18/01/2025 06:05
PCU Exam
what are normal ABG values?
pH: acidic 7.35-7.45 basic
CO2: basic 35-45 acidic
HCO3-: acidic 22-26 basic
normal paO2
80-100 mmHg
what pH levels are lethal?
outside 6.8-7.8
where are ABGs drawn from? what test is done to ensure adequate blood flow?
peripheral artery; allen's test for radial artery
How do the kidneys help maintain acid-base balance?
retain/excrete basic HCO3 and retain/excrete acidic H+
treatments for respiratory acidosis
-oxygen
-intubation
-bronchodilators
-drug reversal agents
-incentive spirometer
-suction
treatments for respiratory alkalosis
-breathing into paper bag
-anxiolytics
-analgesics
-reduce fever
-reduce ventilation
-return to normal altitude
treatments for metabolic acidosis
-IV sodium bicarbonate
-manage blood sugar
-antibiotics
-reversal for OD
-anti-diarrheal agents
-dialysis
-encourage respirations/ventilate
treatments for metabolic alkalosis
-antiemetics
-stop suctioning
-d/c drugs causing acid loss (diuretics, antacids)
-hydrochloric acid (rare)
what is systolic vs diastolic heart failure?
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?
, 18/01/2025 06:05
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?
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?
-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?
drowning: dyspnea, rales/crackles, orthopnea, weakness, nocturnal dyspnea,
increased HR, nagging cough, gaining weight, hypotension
what are symptoms of systolic heart failure?
s3, edema, weight gain, crackles, dyspnea, chest tightness, oliguria, JVD, weak
pulses, cool pale skin, altered mental status
diagnostic tests for heart failure
-ECG
-xray
-ECHO
-BNP (normal < 100 75 & under, < 450 75+)
-cardiac biomarkers
what are treatments for systolic HF?
-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?
beta blockers
which medications for HF interrupts RAAS activation to block vasoconstriction and
ADH?
ace inhibitors (ACE-I), angiotension receptor blockers (ARBs), ARNI
what 3 things occur in diastolic HF?
1. pulmonary congestion
2. pulmonary edema
3. decreased O2 sats
what are treatments for diastolic HF & why?
-beta blockers to slow HR
-ACE-I & ARBs to manage preload + afterload
-diuretics (use less than systolic HF, need to maintain adequate preload for filling)
stages of kidney failure
PCU Exam
what are normal ABG values?
pH: acidic 7.35-7.45 basic
CO2: basic 35-45 acidic
HCO3-: acidic 22-26 basic
normal paO2
80-100 mmHg
what pH levels are lethal?
outside 6.8-7.8
where are ABGs drawn from? what test is done to ensure adequate blood flow?
peripheral artery; allen's test for radial artery
How do the kidneys help maintain acid-base balance?
retain/excrete basic HCO3 and retain/excrete acidic H+
treatments for respiratory acidosis
-oxygen
-intubation
-bronchodilators
-drug reversal agents
-incentive spirometer
-suction
treatments for respiratory alkalosis
-breathing into paper bag
-anxiolytics
-analgesics
-reduce fever
-reduce ventilation
-return to normal altitude
treatments for metabolic acidosis
-IV sodium bicarbonate
-manage blood sugar
-antibiotics
-reversal for OD
-anti-diarrheal agents
-dialysis
-encourage respirations/ventilate
treatments for metabolic alkalosis
-antiemetics
-stop suctioning
-d/c drugs causing acid loss (diuretics, antacids)
-hydrochloric acid (rare)
what is systolic vs diastolic heart failure?
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?
, 18/01/2025 06:05
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?
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?
-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?
drowning: dyspnea, rales/crackles, orthopnea, weakness, nocturnal dyspnea,
increased HR, nagging cough, gaining weight, hypotension
what are symptoms of systolic heart failure?
s3, edema, weight gain, crackles, dyspnea, chest tightness, oliguria, JVD, weak
pulses, cool pale skin, altered mental status
diagnostic tests for heart failure
-ECG
-xray
-ECHO
-BNP (normal < 100 75 & under, < 450 75+)
-cardiac biomarkers
what are treatments for systolic HF?
-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?
beta blockers
which medications for HF interrupts RAAS activation to block vasoconstriction and
ADH?
ace inhibitors (ACE-I), angiotension receptor blockers (ARBs), ARNI
what 3 things occur in diastolic HF?
1. pulmonary congestion
2. pulmonary edema
3. decreased O2 sats
what are treatments for diastolic HF & why?
-beta blockers to slow HR
-ACE-I & ARBs to manage preload + afterload
-diuretics (use less than systolic HF, need to maintain adequate preload for filling)
stages of kidney failure
