NUR 2392 Multidimensional Care II Exam 2

NUR2392 Multidimensional Care II Exam 2 Uncompensated - pH and one other value is abnormal Partial compensation - pH, CO2, and HCO3 are all off Full compensation - pH is normal Acidosis - reduces the excitability of cardiovascular muscle, neurons, skeletal muscle, and smooth muscle. Alkalosis - increases the sensitivity of excitable tissues allowing them to OVERRESPOND without stimulation ABG considerations - - Assess cardiovascular w/ acidosis (cardiac arrest from hyperkalemia) - Assess neuro status - Fall precautions Bicarb HC03 - kidney compensation (slow and powerful) Respiratory PaC02 - Respiratory compensation (fast but limited) Metabolic acidosis causes - DKA, Starvation, diarrhea, kidney failure, dehydration, liver failure, pancreatitis, heavy exercise, seizure activity, fever, hypoxia, ischemia, ethanol/methanol intoxication Metabolic acidosis signs and symptoms - bradycardia, hypotension, thready pulse, CNS depression, hyporeflexia, kussmal resp (with resp compensation), warm, flushed, dry skin. Metabolic acidosis treatment - hydration and medication to treat underlying problems (DKA - give insulin). Metabolic alkalosis causes - antacids, blood transfusion, sodium bicarbonate, total parenteral nutrition (TPN), prolonged vomiting, nasogastric suctioning, hypercortisolism, hyperaldosteronism, Loop/Thiazide diuretics. Metabolic Alkalosis s/s - anxiety, irritability, tetany, seizures, POSITIVE CHVOSTEK, POSITIVE TROUSSEAU, parathesis, hyperreflexia, muscle cramping/twitching, skeletal muscle weakness, Tachycardia, norm/low BP, increased Digoxin toxicity, decreased respiratory effort (muscle weakness). metabolic alkalosis treatment - restore fluid/electrolyte imbalances