PCU Exam Questions and Answers with complete solutions

PCU Exam Questions and Answers with complete solutions what are normal ABG values? - ANS- pH: acidic 7.35-7.45 basic CO2: basic 35-45 acidic HCO3-: acidic 22-26 basic normal paO2 - ANS- 80-100 mmHg what pH levels are lethal? - ANS- outside 6.8-7.8 where are ABGs drawn from? what test is done to ensure adequate blood flow? - ANS- peripheral artery; allen's test for radial artery How do the kidneys help maintain acid-base balance? - ANS- retain/excrete basic HCO3 and retain/excrete acidic H+ treatments for respiratory acidosis - ANS- -oxygen -intubation -bronchodilators -drug reversal agents -incentive spirometer -suction treatments for respiratory alkalosis - ANS- -breathing into paper bag -anxiolytics -analgesics -reduce fever -reduce ventilation -return to normal altitude treatments for metabolic acidosis - ANS- -IV sodium bicarbonate -manage blood sugar -antibiotics -reversal for OD -anti-diarrheal agents -dialysis -encourage respirations/ventilate treatments for metabolic alkalosis - ANS- -antiemetics -stop suctioning -d/c drugs causing acid loss (diuretics, antacids) -hydrochloric acid (rare) what is systolic vs diastolic heart failure? - ANS- systolic: type of L sided HF with reduced EF of < 40%; impaired contraction diastolic: type of L sided HF with preserved EF > 50%; impaired relaxation what 3 things occur in systolic HF? - ANS- 1. SNS activation (increased HR, contractility, peripheral vasoconstriction) 2. RAAS activation (sodium + water retention, peripheral vasoconstriction) 3. LV dilation what are symptoms of right sided heart failure? - ANS- swelling: swelling, weight gain, edema, large neck vein (JVD), lethargy, irregular HR, nocturia, girth, hepatic tenderness, anorexia, ascitis what are treatments for right sided heart failure? - ANS- -sodium and fluid restriction to manage preload -moderate doses of diuretics -ACE, ARBs, beta blockers if due to L ventricular failure what are symptoms of left sided heart failure? - ANS- drowning: dyspnea, rales/crackles, orthopnea, weakness, nocturnal dyspnea, increased HR, nagging cough, gaining weight, hypotension what are symptoms of systolic heart failure? - ANS- s3, edema, weight gain, crackles, dyspnea, chest tightness, oliguria, JVD, weak pulses, cool pale skin, altered mental status diagnostic tests for heart failure - ANS- -ECG -xray -ECHO -BNP (normal < 100 75 & under, < 450 75+) -cardiac biomarkers what are treatments for systolic HF? - ANS- -ARNIs, ACE-Is, ARBs -beta blockers -aldosterone antagonists -diuretics -vasodilators -anticoagulation -physical activity -inotropic agents (w/ caution - can cause dysrhythmia) which medication for HF interrupts SNS to normalize HR, decrease afterload and contractility? - ANS- beta blockers which medications for HF interrupts RAAS activation to block vasoconstriction and ADH? - ANS- ace inhibitors (ACE-I), angiotension receptor blockers (ARBs), ARNI