6.98 PaO2 100 mmHg PaCO2 30 mmHg HCO3 18 mEq/L d. pH 7.58 PaO2 96 mmHg PaCO2 38 mmHg EMAIL ME: D. Metabolic Alkalosis, Partially Compensated - Answer - C (The primary disorder is uncompensated metabolic alkalosis (high HCO3 -). As CO2 is the strongest driver of respiration, it generally will not allow hypoventilation as compensation for metabolic alkalosis.) A nurse is caring for a client admitted with confusion and lethargy. The clients was found at home unresponsive with an empty bottle of aspirin lying next to her bed. VS reveal BP 104/72, HR 116 with regular rhythm, and respiratory rate 42/min and deep. Which of the following arterial blood gas findings should the nurse expect? a. ph 7.68 PaO2 96 mmHg PaCO2 38 mmHg HCO3 28 mEq/L b. pH 7.48 PaO2 100 mmHg PaCO2 28 mmHg HCO3 23 mEq/L c. pH 6.98 PaO2 100 mmHg PaCO2 30 mmHg HCO3 18 mEq/L d. pH 7.58 PaO2 96 mmHg PaCO2 38 mmHg HCO3 29 mEq/L - Answer - C