NUR 327 Final Exam Questions With Correct
Answers
1. Interpret the components of an arterial blood gas and the normal values for
| | | | | | | | | | | |
each component.: pH = pH of the blood
| | | | | | | |
PaCO2 = Respiratory | |
HCO3 = Metabolic
| | |
pH 7.35 - 7.45
| | |
PaCO2 35 - 45 | | |
HCO3 22 - 26 | | |
What would I expect to happen if something else is abnormal?
| | | | | | | | | |
2. Evaluate arterial blood gas results for uncompensated, partially compensat-
| | | | | | | |
ed, and fully compensated acid base imbalances.: pH: 7.18 PaCO2: 53 HCO3: 25
| | | | | | | | | | | | |
pH: 7.30 PaCO2: 30 HCO3: 18
| | | | |
****know how to identify based on scenario s/s**** | | | | | | |
3. Respiratory Alkalosis: Cause: | |
Temperature increased in body (fever) | | | |
Aspirin toxicity
| |
Controlledmechanical ventilation | |
Hyperventilation
|
hYsteria (anxiety) |
Pain / Pregnancy / Pneumonia Neurologic
| | | | |
injuries (head injury/stroke) Embolism &
| | | | |
Edema
|
Asthma due to hyperventilation | | |
Manifestations:
- Fast RR >20 | |
- neuro changes: confused, tired, elevated HR
| | | | |
- Tetany
- EKG changes |
- muscle cramps |
1 |/ |49
,- positive Chvostek's sign (twitch of facial muscles after tapping facial nerve)
| | | | | | | | | |
Tx:
- Teach breathing techniques to slow breathing
| | | | |
2 |/ |49
,- watch K and Ca levels (hypo) | | | | |
- low potassium levels | |
- Watch for hyperventilation in ventilated patients
| | | | |
Nursing care: |
- watch K and Ca levels | | | |
- Watch for hyperventilation in ventilated patients
| | | | |
4. Compare the clinical manifestations, causes, treatments, and nursing care | | | | | | | |
for clients experiencing acid base imbalances including respiratory acidosis,
| | | | | | | | |
respiratory alkalosis, metabolic acidosis, and metabolic alkalosis.: *What do I
| | | | | | | | | |
expect to see vs what is a complication*
| | | | | | | |
- at risk for metabolic acidosis to now they have acidosis
| | | | | | | | |
-- how is the body going to compensate (RR incrs)
| | | | | | | | |
DIC - might expect | | |
Vasooclusive crisis - might expect | | | |
Seizure - might expect respiratory acidosis UC | | | | | |
- might expect metabolic acidosis
| | | | |
5. Respiratory Acidosis: Causes: | |
anything that interferes with respiratory function and retention of CO2
| | | | | | | | |
- bronchoconstriction
- bacterial pneumonia |
- Pulmonary embolism (PE) | |
Drugs
|
Edema
Pneumonia
|
Respiratory center of brain is damaged | | | | |
Emboli
|
Spasms of brachial tubules | | |
Sac elasticity of alveoli sac is damaged (COPD or Emphysema)
| | | | | | | | |
Manifestations:
- confusion, disorientation, decreased level of consciousness, | | | | |
- drowsy
- HA
- Respiratory depression <12 | |
- low BP |
- increased ICP (severe) | |
3 |/ |49
, Tx:
- improve ventilation *Breath faster* | | |
- pulmonary hygiene: increased fluid intake, and ambulation | | | | | |
- admin O2 |
- encourage coughing and deep breathing (if awake) | | | | | |
- respiratory Tx if indicated | | |
- hold narcotics/sedatives
|
- watch potassium levels | |
- administer antibiotics (if indicated) | | |
- May need ET tube if pt in resp distress
| | | | | | | |
Nursing care: |
- monitor for hyperkalemia | |
6. Metabolic Acidosis: Causes: | |
anything that increases H+ or decreased HCO3 | | | | | |
- renal impairment |
- diabetes
- starvation
- prolonged diarrhea |
Accumulation of lactate leading to lactic acidosis (sepsis) | | | | | | |
Chronic diarrhea (most common)
| | | |
Impaired renal function (most common) | | | |
Diabetic ketoacidosis (DKA)
| | |
|Salicylates toxicity |
Manifestations:
Neurological changes
| |
HA
|
fatigue
tachypne
|
a low BP | |
cold clammy skin
| |
vomiting
|
nausea
increased respiratory rate Kussmaul | | |
breathing - fast and deep confused
| | | | | |
weak
ECG - T waves (hyperkalemia)
| | | |
4 |/ |49
Answers
1. Interpret the components of an arterial blood gas and the normal values for
| | | | | | | | | | | |
each component.: pH = pH of the blood
| | | | | | | |
PaCO2 = Respiratory | |
HCO3 = Metabolic
| | |
pH 7.35 - 7.45
| | |
PaCO2 35 - 45 | | |
HCO3 22 - 26 | | |
What would I expect to happen if something else is abnormal?
