NUR 2392 Multidimensional Care II- Module 5, 6, & 7
Review Exam Questions With Complete Verified
Solutions
1. Blood Gases
a. Compensation
i. Chemical How
= buffers
ii. Respiratory How
iii. Kidneys How
b. PH, PCO2, HCO3 (know the normal range)
i. Analyze and determine Blood Gas Imbalance ii. Determine if there is
compensation (full/partial/none)
2. Imbalance:
= Remember you need to treat the underlying cause
3. What Acid Base Imbalance is indication for the administration of Ammonium Chloride. =
metabolic alkalosis
4. What is the MOST important system to monitor in Acidosis?
= cardiovascular
5. What is a common electrolyte imbalance identified in renal failure? = hyperkalemia
6. Aspirin toxicity can lead to what ACID-BASE imbalances explain?
= respiratory alkalosis first, and then metabolic acidosis
7. If the pH is high, what does this mean? What causes this?
= Alkalosis/basic – C02 excretion – d/t suctioning etc.
8. If the pH is low, what does this mean? What causes this?
= Acidic – ketones from DKA, Retention of Co2
, a. Metabolic Acidosis CO2 excess (overproduction of H+ ions/under-elimination of bicarb) -
breakdown of excess fatty acids/ excessive intake of fatty acids (too much running & not
taking enough diets to cover the loss)
i. Causes: example DKA = DKA; Renal failure; Starvation; Diarrhea; Ileostomy;
Hyperthyroidism; Pancreatitis; Liver failure; Dehydration; Seizure activity;
Ethanol intoxication; Aspirin toxicity ii. S/S: Break it down by system, also what
is the first system that where you will see changes. – bradycardia, low BP, Kussmal
(fast & shallow)
1. Cardiac… - monitor (during any acidosis) iii. Interventions
The Goal is to Increase the Bicarb to match the CO2
1. Intervention are not one size fits all-look at what you cause, list them 2.
Sodium Bicarb is administered if PH < 7.2
b. Respiratory Acidosis: CO2 excess /Co2 retention/decreased PaO2
i. Causes (Depress/hypoventilation-mechanical/obstruction)
= Respiratory depression; Inadequate chest expansion; Airway obstruction or
aspiration of foreign body; Opioids; Anesthetics; Ascites; Pulmonary embolism;
Pulmonary edema; Hypoventilation; Rib fractures; TB; Emphysema; Drowning;
ARDS; Pneumonia; COPD, Severe asthma ii.
S/S = low BP, Kussmal, impaired gas exchange
iii. Interventions The Goal is to Increase the Bicarb – increase rate of breathing
1. Interventions are not one size fits all-look at what you cause)
c. Metabolic Alkalosis: Base Excess or CO2 deficit (loss)
i. Causes – Base excess = Excess intake of bicarbonates, carbonates, acetates,
citrates, Citrate used as anticoagulant in blood products. Acid deficit -
Prolonged vomiting, excess cortisol, hyperaldosteronism, thiazide diuretics,
prolonged NG suction, loss of gastric fluid.
ii. S/S -
iii. Interventions The Goal is to prevent further loss of CO2 1. (it’s not one size
fits all-look at what you cause)
2. education
d. Respiratory Alkalosis: CO2 deficit
i. Causes = hyperventilation, fear, anxiety, mechanical ventilation, salicylate
toxicity, high altitudes, shock, early stage acute pulmonary problems
ii. S/S – dizziness, confusion, normal BP, nausea, trousseau sign
iii. Interventions: The Goal is to prevent further loss of CO2
1. (it’s not one size fits all-look at what you cause)
9. Draw a picture. Describe this in your own words.
a. Trousseau sign: delete that
b. Kussmal Respirations: what is this, when do you see and what is its mechanism?
c. Why do you need to understand a prolonged QT interval (ECG)?????
Review Exam Questions With Complete Verified
Solutions
1. Blood Gases
a. Compensation
i. Chemical How
= buffers
ii. Respiratory How
iii. Kidneys How
b. PH, PCO2, HCO3 (know the normal range)
i. Analyze and determine Blood Gas Imbalance ii. Determine if there is
compensation (full/partial/none)
2. Imbalance:
= Remember you need to treat the underlying cause
3. What Acid Base Imbalance is indication for the administration of Ammonium Chloride. =
metabolic alkalosis
4. What is the MOST important system to monitor in Acidosis?
= cardiovascular
5. What is a common electrolyte imbalance identified in renal failure? = hyperkalemia
6. Aspirin toxicity can lead to what ACID-BASE imbalances explain?
= respiratory alkalosis first, and then metabolic acidosis
7. If the pH is high, what does this mean? What causes this?
= Alkalosis/basic – C02 excretion – d/t suctioning etc.
8. If the pH is low, what does this mean? What causes this?
= Acidic – ketones from DKA, Retention of Co2
, a. Metabolic Acidosis CO2 excess (overproduction of H+ ions/under-elimination of bicarb) -
breakdown of excess fatty acids/ excessive intake of fatty acids (too much running & not
taking enough diets to cover the loss)
i. Causes: example DKA = DKA; Renal failure; Starvation; Diarrhea; Ileostomy;
Hyperthyroidism; Pancreatitis; Liver failure; Dehydration; Seizure activity;
Ethanol intoxication; Aspirin toxicity ii. S/S: Break it down by system, also what
is the first system that where you will see changes. – bradycardia, low BP, Kussmal
(fast & shallow)
1. Cardiac… - monitor (during any acidosis) iii. Interventions
The Goal is to Increase the Bicarb to match the CO2
1. Intervention are not one size fits all-look at what you cause, list them 2.
Sodium Bicarb is administered if PH < 7.2
b. Respiratory Acidosis: CO2 excess /Co2 retention/decreased PaO2
i. Causes (Depress/hypoventilation-mechanical/obstruction)
= Respiratory depression; Inadequate chest expansion; Airway obstruction or
aspiration of foreign body; Opioids; Anesthetics; Ascites; Pulmonary embolism;
Pulmonary edema; Hypoventilation; Rib fractures; TB; Emphysema; Drowning;
ARDS; Pneumonia; COPD, Severe asthma ii.
S/S = low BP, Kussmal, impaired gas exchange
iii. Interventions The Goal is to Increase the Bicarb – increase rate of breathing
1. Interventions are not one size fits all-look at what you cause)
c. Metabolic Alkalosis: Base Excess or CO2 deficit (loss)
i. Causes – Base excess = Excess intake of bicarbonates, carbonates, acetates,
citrates, Citrate used as anticoagulant in blood products. Acid deficit -
Prolonged vomiting, excess cortisol, hyperaldosteronism, thiazide diuretics,
prolonged NG suction, loss of gastric fluid.
ii. S/S -
iii. Interventions The Goal is to prevent further loss of CO2 1. (it’s not one size
fits all-look at what you cause)
2. education
d. Respiratory Alkalosis: CO2 deficit
i. Causes = hyperventilation, fear, anxiety, mechanical ventilation, salicylate
toxicity, high altitudes, shock, early stage acute pulmonary problems
ii. S/S – dizziness, confusion, normal BP, nausea, trousseau sign
iii. Interventions: The Goal is to prevent further loss of CO2
1. (it’s not one size fits all-look at what you cause)
9. Draw a picture. Describe this in your own words.
a. Trousseau sign: delete that
b. Kussmal Respirations: what is this, when do you see and what is its mechanism?
c. Why do you need to understand a prolonged QT interval (ECG)?????
