Summary NUR2392 Multidimensional Care II MDC 2 Final Exam Study Guide

NUR2392 Multidimensional Care II MDC 2 Final Exam Study Guide *The exam questions are not limited to only what is listed on this guide, please refer to your chapter readings and module materials Chapter 12 – Assessment and Care of Patients with Problems of Acid-Base Balance • ABG ranges and analysis pH- Hydrogen- 7.35-7.45 PaCO2- carbon dioxide- 35-45mmHg HCO3-Bicarbonate- 22-26 mmol/L PaO2- less than 79 torr Respiratory Acidosis- Low pH Less than 7.35, Higher PaCO2, Low Pao2, Higher Bicarb - Common Causes: Narcotics, asthma, COPD, airway obstruction, pneumonia, myasthenia gravis ----- not enough oxygen taken in and carbon dioxide removed- serum potassium elevated if acute—normal or low if renal compensation present) - Diagnosis: Chara. By lower pH and increased PaCo2 Decreased Pao2 with rising Paco2, Kussmaul respiration, Skin changes- warm, dry, and pink vasodilation. Neuromuscular changes- decreased muscle tone, deep tendon reflexes. Cardiovascular changes- early: high HR, cardiac output changes. Worsening: hyper KAL, decreased HR; T wave peaked and QRS widened, weak peripheral pulses, hypotension - Treatment: focus on improving gas exchange- Drug therapy- bronchodilators, anti- inflammatories, mucolytics, oxygen therapy(be careful giving oxygen to COPD pts- can lead to respiratory arrets with too much OX), pulmonary hygiene, ventilation support, prevention of complications Respiratory Alkalosis- Higher pH greater than 7.45, Low Paco2, o2 and bicarb usually normal - Causes: hyperventilation- anxiety,