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NURS 231 FINAL EXAM QUESTIONS AND ANSWERS
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NURS 231 FINAL EXAM QUESTIONS AND ANSWERS
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NURS 231 FINAL EXAM QUESTIONSAND ANSWERS
pulmonaryaembolisma(PE)a-aans--Blockingaofaaapulmonaryaarteryadueatoaaabloodaclot
concepts:aclotting,aperfusion,aacid-baseaimbalance
actualao2acontentaofatheablooda-aans--SaO2axaHgbaxa1.34
respiratoryaalkalosisacausedabya-aans--anythingathatacausesaHYPERVENTILATION
-anxiety,amechanicalaventilation,ahypoxemia/hypoxia,aCNSastimulation
*tooafastaORatooadeep*
blowingaoffaCO2a-->aalkalosis
oxygenationaproblem
-decaO2a->aincaRRa->aincaPH
Alkalosisa-aans---relativeahypokalemia
-hypocalcemia
S/Sxaarear/tahypocalcemia
-numbnessaoratingling
-tetanyaandaconvulsions
-increasedaDTR
-CNSaexcitation
respiratoryaacidosisacausedabya-aans--anythingacausedabyaHYPOventilation
*extra-pulmonary*
-RRatooaslow
-depthatooashallow
*intra-pulmonary*
-pathologyainathealungathatainterferesawithagasaexchage
,-ex:aCOPD,aARDS,aPE
Acidosisa-aans---relativeahyperkalemia
-s/sxahypercalcemia
-lethargy,aCNSadepression,adecreasedaDTR
-Hgbadropsa-aSaO2adrops
-hypotension
-HA,aconfusion,adrowsiness
interventionsaforasevereaacidosisa-aans---moreaO2
-elevateaHOB
-stimulateapt
-c&dbaifacooperativea
-collabawaRTaandaphysician
-rapidaresponse?
Acutearespiratoryafailurea-aans--ventilatory/oxygenationafailure
ptaisaALWAYSahypoxemic
PaO2a<a60a=aoxygenationafailure
PaCO2a>50a=aventilatoryafailure
SaO2a<90%a=aboth
BiPAPa(bi-levelaventilation)a-aans---NIPPV
-mayapostponeaoraavoidaintubation
-CPAPa+aPS
CPAP/PEEPa-aans---positiveapressure
-positiveaendaexpiratoryapressure
-CONTINUOUSaposaairwayapressure
-"stent"aairwayaopen
-"recruit"aalveoli
-preventaatelectasis
-IMPROVEaOXYGENATION
PSa(pressureasupport)a-aans---positiveapressureaduringainspiration
-noasetarate,aptaMUSTabeabreathing
-improvesaventilation
-clearsaCO2
nursingaresponsibilitiesaforaNIPPVa-aans---monitoraresponse
-maintainaequipment
-preventacomplications
, pulmonaryaembolisma-aans--clotainatheapulmonaryavasculature
-nota"in"athealung
PEaspecificaassessmentafindingsa-aans---pleuriticachestapain
-dryacough
-hemoptysis
PEaABGsa-aans---respiratoryaalkalosisainitially
-thinkatachypnea
LATER:arespiratoryaacidosisar/taworseningagasaexchangeaandahypoventilation
PEaimaginga-aans--CTascana-abestaoption
VQascana-ararelyadoneanow
pulmonaryaangiographya-agoodabutainvasive
PEatherapya-aans--anticoagulants
fibrinolytics
Heparin
-aPTT:a1.5-2xacontrol
AcuteaRespiratoryaDistressaSyndromea(ARDS)a-aans--*-
persistingaandaprofoundahypoxemia*
-decreasedapulmonaryacompliance
-dyspnea
-noncardiac-associateabilateralapulmonaryaedema
-denseapulmonaryainfilatratesaseenaonaxraya-a"whiteaouts"
refractoryahypoxemiaa-aans--HallmarkaofaARDS
doesanotarespondatoaO2atherapy
ARDSacausesa-aans--acutealungainjury:
-sepsis
-burns
-trauma
-pancreatitis
-transfusion
-aspiration
SIRSa-asystemicainflammatoryaresponseasyndrome
CO2adilatesavesselsawhichacausesa-aans--hypotension
EarlyaARDSaABGa-aans--respiratoryaalkalosis
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