NUR 2392 / NUR2392 Exam 2 Review (Latest 2021 / 2022): Multidimensional Care II / MDC 2 - Rasmussen

NUR 2392 / NUR2392 Exam 2 Review (Latest 2021 / 2022): Multidimensional Care II / MDC 2 - Rasmussen look at pH Correct Answer: What is your first step when interpreting ABGs? Respiratory acidosis Correct Answer: What acid-base imbalance would you expect to see in an asthmatic patient? *COPD* *asthma* *muscle weakness* ▪ inadequate chest expansion ▪ pneumonia ▪ pulmonary edema ▪ sleep apnea ▪ respiratory depression r/t: drugs, alcohol, anesthesia, electrolyte imbalance ▪ high ICP Correct Answer: Common causes of Respiratory Acidosis *Vital Signs, think LOW & SLOW* ▪ bradycardia, thready weak pulses ▪ hypotension ▪ hypoxia *Electrolyte Imbalance* ▪ hyperkalemia *Skin* ▪ pale, cyanotic *CNS Depression, think LOW & SLOW* ▪ lethargy ▪ confusion ▪ stupor ▪ coma ▪ headache *Musculoskeletal, think LOW & SLOW* ▪ hyporeflexia ▪ muscle weakness ▪ flaccid paralysis *Cardiac* ▪ heart dysrhythmias (due to hyperkalemia) ▪ increased cardiac output ▪ EKG changes - tall T waves, wide QRS, prolonged PR interval Correct Answer: S/S of Respiratory Acidosis (acidosis has similar s/s no matter if met. or resp.) *stabilize airway (patent)* *bronchodilators* ▪ O2 ▪ Pulmonary hygiene (positioning and breathing/coughing techniques) ▪ Suction PRN ▪ If on ventilation, increase ventilation rate. ▪ Endotracheal intubation For underlying causes: ▪ Correct electrolyte balance (hyperkalemia) ▪ Antibiotics (if it's infection) Correct Answer: Treatment for Respiratory Acidosis ▪ increase respirations to increase pH Correct Answer: What does your body do to compensate for respiratory acidosis? ▪ impaired gas exchange Correct Answer: Nursing Diagnosis for Respiratory Acidosis respiratory acidosis Correct Answer: low pH, high CO2 metabolic acidosis Correct Answer: low pH, low HCO3 respiratory alkalosis Correct Answer: high pH, low CO2 metabolic alkalosis Correct Answer: high pH, high HCO3 Uncompensated Correct Answer: pH and one other value are abnormal. Fully compensated Correct Answer: pH is normal, but the other 2 are abnormal. Partially compensated Correct Answer: all 3 values are abnormal *overproduction of hydrogen ions* *aspirin toxicity* ▪ kidney failure, liver failure, pancreatitis ▪ diarrhea (ACI-dosis sounds like ASS) ▪ dehydration ▪ ingestion of acids: ethanol, methanol, salicylate acid ▪ lactic acidosis ▪ diabetic ketoacidosis, starvation ▪ hypermetabolism: excessive exercises, seizures, fever, hypoxia Correct Answer: Causes of Metabolic Acidosis *Vital Signs, think LOW & SLOW* *Kussmaul respirations* ▪ bradycardia, thready weak pulse ▪ hypotension ▪ hypoxia *Electrolyte Imbalances* ▪ hyperkalemia ▪ hyperglycemia (if the cause is DKA) *Skin* ▪ warm, flushed, dry (due to vasodilation) *CNS depression, think LOW and SLOW* ▪ lethargy ▪ confusion ▪ stupor ▪ coma ▪ Headache *Musculoskeletal, think LOW and SLOW* ▪ hyporeflexia ▪ muscle weakness ▪ flaccid paralysis *Cardiac* ▪ heart dysrhythmias (due to *hyperkalemia*) ▪ increased cardiac output ▪ EKG changes - tall T waves, wide QRS, prolonged PR interval Correct Answer: S/S of Metabolic Acidosis (acidosis has similar s/s no matter if met. or resp.) Peaked T waves Wide QRS Prolonged PR interval Correct Answer: How does the EKG change for a patient with metabolic acidosis? *administer sodium bicarbonate* ▪ insulin (if cause is DKA) ▪ fluid/electrolyte replacement (remember some causes are dehydration/diarrhea) ▪ treat underlying cause... Correct Answer: Treatment for Metabolic Acidosis Mechanical ventilation Correct Answer: *que