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NP235 MedSurg questions with 100% correct answers

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complete blood count test - ANSWER-Red blood cells, which carry oxygen White blood cells, which fight infection Hemoglobin, the oxygen-carrying protein in red blood cells Hematocrit, the proportion of red blood cells to the fluid component, or plasma, in the blood Platelets, which help with blood clotting Red blood cells - ANSWER-The normal range: for men, it is 5 million to 6 million cells/mcL for women, it is 4 million to 5 million cells/mcL comprise 45% of blood volume round with a flattish, indented center, like doughnuts without a hole Hemoglobin - ANSWER-The normal range: for men is 14 to 17 grams per deciliter (gm/dL) for women, it's 12 to 15 gm/dL A protein inside red blood cells that carries oxygen from the lungs to tissues and organs in the body and carries carbon dioxide back to the lungs. For a low RBC count, symptoms could include - ANSWER-Fatigue shortness of breath dizziness, weakness, or lightheadedness, particularly when a person changes position quickly increased heart rate headaches pale skin For a high RBC count, symptoms such as: - ANSWER-fatigue shortness of breath joint pain tenderness in the palms of the hands or soles of the feet itching skin, particularly after a shower or bath sleep disturbance Hematocrit - ANSWER-blood test determines the percentage of red blood cells (RBC's) in the blood. indicates the percentage of blood by volume that is composed of red blood cells. "anemia" results from having too few red blood cells. Hematocrit Range - ANSWER-For men, 38.8 to 50 percent For women, 34.9 to 44.5 percent For children ages 15 and younger, the normal range varies by age and sex. Hemoglobin Range - ANSWER-for men is 14 to 17 grams per deciliter (gm/dL) for women, it's 12 to 15 gm/dL Low hematocrit indicates - ANSWER-An insufficient supply of healthy red blood cells (anemia) A large number of white blood cells due to long-term illness, infection or a white blood cell disorder such as leukemia or lymphoma Vitamin or mineral deficiencies Recent or long-term blood loss higher than normal hematocrit can indicate - ANSWER-Dehydration A disorder, such as polycythemia vera, that causes the body to produce too many red blood cells Lung or heart disease five different types of WBCs/leukocytes - ANSWER-neutrophils lymphocytes basophils eosinophils Monocytes. WBC's are the military (they defend aganist foreign invaders) White Blood Cell (WBC) normal range - ANSWER-4,500 to 10,000 cells per microliter (cells/mcL) Platelets - ANSWER-also called thrombocytes, are special cell fragments that play an important role in normal blood clotting. normal platelet count - ANSWER-150,000 to 450,000 per microliter of blood. Primary or essential thrombocytosis - ANSWER-Abnormal cells in the bone marrow cause an increase in platelets, but the reason is unknown Secondary thrombocytosis - ANSWER-caused by an ongoing condition or disease such as anemia, cancer, inflammation, or infection thrombocytopenia. - ANSWER-When a person does not have enough platelets Symptoms include easy bruising, and frequent bleeding from the gums, nose, or GI tract. Platelet counts drops when something is preventing the body from producing platelets Causes of thrombocytopenia - ANSWER-Medications An inherited condition Certain types of cancer, such as leukemia or lymphoma Chemotherapy treatment for cancer Kidney infection or dysfunction Too much alcohol Sodium (Na) - ANSWER-helps the body keep fluids in a normal balance. It plays a key role in normal nerve and muscle function. sodium range - ANSWER-Normal Range: 135 - 145 mEq/L Sodium Deficiency (hyponatremia) - ANSWER-Losing sodium quickly is a medical emergency. It can cause loss of consciousness, seizures, and coma. Common symptoms of low blood sodium (hyponatremia) - ANSWER-Weakness fatigue or low energy headache nausea vomiting muscle cramps or spasms confusion irritability Sodium Overload (Hypernatremia) - ANSWER-dehydration severe, watery diarrhea vomiting fever delirium or dementia certain medications poorly controlled diabetes larger burn areas on the skin kidney disease a rare condition known as diabetes insipidus Common symptoms of high blood sodium (hypernatremia) include: - ANSWERconfusion neuromuscular excitability hyperreflexia seizures coma Potassium (K+) - ANSWER-critical for the normal functioning of t

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NP235 ABG
ABG Interpretation - ANSWER-•The level of the CO2 is controlled by breathing so any
abnormal values in carbon dioxide levels are considered to be a respiratory problem

•The level of HCO3 in the blood is controlled by the renal system so any abnormal
values in the Bicarbonate levels are considered to be a metabolic problem

pH - ANSWER-•The relative concentration of hydrogen in arterial blood
❖The chief component of acid-base balance
❖Normal Range is 7.35-7.45

(Acidosis) 7.35 7.40 7.45 (Alkalosis)

PaCO2 - ANSWER-•Partial pressure of carbon dioxide

⮚CO2 functions as acid reserve
⮚Normal range is 35- 45 mmHg
⮚CO2 levels typically stimulate respiration

⮚pCO2 (Alkalosis) 35 40 45 (acidosis)

Bicarbonate (HCO3) - ANSWER-•Indicator for the base reserve
•Reflects the kidneys and/ or metabolic function

•HCO3 (Acidosis) 22 24 26 (Alkalosis)

PaO2 - ANSWER-•Partial pressure of oxygen
▪Does not play an active role in acid/base balance
▪Normal for adults < 60 years is 80-100mmHg
▪After the age of 60, normal PaO2 levels are slightly lower due to decreasing lung
compliance

Normal 80-100mmHg
Mild 60-80mmHg
Moderate 40-60mmHg
Severe <40mmHg

Oxygen Saturation (SaO2) - ANSWER-•Percent of hemoglobin which is bound to
oxygen
•Normal is 94-100%

Normal Values - ANSWER-Low End. High End

, •pH (< acidic) 7.35. 7.45 (>alkalotic)

•pCO2 (<alkalotic)35 45 (>acidic)

•pO2 80mmHg 100 mmHg

•HCO3 (< acidic) 22 26 (>alkalotic)

Is is Metabolic or Respiratory? - ANSWER-•For Metabolic disorders remember the Ph
changes in the same direction as the HC03

•For Respiratory disorders remember the Ph changes in the opposite direction as the
Co2.

Metabolic Acidosis: Serum pH/Serum HC03 decreased ; the PaCo2 decreases to
compensate.
Metabolic Alkalosis: Serum pH/Serum HC03 increased ; the PaCo2 increases to
compensate.
Respiratory Acidosis: Serum pH decreased / PaCo2 increased ; the HC03 increases to
compensate
Respiratory Alkalosis: Serum pH increased / PaCo2 decreased ; HC03 decreases to
compensate.

Hypoxemia: - ANSWER-•Low oxygen content in arterial blood (seen on the ABGs)

Hypoxia: - ANSWER-•Inadequate oxygen at the tissue or cellular level (clinical
judgement)
•Clinical signs/symptoms:
-Tachycardia
-Cyanosis
-Hyperventilation
-Restlessness, uncoordinated activities
-hypertension

Hypercarbia> Increase Co2 - ANSWER-Clinical signs/symptoms:
▪Lethargy, confusion, progressing coma
▪Depression of reflexes, tremors
▪Reversal of sleep pattern, headaches
▪Full bounding pulses with a warm periphery

Respiratory Acidosis - ANSWER-Causes

•COPD
•Over sedation
•Neuromuscular disorder
•Hypoventilation with mechanical ventilation

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