WCU advanced med surg exam 1
Respiratory alkalosis risk factors - ✔️✔️hyperventilation (anxiety, head trauma,
salicylate toxicity), hypoxemia (PNA, altitude sickness, shock, asphyxiation)
Respiratory alkalosis interventions - ✔️✔️Regulate 02 therapy, reduce anxiety,
rebreathing techniques
metabolic acidosis risk factors - ✔️✔️DKA, starvation, lactic acidosis (seizures),
kidney/liver failure, diarrhea, overdose (salicylates or ethanol, pancreatitis, liver failure
metabolic acidosis clinical manifestations - ✔️✔️bradycardia, weak pulses,
hypotension, tachypnea, confusion, flaccid paralysis, drowsiness, warm flushed skin,
kussmaul's respirations
Metabolic acidosis interventions - ✔️✔️treat underlying causes. adminster fluids,
electrolyes, sodium bicarbonate (1 mEq/kg)
metabolic alkalosis risk factors - ✔️✔️ingestion of antacids, GI suction (acid deficit),
hypokalemia, TPN, blood transfusion, prolonged vomiting
metabolic alkalosis clinical manifestations - ✔️✔️tachycardia, numbness, tingling,
tetany/hyperreflexia, confusion, convulsions
respiratory acidosis risk factors - ✔️✔️respiratory depression, pneumothorax, airway
obstructions, inadequate ventilation
Respiratory acidosis clinical manifestaions - ✔️✔️confusion, anxiety, cyanotic, coma
respiratory acidosis interventions - ✔️✔️maintain patent airway, reversal agent for
narcotics, regulate vent therapy, bronchodilators, mucolytics
metabolic alkalosis interventions - ✔️✔️treat underlying cause, administer fluids,
antiemetics, electrolytes
respiratory system diagnostic procedures - ✔️✔️pulmonary function test, chest x rays,
sputum culture. CT scan. MRI, ABGs. Bronchoscopy, thoracentesis
pulmonary function tests indications - ✔️✔️episodes of dyspnea, preoperative if at high
risk for respiratory complications. this assess for lung disease. can cause dizzyness
, pulmonary function test prep - ✔️✔️no smoking for 6-8 hours before test. no inhalers 4-
6 hours before the test
pulmonary function test measures: - ✔️✔️lung volume and capacity, diffusion, gas
exchange, flow rates, airway resistance along the distribution of ventilation
incentive spirometer - ✔️✔️measures amount of air with inhale and exhale. risk for
dizzyness
incentive spirometer use - ✔️✔️breathe in tracer gas. This detects when you breathe
out the gas, assess transfer of 02 and c02 in lungs and blood stream
ABGS purpose - ✔️✔️measures status of oxygenation & acid-base balance of blood.
Can determine effectiveness of treatments, guide 02 therapy, evaluate patient's
response when weaning off vent. Obtained to an arterial puncture through the arterial
line
ABG components - ✔️✔️pH (7.35-7.45), PaC02(35-45), HC03(22-26), Sa02(95-100),
Pa02(80-100)
Before the ABG arterial puncture - ✔️✔️Allen test
Allen test purpose - ✔️✔️To assess the patency of the ulnar artery
Allen test procedure - ✔️✔️1. Have patient rest writs on pillow facing up.
