NR 226 Weeks 4, 5, and 6 Review Questions and Answers

NR 226 Weeks 4, 5, and 6 Review Questions and Answers ABG normal ranges pH: acidic 7.35 - 7.45 basic CO2: basic 35 -45 acidic HCO3 (bicarb): acidic 22 - 26 basic ABG: what determines metabolic status vs what determines respiratory status HCO3 determines metabolic status and CO2 determines respiratory status 2/3 of the body's fluid resides in _____ while 1/3 of body's fluid resides in _____ 2/3: intra-cellular compartment 1/3: extra-cellular compartment either interstitial or intravascular when blood tonicity rises it triggers ____ which allows the ____ to absorb more water triggers vasopressin and allows the kidneys to absorb more water which means the urine will be more concentrated tonicity referring to IV fluids means how the IV fluid will affect the body relevant to fluid movement this tonicity means same number of particles as fluid isotonic this tonicity means more particles than fluid hypertonic this tonicity means more fluid than particles hypotonic (mineral salts) these compounds separate into ions when dissolved in water and move nutrients into cell and water out electrolytes positively charged ions vs negatively charged ions +: sodium, potassium, calcium, magnesium -: chloride and bicarb using ATP to move electrolytes across cell from low to high concentration active transport passive transport from high to low concentration diffusion water moves across semi permeable membrane osmosis fluid in cell exerts this to pull water into cell until concentration of particles is equal to fluid osmotic pressure fluid moving in and out of capillaries between interstitial and intravascular compartments filtration outward force of fluid pressing outward against surface hydrostatic pressure blood proteins too large to leave capillaries so they exert osmotic pressure to move fluids colloids fluid accumulates where resulting in edema interstitial space abnormal fluid output vomiting, wound drainage, hemorrhage fluid is typically excreted by four organs skin, GI tract, kidneys and lungs this fluid excretion system controls how much water is secreted through urine and causes renal cells to reabsorb water ADH this fluid excretion system controls how much sodium and water is excreted, controls bp, causes sodium reabsorption RAAS the RAAS releases renin when ___ levels are too low, then ____ is released and causes vasoconstriction to raise bp sodium angiotensin excess fluid volume does this raise or lower bp hypervolemia raises bp deficit fluid volume does this raise or lower bp hypovolemia lowers bp NREM sleep nonrapid eye movement sleep, stages I - III REM occurs when and how long is average cycle rapid eye movement occurs at the end of each cycle for 90 minutes, breathing becomes irregular Stages of NREM N1: very short right when you fall asleep, can be awakened easily N2: about 30-60 minutes, muscles relaxed N3: deep sleep about 20-40 minutes, body movements, hard to wake, repeated 3-4 times per ngiht ulcer in lining of esophagus, stomach or small intestine contributes to reflux and stomach acid causes burning and disrupts sleep peptic ulcer disease (a sleep associated condition) nursing intervention of peptic ulcer disease proton pump inhibitor to decrease reflux meds ending in -prizole assessing for sleep apnea questions do you snore? do you wake up feeling fatigued? how many pillows do you use? pushes warm humidified air through mouth and nose to prevent airway from collapsing CPAP machine to prevent obstructive sleep apnea sleep hygiene bedtime routine, stress reduction, less device usage, environment, eating , stimulants sleep meds hypnotics: ambien and lunesta sedatives: depressants and barbiturate short/intermediate acting benzodiazepines: versed, xanax, activan excessive daytime sleepiness narcolepsy seen in children. somnambulism (sleep walking), night terror, sleep paralysis parasomnia who said pain is subjective, it is whatever pt tells us it is margaret mccaffery can affect sensation of pain neurological functioning, peripheral neuropathy chronic pain without identifiable physical or psychological cause idiopathic pain