NUR 425 Exam 3 Study Questions and 100% Correct Answers
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Course
NUR 425
Institution
NUR 425
Which of the following is the body's first line of defense against an acid-base imbalance? Chemical and protein buffers
In regards to acid-base imbalance, what does "compensation" mean? It is the body's attempt to correct the acid-base imbalance
Which of the following places a patient at risk for...
NUR 425 Exam 3 Study Questions and
100% Correct Answers
Which of the following is the body's first line of defense against an acid-base
imbalance? ✅Chemical and protein buffers
In regards to acid-base imbalance, what does "compensation" mean? ✅It is the body's
attempt to correct the acid-base imbalance
Which of the following places a patient at risk for a state of acidosis? (SELECT ALL
THAT APPLY)
a. A patient with severe anxiety
b. A patient rescued from a drowning
c. A patient who consumed an entire bottle of Tums
d. A patient with severe diarrhea
e. A patient with kidney failure ✅B,D,E
In general, respiratory alkalosis is due to what? ✅Breathing too quickly and/or deeply
Which of the following values is associated with "alkalosis"?
(SELECT ALL THAT APPLY)
a. ph: 7.5
b. CO2: 30
c. HCO3: 20
d. CO2: 45
e. HCO3: 45 ✅A,B,E
The amount of air in milliliters to be delivered with each breath describes which
ventilator setting? ✅Tidal Volume
Patients A and B are both on mechanical ventilatory support.
,Patient A is receiving an FiO2 of 70% and patient B is receiving an FiO2 of 30%
Which statement about these patients is most accurate? ✅70% of the air being
delivered to patient B is NOT oxygen
What is the nurse's responsibility related to intubation? ✅Monitor the patient's SaO2
and alert the team of any complications during intubation attempts
Which of the following is true about pressure versus volume modes? ✅Pressure
modes deliver breaths with a set amount of pressure measured in cmH20
What is PEEP? ✅The amount of pressure delivered at the end of exhalation aimed at
keeping the alveoli open
Which of the following is the correct formula for calculating CPP? ✅MAP-ICP=CPP
Which of the following is a normal ICP value? ✅9
Which of the following is a normal CPP value? ✅80
According to the Monro Kellie Hypothesis, which of the following is true? ✅If the
volume of the brain increases, the blood and/or CSF must decrease
Calculate this patient's CPP and determine what nursing intervention is indicated
MAP: 72
ICP: 20 ✅CPP is 52, measures to reduce ICP are indicated
A 55 year old male with a brain tumor is hypoxic and hypercarbic (high CO2), what is he
at risk for? ✅Increased ICP due to cerebral vasodilation
Calculate this patient's CPP and determine what nursing intervention is indicated
MAP: 50
ICP: 5 ✅CPP: 45
Administer prescribed norepinephrine
Which could be a cause of increased intracranial pressure?
(SELECT ALL THAT APPLY)
a. hip extension
,b. hydrocephalus
c. reduced outflow of blood from the brain
d. pain
e. anxiety ✅B,C,D,E
Homeostasis ✅crucial to sustain life
Acid Base Imbalance ✅just a symptom of disease- not a disease itself
Examples of health problems that lead to imbalance: ✅DM
COPD
Kidney disease
GI Disturbances
Drawing an ABG ✅Specimen comes from arterial blood;
- thus the A
Can be a direct stick to the artery - (radial, brachial, or femoral)
If frequent ABG's needed
- an Arterial Line is usually placed
Allow a minimum of 20 minutes after suctioning
- (suction time < 15 seconds), vent or oxygenation changes to obtain an ABG
PaO2: ✅how much oxygen is in the blood
SaO2: ✅how much oxygen is attached to the hemoglobin? ("oxyhemoglobin")
PaCO2: ✅How much CO2 is in the blood?
Did enough/too much CO2 get "blown off" by the lungs or is it building up?
HCO3: ✅How much bicarbonate is in the blood?
How are the kidneys working?
Is there a metabolic issue?
Normal pH: ✅7.35-7.45
Acidosis pH: ✅< 7.35
, Death: 6.8 and less
Alkalosis pH: ✅> 7.45
Death: 7.8+
How do our bodies NORMALLY regulate acids and bases? ✅Buffer System
Respiratory System
Renal System
Buffer System ✅(proteins, ions etc absorb/release H+)
- Fastest- immediate, but low threshold
Respiratory System ✅(Changes in CO2)
- Moderate- Effects within minutes, max effect in 24h, more sustainable but not long
term
Renal System ✅(Changes in H+ and HCO3-)
- Slowest- Effects take days, but more sustainable
Buffers: ✅- Fastest-acting system
- Primary regulator, but cannot maintain pH without Respiratory & renal systems
- Change strong acids to weaker acids
- Bind acids to neutralize their effect
Buffer system can't maintain pH without ✅good kidney and lung function
Kidneys impact pH with ✅HCO3
Lungs impact pH with ✅CO2
How do CO2 and HCO3 Affect pH? ✅- Hydrogen and Bicarbonate join to make
carbonic acid
- Carbonic acid becomes water and Carbon dioxide
(Reversible process)
H+ + HCO3- H2CO3 H2O + CO2
↑ HCO3 = BASE
↓ HCO3= ACID
↑ CO2 = ACID
↓ CO2= BASE
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