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PrepU Quizzes F&E Med Surg (Answered) Complete Solution

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PrepU Quizzes F&E Med Surg A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia: pH, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm Hg; and HCO3--, 24 mEq/L. What do these values indicate? Respiratory alkalosis - A client with pneumonia may hyperventilate in an effort to increase oxygen intake. Hyperventilation leads to excess carbon dioxide (CO2) loss, which causes alkalosis — indicated by this client's elevated pH value. With respiratory alkalosis, the kidneys' bicarbonate (HCO3-) response is delayed, so the client's HCO3- level remains normal. The below-normal value for the partial pressure of arterial carbon dioxide (PaCO2) indicates CO2 loss and signals a respiratory component. Because the HCO3- level is normal, this imbalance has no metabolic component. Therefore, the client is experiencing respiratory alkalosis. Which of the following arterial blood gas results would be consistent with metabolic alkalosis? Serum bicarbonate of 28 mEq/L - Evaluation of arterial blood gases reveals a pH greater than 7.45 and a serum bicarbonate concentration greater than 26 mEq/L. A group of nursing students are studying for a test over acid-base imbalance. One student asks another what the major chemical regulator of plasma pH is. What should the second student respond? Bicarbonate-carbonic acid buffer system - The major chemical regulator of plasma pH is the bicarbonate-carbonic acid buffer system. A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? Light-headedness or paresthesia - The client with respiratory alkalosis may complain of light-headedness or paresthesia (numbness and tingling in the arms and legs). Nausea, vomiting, abdominal pain, and diarrhea may accompany respiratory acidosis. Hallucinations and tinnitus rarely are associated with respiratory alkalosis or any other acid-base imbalance. Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? Instruct the client to breathe into a paper bag. - The ABG results reveal respiratory alkalosis. The best intervention to raise the PaCO2 level would be to have the client breathe into a paper bag. Administering a decongestant, offering fluids frequently, and administering supplemental oxygen wouldn't raise the lowered PaCO2 level. A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What disorder is indicated by these findings? Respiratory alkalosis - Respiratory alkalosis results from alveolar hyperventilation. It's marked by a decrease in PaCO2 to less than 35 mm Hg and an increase in blood pH over 7.45. Metabolic acidosis is marked by a decrease in HCO3? to less than 22 mEq/L, and a decrease in blood pH to less than 7.35. In respiratory acidosis, the pH is less than

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Nursing 113 exam 1
Gain entry via mucocutaneous surfaces. Begins to multiply causing cell
destruction and vesicle formation.
Painful red vesicles 2-14 days after exposure
Small painful blisters filled with clear fluid
Genital Herpes Pathophysiology
May have no symptoms
First outbreak is accompanied by flu-like symptoms- fever and body aches
Urinary retention
Dysuria
Vaginal discharge
Urethral discharge men
Refional lymphadenopathy
Genital Herpes symptoms
Presumptive diagnosis
Viral culture is most definitive
No cure
Genital Herpes diagnosis and treatment
Acyclovir (Zovirax) 7-10 days or until lesions healed
Valacyclovir (Valtrex)
Famciclovir (Famvir)
Genital Herpes Pharmacology
HPV transmitted by vaginal, anal, oral-genital contact
Incubation period 2-3 months
HPV Patho
Clinical appearance on physical examination
Regular screening, Pap tests
Identify precancerous lesions
HPV Diagnosis and treatment
No drug to cure virus itself
Topical agents
Podofilox, imiquimod client applied
Podophyllum, trichloroacetic acid provider administered
Gardasil, Cervarix vaccinations
HPV Pharmacologic therapies
Chlamydia trachomatis
Chlamydia Patho
Dysuria, urinary frequency and discharge
Chlamydia signs and symptoms
Untreated chlamydia can lead to:
PID
Infertility
Ectopic pregnancy
Chlamydia complications

,PCR test
Nucleic acid hybridization test
Chlamydia diagnosis
Azithromycin (Zithromax), doxycycline ( Causes Diarrhea)
Both partners treated
Chlamydia Pharmacologic therapy
Pyogenic bacteria that causes inflammation

In men, acute pain
Epididymus, periurethral glands

In women
PID, endometritis, salpingitis, pelvic peritonitis
Gonorrhea Patho
Men
Dysuria, serous, milky, purulent penile discharge
Women
Dysuria, urinary frequency, abnormal menses
Increased vaginal discharge, dyspareunia

Anorectal gonorrhea
Pruritis, mucopurulent discharge, bleeding, pain

Gonococcal pharyngitis
Gonnorrhea signs and symptoms
Blindness, infection of joints, potentially lethal
Gonorrhea Complications in Newborns
PID in women

Epididymitis, prostatitis in men

Spread of infection to blood, joints

Increased susceptibility to, transmission of HIV
Gonorrhea complications
Cultures
Urinalysis
Gram stain
Tests for other STI
Gonorrhea Diagnositics
Eradication of organism
Prevention of reinfection or transmission other STIs
Gonorrhea Treatment
Break in skin, mucous membrane
Spread through blood, lymphatic system

, Congenital syphilis
Transferred to fetus through placental circulation
Syphilis Patho
Chancre, regional lymph node enlargement
3-4 weeks after infectious contact
Little or no pain
Highly infectious
Primary syphilis
6 weeks after initial chancre
Systemic with spirochete spreading to all major organ systems
Skin rash, mucous patches in oral cavity, sore throat
Generalized lympadenopathy, condyloma lata
Secondary syphilis
2 or more years after initial infection
Sexual transmission is possible in latent syphilis
Two types
Benign late syphilis
Diffuse inflammatory response
Latent and tertiary syphilis
Venereal Disease Research Laboratory (VDRL)
FTA-ABS confirmatory
Syphilis diagnosis
Penicillin G
IM in single dose
Treatment may result in Jarisch-Herxheimer reaction
Syphilis treatment
stop/limit smoking
limit caffeine, Alcohol, social drugs
street drugs pose real threat to the fetus

Women with chronic health disorders such as thyroid disease, seizures,
hypertension, and diabetes should talk to the doctor before having a baby ( some
medications may need to be changed for the safety of fetus)
Preconception teaching
both partners should have a physical and a dental exam prior to pregnancy to
avoid any necessary procedures that may cause harm to the fetus
preconception physical
calcium
protein
iron
b complex vitamin
vitamin c
magnesium
folic acid
( do not exceed recommended doses of these)
Preconception nurtrition

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