2. blanche radial and ulnar artery
3. have patient repeated make a fist
4. check for venous return
intra arterial puncture - ✔️✔️use heparinized needle
post arterial puncture - ✔️✔️hold pressure for 5 minutes, hold for 20 if on
anticoagulants. keep on ice and transport specimen immediately
arterial line draw - ✔️✔️use heparinized needle with flush
arterial puncture complications - ✔️✔️hematoma, arterial occlusion, edema, loss of
pulse, embolism
bronchoscopy purpose - ✔️✔️visualize larynx, trachea, & bronchi. obtain tissue biopsy,
foreign body removal
pre-bronchoscopy - ✔️✔️informed consent, assess for allergies and anticoagulants,
NPO, Meds (viscous lidocaine or local anesthetic)
Respiratory alkalosis risk factors - ✔️✔️hyperventilation (anxiety, head trauma,
salicylate toxicity), hypoxemia (PNA, altitude sickness, shock, asphyxiation)
Respiratory alkalosis interventions - ✔️✔️Regulate 02 therapy, reduce anxiety,
rebreathing techniques
metabolic acidosis risk factors - ✔️✔️DKA, starvation, lactic acidosis (seizures),
kidney/liver failure, diarrhea, overdose (salicylates or ethanol, pancreatitis, liver failure
metabolic acidosis clinical manifestations - ✔️✔️bradycardia, weak pulses,
hypotension, tachypnea, confusion, flaccid paralysis, drowsiness, warm flushed skin,
kussmaul's respirations
Metabolic acidosis interventions - ✔️✔️treat underlying causes. adminster fluids,
electrolyes, sodium bicarbonate (1 mEq/kg)
metabolic alkalosis risk factors - ✔️✔️ingestion of antacids, GI suction (acid deficit),
hypokalemia, TPN, blood transfusion, prolonged vomiting
metabolic alkalosis clinical manifestations - ✔️✔️tachycardia, numbness, tingling,
tetany/hyperreflexia, confusion, convulsions
respiratory acidosis risk factors - ✔️✔️respiratory depression, pneumothorax, airway
obstructions, inadequate ventilation
Respiratory acidosis clinical manifestaions - ✔️✔️confusion, anxiety, cyanotic, coma
respiratory acidosis interventions - ✔️✔️maintain patent airway, reversal agent for
narcotics, regulate vent therapy, bronchodilators, mucolytics
metabolic alkalosis interventions - ✔️✔️treat underlying cause, administer fluids,
antiemetics, electrolytes
respiratory system diagnostic procedures - ✔️✔️pulmonary function test, chest x rays,
sputum culture. CT scan. MRI, ABGs. Bronchoscopy, thoracentesis
pulmonary function tests indications - ✔️✔️episodes of dyspnea, preoperative if at high
risk for respiratory complications. this assess for lung disease. can cause dizzyness
, pulmonary function test prep - ✔️✔️no smoking for 6-8 hours before test. no inhalers 4-
6 hours before the test
pulmonary function test measures: - ✔️✔️lung volume and capacity, diffusion, gas
exchange, flow rates, airway resistance along the distribution of ventilation
incentive spirometer - ✔️✔️measures amount of air with inhale and exhale. risk for
dizzyness
incentive spirometer use - ✔️✔️breathe in tracer gas. This detects when you breathe
out the gas, assess transfer of 02 and c02 in lungs and blood stream
ABGS purpose - ✔️✔️measures status of oxygenation & acid-base balance of blood.
Can determine effectiveness of treatments, guide 02 therapy, evaluate patient's
response when weaning off vent. Obtained to an arterial puncture through the arterial
line
ABG components - ✔️✔️pH (7.35-7.45), PaC02(35-45), HC03(22-26), Sa02(95-100),
Pa02(80-100)
Before the ABG arterial puncture - ✔️✔️Allen test
Allen test purpose - ✔️✔️To assess the patency of the ulnar artery
Allen test procedure - ✔️✔️1. Have patient rest writs on pillow facing up.
2. blanche radial and ulnar artery
3. have patient repeated make a fist
4. check for venous return
intra arterial puncture - ✔️✔️use heparinized needle
post arterial puncture - ✔️✔️hold pressure for 5 minutes, hold for 20 if on
anticoagulants. keep on ice and transport specimen immediately
arterial line draw - ✔️✔️use heparinized needle with flush
arterial puncture complications - ✔️✔️hematoma, arterial occlusion, edema, loss of
pulse, embolism
bronchoscopy purpose - ✔️✔️visualize larynx, trachea, & bronchi. obtain tissue biopsy,
foreign body removal
pre-bronchoscopy - ✔️✔️informed consent, assess for allergies and anticoagulants,
NPO, Meds (viscous lidocaine or local anesthetic)
