Exam (elaborations)
Final exam NUR 104/112 Complete Q’s and A’s A+ Graded
Final exam NUR 104/112 Complete Q’s and A’s A+ Graded
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Final exam NUR 104/112 Complete Q’s andA’s A+ Graded
pH value - -7.35-7.45
-PaCo2 - -35-45 mmHg
-HCO3- - -22-26 mEq/L
-PaO2 - -80-100 mmHg
-SaO2 - ->95%
-respiratory acidosis causes - -central nervous system depression,
pneumothorax, hypoventilation, bronchial obstruction and atelectasis, severe
pulmonary infections, heart failure with pulmonary edema, massive
pulmonary embolus, myasthenia gravis, multiple sclerosis
-clinical manifestations of respiratory acidosis - -• Dyspnea
• Restlessness
• Headache
• Tachycardia
• Confusion
• Lethargy
• Dysrhythmias
• Respiratory distress
• Drowsiness
• Decreased responsiveness
-causes of respiratory alkalosis - -anxiety (hyperventilation), fever
(increases metabolic rate), pain, hypoxia, thyrotoxicosis, central system
lesions, salicylate intoxication, hepatic failure, pregnancy, early pulmonary
edema
-clinical manifestations of respiratory alkalosis - -Hyperventilation,
Lightheadedness, confusion, decreased concentration, paresthesias, tetanic
spasms in the extremities, cardiac dysrhythmias, palpitations, sweating, dry
mouth, blurred vision
-causes of metabolic acidosis - -DKA, Starvation, Renal failure, Severe
diarrhea, starvation, ketoacidosis, anaerobic metabolism, salicylate
intoxication
, -clinical manifestations of metabolic acidosis - -Headache, confusion,
restlessness, lethargy, kussmaul respirations, flushed skin, nausea, vomiting,
seizures, twitching, weakness
-causes of metabolic alkalosis - -excess use of bicarbonate, lactate
administration in dialysis, excess ingestion of antacids, vomiting, nasogastric
suctioning, hypokalemia, hypochloremia, administration of diuretics,
increased levels of aldosterone
-nursing interventions for respiratory alkalosis - -- Teach patient breathing
techniques to slow down breathing, holding breath..."rebreathing into a
paper bag or re-breather mask
- Watch potassium levels (hypokalemia..remember hyperkalemia in
respiratory acidosis & hypocalcemia) and for signs and symptoms of low
calcium and potassium levels.
- Closely watch patients on mechanical ventilation to ensure breaths are not
hyperventilating the patient
-nursing interventions of respiratory acidosis - -O2, patent airway,
repositioning, breathing techniques, ventilatory support, bronchodilators,
mucolytics, good chest physiotherapy
-nursing interventions for metabolic acidosis - -- Watch respiratory system
and ABGs closely...if too bad may need intubation
- Assess other electrolyte levels (esp. potassium because during active
acidosis it will be high...however when it resolves there is an extracellular to
intracellular shift of K+ back into the cell which will causes HYPOkalemia)
- Watch neuro status, safety, and place in seizure precaution
- Dialysis may be needed if they patient is experiencing acidosis (high anion
gap issue ex: renal failure)
- Diabetic ketoacidosis: administer prescribed insulin to help glucose go back
into cell which will help the body start regulating how it metabolizes
glucose...hence not more ketones (acids)
- Strict I&O
-nursing interventions for metabolic alkalosis - -- monitor level of
consciousness and vitals
- give IV fluids and electrolyte supplements
- discontinue diuretics and suctioning
-A nurse is caring for a patient with who is experiencing leukocytosis. When
providing care to this patient, which action by the nurse is the most
appropriate? - -Assessing for the source of infection
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