UPNS 323 Adult Health and Illness- Spring 2019
Exam 1 Blueprint
30 Questions
45 minutes to complete Test, 10 minutes to Review Rationales
Fluid and Electrolytes 4
Blood 1
ABG 5
Cancer 7
Heme 8
HIV 5
30 questions total
Two select all that apply
Pao2- o2 dissolved in arterial blood 80-100
Paco2- carbon dioxide dissolved in arterial blood
hCO3- bicarbonate in the bloodstream, kidneys and liver
Patient assessment
- breathing fast and shallow- red flag
- heart rate is fluctuating erratically and it is not normal- red flag
Anything on the left side is acidic, anything on the right is basic
Acidic ------ alkaline (basic)
pH 7.35-7.45
PaCO2 45-35 (respiratory)
HCO3 22-26 (metabolic)
ROME:
R-respiratory
opposite- pH is high and other is low (paco2 is less than 35)
Alkalosis- hyperventilation
O-opposite
pH is low and other is high (PACO2 is higher than 45)
Acidosis (hypoventilation)
Hypoventilation from pain or distension, massive pulmonary embolism,
, M-metabolic
pH is high and other is high
Alkalosis- difficult to treat
E- equal
pH is low and other is low
Acidosis- renal failure, diabetic ketoacidosis, anaerobic metabolism, starvation, salicylate
intoxication
Uncompensated: CO2 or HCO3 is normal
Partially compensated: nothing is normal
Fully compensated: pH is normal
RBC:
- Reticulocyte count- measure of immature RBCs, reflection of bone marrow productivity
- Measuring hematocrit- measures packed cell volume of RBC expressed as a percent of
total blood volume
- Critical value Hct < 15% (leads to heart failure); Hct of < 24 % indicates need for
transfusion – but this value depends on condition of patient
Hemoglobin- measures gas carrying capacity of the RBC (less than 5 or greater than 20 is
dangerous)
- Anemia (symptoms- pallor, glossitis (red swollen tongue), koilonychia (spoon shaped
brittle nails), stomatitis (dry corners of mouth))
- Normal range is 13.5-17.5
- 10-14 is mild (no symptoms)
- 6-10 is moderate anemia (raised cardiopulmonary symptoms)
- Less than 6 is severe anemia (involves multiple body systems)
- Iron deficiency anemia- serum ferritin levels less than 12 (from blood loss and poor
intestinal absorption)
- macro anemia- acute sudden blood loss
- Interventions- liver, red meat, red wine, green veggies
- Vitamin B12 deficiency- vegetarians, low dairy intake, small bowel problems, tapeworm
- Interventions- increase B12 and folic acid, take vitamin supplements (IM if
severe), beef, chicken, ham, fish, whole egg
- Patient has poor balance
- Pernicious anemia- cobalamin (need an intrinsic factor)
- Signs and symptoms- mood swings, infections, hbg 7-8, lemon yellow skin
- Schilling test- determines amount of b12 in urine (24 hour test), B12 injection
also given- cyanocobalamin
- Folic acid deficiency- RBC have shorter life span, from meds (antiseizure, birth control),
malabsorption
Exam 1 Blueprint
30 Questions
45 minutes to complete Test, 10 minutes to Review Rationales
Fluid and Electrolytes 4
Blood 1
ABG 5
Cancer 7
Heme 8
HIV 5
30 questions total
Two select all that apply
Pao2- o2 dissolved in arterial blood 80-100
Paco2- carbon dioxide dissolved in arterial blood
hCO3- bicarbonate in the bloodstream, kidneys and liver
Patient assessment
- breathing fast and shallow- red flag
- heart rate is fluctuating erratically and it is not normal- red flag
Anything on the left side is acidic, anything on the right is basic
Acidic ------ alkaline (basic)
pH 7.35-7.45
PaCO2 45-35 (respiratory)
HCO3 22-26 (metabolic)
ROME:
R-respiratory
opposite- pH is high and other is low (paco2 is less than 35)
Alkalosis- hyperventilation
O-opposite
pH is low and other is high (PACO2 is higher than 45)
Acidosis (hypoventilation)
Hypoventilation from pain or distension, massive pulmonary embolism,
, M-metabolic
pH is high and other is high
Alkalosis- difficult to treat
E- equal
pH is low and other is low
Acidosis- renal failure, diabetic ketoacidosis, anaerobic metabolism, starvation, salicylate
intoxication
Uncompensated: CO2 or HCO3 is normal
Partially compensated: nothing is normal
Fully compensated: pH is normal
RBC:
- Reticulocyte count- measure of immature RBCs, reflection of bone marrow productivity
- Measuring hematocrit- measures packed cell volume of RBC expressed as a percent of
total blood volume
- Critical value Hct < 15% (leads to heart failure); Hct of < 24 % indicates need for
transfusion – but this value depends on condition of patient
Hemoglobin- measures gas carrying capacity of the RBC (less than 5 or greater than 20 is
dangerous)
- Anemia (symptoms- pallor, glossitis (red swollen tongue), koilonychia (spoon shaped
brittle nails), stomatitis (dry corners of mouth))
- Normal range is 13.5-17.5
- 10-14 is mild (no symptoms)
- 6-10 is moderate anemia (raised cardiopulmonary symptoms)
- Less than 6 is severe anemia (involves multiple body systems)
- Iron deficiency anemia- serum ferritin levels less than 12 (from blood loss and poor
intestinal absorption)
- macro anemia- acute sudden blood loss
- Interventions- liver, red meat, red wine, green veggies
- Vitamin B12 deficiency- vegetarians, low dairy intake, small bowel problems, tapeworm
- Interventions- increase B12 and folic acid, take vitamin supplements (IM if
severe), beef, chicken, ham, fish, whole egg
- Patient has poor balance
- Pernicious anemia- cobalamin (need an intrinsic factor)
- Signs and symptoms- mood swings, infections, hbg 7-8, lemon yellow skin
- Schilling test- determines amount of b12 in urine (24 hour test), B12 injection
also given- cyanocobalamin
- Folic acid deficiency- RBC have shorter life span, from meds (antiseizure, birth control),
malabsorption
