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NUR 265 EXAM 3 STUDY QUESTIONS.
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NUR 265 Exam 3 Study Questions► What is the normal arterial blood gas (ABG) range for the partial
pressure of oxygen (PO2)?
o 80-100 mmHg
o What if it’s higher than 100? What if it’s lower than 80?
Higher = too much oxygenation … lower = hypoxia
► What is the normal arterial blood gas (ABG) range for the partial
pressure of carbon dioxide (PaCO2)?
o 35-45 mmHg
o What if it’s lower than 35? What is it’s higher than 45?
Decreased = Respiratory alkalosis … increased =
Respiratory Acidosis
► What is the normal range for the compensatory arterial blood gas
(ABG) bicarbonate (HCO3)?
o 21-28 mEq/L
o What is it’s higher than 28? What if it’s lower than 21?
Higher = respiratory acidosis (compensation for metabolic
alkalosis) … Lower = respiratory alkalosis (compensating
for metabolic acidosis)
► What is the normal range for glucose?
o 60-100 mg/dL
► What is the range of pre-diabetes for an impaired fasting glucose (IFG)
test?
o 100-125 mg/dL
► What is the range of pre-diabetes for a 2 hour oral glucose tolerance
(IGT) test?
o 140-199 mg/dL
► What is the normal range for a glycosylated hemoglobin (HbA1C) test?
4-6%
► What is the reference range for the electrolyte phosphorus?
o 3 – 4.5 mg/deciLiter
► What is the reference range for the electrolyte magnesium?
o 1.3 – 2.1 milli-Equivalents/Liter
► What is the reference range for the electrolyte chloride?
o 98 – 106 milli-Equivalents/Liter
► What is the reference range for the electrolyte calcium?
o 9 – 10.5 mg/deciLiter
► What is the reference range for the electrolyte potassium?
o 3.5 – 5 milli-Equivalents/Liter
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► What is the reference range for the electrolyte sodium?
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o 136 – 145 milli-Equivalents/Liter
,► What is the reference range for hemoglobin?
o 14-18 gram/deciliter
► What is the reference range for hematocrit?
o 42-52%
► What is the reference range for blood osmolarity?
o 285-295 mOsm/kg
► What are the normal levels for serum creatinine?
o 0.6-1.2
► What are the normal levels for BUN?
o 10-20
► What is the leading cause of death in head trauma patients who arrive
to the hospital?
o Increased Intracranial Pressure
► What causes increased intracranial pressure to kill someone?
o Pressure causes the medulla oblongata to herniate
o What symptoms occur when the medulla oblongata gets
compressed from intracranial pressure?
Severe bradycardia, widening pulse pressure, elevated
systolic pressure
What is this presentation of symptoms known as?
Cushing’s triad
► What section of the brain will experience inflammation from
intracranial pressure first?
o The frontal lobe
o What is the frontal lobe responsible for?
(1) Level of consciousness (2) judgment (3) awareness
o What symptoms could be expected from injury to the frontal lobe
due to intracranial pressure?
(1) Change in level of consciousness (the first sign!!!) (2)
lethargy (3) stupor (4) disorientation or alert but not
oriented (5) coma
► What are the earliest signs of increased intracranial pressure?
o Change in level of consciousness = (1) confusion (2) lethargy (3)
slurred speech (4) irritability
► If intracranial pressure is affecting the hypothalamus, how would it be
exhibited?
o Temperature would increase
► What can be done to prevent and detect intracranial pressure?
o Getting baseline vitals
► If a patient exhibits sluggish pupil dilation bilaterally, what cranial
2
nerve is being affected?
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o Cranial nerve 3 (oculomotor)
, o What does this mean is happening to the patient?
Intracranial pressure is reaching the brainstem
► An ovoid pupil reaction has what presentation?
o A size between normal and dilated
o What does this mean about intracranial pressure?
That it has progressed to the brainstem, specifically the
pons
► Name the 12 cranial nerves in order.
o (1) olfactory (2) optic (3) oculomotor (4) trochlear (5) trigeminal
(6) abducens (7) facial (8) vestibulocochlear (9)
glossopharyngeal (10) vagus (11) accessory (12) hypoglossal
► How do you test cranial nerves 3, 4, and 6?
o Following a pen with eyes through different fields of vision
o What if the patient’s eyes start moving rapidly?
There is compression of the brainstem
► What are the late signs of ICP?
o (1) severe headaches (2) nausea (3) projectile vomiting (4)
seizures (5) papilledema (6) decerebrate posturing (7)
decorticate posturing (8)ataxia (9) nuchal rigidity or stiff neck
(10) cerebrospinal fluid leaking from ears or otorrhea (11)
cerebrospinal fluid leaking from nose or rhinorrhea
o How do you assess for papilledema and what does it mean is
happening?
With an ophthalmoscope and increased blood flow to optic
disc in the eye
o How can you tell the fluid leaking from the patient’s nose is
cerebrospinal fluid?
From the halo sign created by the glucose and protein in
the droplet
o Why don’t you want to move the patient with a stiff neck?
Because it could cause phrenic nerve damage
► What is decorticate posturing?
o Abnormal posturing from lesions in the corticospinal pathways
o What does this do to the body? [HINT:: think cocoon]
Arms, wrists, and fingers are flexed with internal rotation in
the legs
► What is decerebrate posturing? [HINT:: think butterfly]
o Abnormal posturing from dysfunction in the brainstem
o How is it characterized?
Extension of arms and legs, pronation of the arms, body
3
spasms that
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► What should you assume for any patient with a head injury?
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