NUR2392 MULTIDIMENSIONAL CARE II EXAM 2 | DETAILED |
ANSWERS | BRAND NEW| 100% ACCURATE
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
Respiratory acidosis cause Opioids, anesthetics, electrolyte imbalance, inadequate
chest expansion, muscle weakness, airway obstruction, alveolar-capillary block.
Respiratory acidosis s/s bradycardia, hypotension, thready pulse, CNS depression,
hyporeflexia, ineffective respirations, pale-to-cyanotic dry skin.
Respiratory acidosis treatment (Assess airway) Improve gas exchange, drug therapy
(bronchodilators, anti-inflammatory), oxygen therapy (lowest flow possible), ventilation.
Respiratory alkalosis cause Hyperventilation (fear, anxiety), mechanical ventilation,
salicylate toxicity, high altitudes, early-stage acute pulmonary issues.
respiratory alkalosis s/s anxiety, irritability, tetany, seizures, POSITIVE CHVOSTEK,
POSITIVE TROUSSEAU (hypocalcemia), parathesis, hyperreflexia, muscle
cramping/twitching, skeletal muscle weakness, Tachycardia, norm/low BP, increased
Digoxin toxicity, hyperventilation
respiratory alkalosis treatment restore fluid/electrolyte imbalances
How do acid/base imbalances affect electrolytes - Potassium levels increase in
acidosis as the body attempts to maintain electroneutrality during buffering.
- Potassium is elevated in acute respiratory acidosis and normal/low in chronic
respiratory acidosis when kidney compensation is present
- Alkalosis = hypocalcemia and hypokalemia
- Acidosis = HYPERkalemia
alkalosis hypocalcemia and hypokalemia
acidosis HYPERkalemia
Upper GI consists of mouth, pharynx, esophagus, stomach, and duodenum.
Barret's Epithelium premalignant; columnar epithelium that develops in lower
esophagus