| | | | | | | | | |
2. Evaluate arterial blood gas results for uncompensated, partially compensat-
| | | | | | | |
ed, and fully compensated acid base imbalances.: pH: 7.18 PaCO2: 53 HCO3: 25
| | | | | | | | | | | | |
pH: 7.30 PaCO2: 30 HCO3: 18
| | | | |
****know how to identify based on scenario s/s**** | | | | | | |
3. Respiratory Alkalosis: Cause: | |
Temperature increased in body (fever) | | | |
Aspirin toxicity
| |
Controlledmechanical ventilation | |
Hyperventilation
|
hYsteria (anxiety) |
Pain / Pregnancy / Pneumonia Neurologic
| | | | |
injuries (head injury/stroke) Embolism &
| | | | |
Edema
|
Asthma due to hyperventilation | | |
Manifestations:
- Fast RR >20 | |
- neuro changes: confused, tired, elevated HR
| | | | |
- Tetany
- EKG changes |
- muscle cramps |
1 |/ |49
,- positive Chvostek's sign (twitch of facial muscles after tapping facial nerve)
| | | | | | | | | |
Tx:
- Teach breathing techniques to slow breathing
| | | | |
2 |/ |49
,- watch K and Ca levels (hypo) | | | | |
- low potassium levels | |
- Watch for hyperventilation in ventilated patients
| | | | |
Nursing care: |
- watch K and Ca levels | | | |
- Watch for hyperventilation in ventilated patients
| | | | |
4. Compare the clinical manifestations, causes, treatments, and nursing care | | | | | | | |
for clients experiencing acid base imbalances including respiratory acidosis,
| | | | | | | | |
respiratory alkalosis, metabolic acidosis, and metabolic alkalosis.: *What do I
| | | | | | | | | |
expect to see vs what is a complication*
| | | | | | | |
- at risk for metabolic acidosis to now they have acidosis
| | | | | | | | |
-- how is the body going to compensate (RR incrs)
| | | | | | | | |
DIC - might expect | | |
Vasooclusive crisis - might expect | | | |
Seizure - might expect respiratory acidosis UC | | | | | |
- might expect metabolic acidosis
| | | | |
5. Respiratory Acidosis: Causes: | |
anything that interferes with respiratory function and retention of CO2
| | | | | | | | |
- bronchoconstriction
- bacterial pneumonia |
- Pulmonary embolism (PE) | |
Drugs
|
Edema
Pneumonia
|
Respiratory center of brain is damaged | | | | |
Emboli
|
Spasms of brachial tubules | | |
Sac elasticity of alveoli sac is damaged (COPD or Emphysema)
| | | | | | | | |
Manifestations:
- confusion, disorientation, decreased level of consciousness, | | | | |
- drowsy
- HA
- Respiratory depression <12 | |
- low BP |
- increased ICP (severe) | |
3 |/ |49
, Tx:
- improve ventilation *Breath faster* | | |
- pulmonary hygiene: increased fluid intake, and ambulation | | | | | |
- admin O2 |
- encourage coughing and deep breathing (if awake) | | | | | |
- respiratory Tx if indicated | | |
- hold narcotics/sedatives
|
- watch potassium levels | |
- administer antibiotics (if indicated) | | |
- May need ET tube if pt in resp distress
| | | | | | | |
Nursing care: |
- monitor for hyperkalemia | |
6. Metabolic Acidosis: Causes: | |
anything that increases H+ or decreased HCO3 | | | | | |
- renal impairment |
- diabetes
- starvation
- prolonged diarrhea |
Accumulation of lactate leading to lactic acidosis (sepsis) | | | | | | |
Chronic diarrhea (most common)
| | | |
Impaired renal function (most common) | | | |
Diabetic ketoacidosis (DKA)
| | |
|Salicylates toxicity |
Manifestations:
Neurological changes
| |
HA
|
fatigue
tachypne
|
a low BP | |
cold clammy skin
| |
vomiting
|
nausea
increased respiratory rate Kussmaul | | |
breathing - fast and deep confused
| | | | | |
weak
ECG - T waves (hyperkalemia)
| | | |
4 |/ |49
