MDC II - Exam 2 Latest Update Graded A+

MDC II - Exam 2 Latest Update Graded A+ Causes of respiratory acidosis (low ph/ high CO2) -Hypoventilation -Drug overdose -Pulmonary edema -Chest trauma/neuromuscular disease -COPD -Airway obstruction Causes of Metabolic Acidosis (low pH/low HCO3) -Diabetic ketoacidosis -Salicylate OD -Renal failure -Severe diarrhea -Sepsis -Shock How to evaluate that treatment is working for respiratory acidosis? -Maintains adequate gas exchange -Arterial pH above 7.2 and closer to 7.35 -PaO2 level above 90 mmHg or at least 10 mm Hg higher than their admission level -PaCO2 levels below 45 mmHg or at least 15 mm Hg below their admission level Alkalosis pathophysiology Alkalosis is a decrease in the free hydrogen ion level of the blood and is reflected by an arterial blood pH above 7.45. Metabolic Alkalosis: Base excess in what? Excessive intake bicarbonates, carbonates, acetates, citrates Cause of acid deficit? Prolonged vomiting, excess cortisol, hyperaldosteronism, thiazide diuretics, prolonged NG suction, loss of gastric fluids. Hallmark of base excess acidosis? ABG result with ↑ pH and ↑ bicarbonate level with normal O2 and CO2 levels What is citrate? citrate is an anticoagulant used in blood products that is rapidly metabolized in the liver What can happen when blood is rapidly administered? rapid administration of large quantities of stored blood can cause hypocalcemia and hypomagnesmia. The nurse is evaluating the laboratory work of a patient who has uncontrolled metabolic acidosis. Which outcome would result from this condition? A.pH 7.40 B.Pao2 98 mm Hg C.Bicarbonate 38 mEq/L Serum potassium 5.7 mEq/L ANS: D Metabolic acidosis is reflected by several changes in ABG values. The pH is low (<7.35). The bicarbonate level is low (<21 mEq/L). The partial pressure of arterial oxygen (Pao2) is normal because gas exchange is adequate. The serum potassium level is often high in acidosis as the body attempts to maintain electroneutrality during buffering. The nurse is reviewing the standing orders for a patient who was admitted for evaluation of chest pain. The patient has a history of chronic obstructive