NUR 2392 MULTIDIMENSIONAL CARE 2 FINAL EXAM /MDC2
FINAL ACTUAL EXAM 75 QUESTIONS AND CORRECT DETAILED
ANSWERS
Uncompensated - ANSWER: pH and one other value is abnormal
Partial compensation - ANSWER: pH, CO2, and HCO3 are all off
Full compensation - ANSWER: pH is normal
Acidosis - ANSWER: reduces the excitability of cardiovascular muscle, neurons,
skeletal muscle, and smooth muscle.
Alkalosis - ANSWER: increases the sensitivity of excitable tissues allowing them to
OVERRESPOND without stimulation
ABG considerations - ANSWER: - Assess cardiovascular w/ acidosis (cardiac arrest
from hyperkalemia)
- Assess neuro status
- Fall precautions
Bicarb HC03 - ANSWER: kidney compensation (slow and powerful)
Respiratory PaC02 - ANSWER: Respiratory compensation (fast but limited)
Metabolic acidosis causes - ANSWER: DKA, Starvation, diarrhea, kidney failure,
dehydration, liver failure, pancreatitis, heavy exercise, seizure activity, fever,
hypoxia, ischemia, ethanol/methanol intoxication
Metabolic acidosis signs and symptoms - ANSWER: bradycardia, hypotension,
thready pulse, CNS depression, hyporeflexia, kussmal resp (with resp
compensation), warm, flushed, dry skin.
Metabolic acidosis treatment - ANSWER: hydration and medication to treat
underlying problems (DKA - give insulin).
Metabolic alkalosis causes - ANSWER: antacids, blood transfusion, sodium
bicarbonate, total parenteral nutrition (TPN), prolonged vomiting, nasogastric
suctioning, hypercortisolism, hyperaldosteronism, Loop/Thiazide diuretics.
Metabolic Alkalosis s/s - ANSWER: anxiety, irritability, tetany, seizures, POSITIVE
CHVOSTEK, POSITIVE TROUSSEAU, parathesis, hyperreflexia, muscle
cramping/twitching, skeletal muscle weakness, Tachycardia, norm/low BP,
increased Digoxin toxicity, decreased respiratory effort (muscle weakness).
, metabolic alkalosis treatment - ANSWER: restore fluid/electrolyte imbalances
Respiratory acidosis cause - ANSWER: Opioids, anesthetics, electrolyte imbalance,
inadequate chest expansion, muscle weakness, airway obstruction, alveolar-
capillary block.
Respiratory acidosis s/s - ANSWER: bradycardia, hypotension, thready pulse, CNS
depression, hyporeflexia, ineffective respirations, pale-to-cyanotic dry skin.
Respiratory acidosis treatment - ANSWER: (Assess airway) Improve gas exchange,
drug therapy (bronchodilators, anti-inflammatory), oxygen therapy (lowest flow
possible), ventilation.
Respiratory alkalosis cause - ANSWER: Hyperventilation (fear, anxiety), mechanical
ventilation, salicylate toxicity, high altitudes, early-stage acute pulmonary issues.
respiratory alkalosis s/s - ANSWER: anxiety, irritability, tetany, seizures, POSITIVE
CHVOSTEK, POSITIVE TROUSSEAU (hypocalcemia), parathesis, hyperreflexia,
muscle cramping/twitching, skeletal muscle weakness, Tachycardia, norm/low BP,
increased Digoxin toxicity, hyperventilation
respiratory alkalosis treatment - ANSWER: restore fluid/electrolyte imbalances
How do acid/base imbalances affect electrolytes - ANSWER: - Potassium levels
increase in acidosis as the body attempts to maintain electroneutrality during
buffering.
- Potassium is elevated in acute respiratory acidosis and normal/low in chronic
respiratory acidosis when kidney compensation is present
- Alkalosis = hypocalcemia and hypokalemia
- Acidosis = HYPERkalemia
alkalosis - ANSWER: hypocalcemia and hypokalemia
acidosis - ANSWER: HYPERkalemia
Upper GI consists of - ANSWER: mouth, pharynx, esophagus, stomach, and
duodenum.
Barret's Epithelium - ANSWER: premalignant; columnar epithelium that develops in
lower esophagus
Zollinger-Ellison syndrome (dumping syndrome) - ANSWER: happens in PT with
gastrectomy, from rapid emptying of food contents into the small intestine.
Dumping syndrome S/S - ANSWER: nausea, distension, cramping pains, diarrhea
within 15 minutes after eating
FINAL ACTUAL EXAM 75 QUESTIONS AND CORRECT DETAILED
ANSWERS
Uncompensated - ANSWER: pH and one other value is abnormal
Partial compensation - ANSWER: pH, CO2, and HCO3 are all off
Full compensation - ANSWER: pH is normal
Acidosis - ANSWER: reduces the excitability of cardiovascular muscle, neurons,
skeletal muscle, and smooth muscle.
Alkalosis - ANSWER: increases the sensitivity of excitable tissues allowing them to
OVERRESPOND without stimulation
ABG considerations - ANSWER: - Assess cardiovascular w/ acidosis (cardiac arrest
from hyperkalemia)
- Assess neuro status
- Fall precautions
Bicarb HC03 - ANSWER: kidney compensation (slow and powerful)
Respiratory PaC02 - ANSWER: Respiratory compensation (fast but limited)
Metabolic acidosis causes - ANSWER: DKA, Starvation, diarrhea, kidney failure,
dehydration, liver failure, pancreatitis, heavy exercise, seizure activity, fever,
hypoxia, ischemia, ethanol/methanol intoxication
Metabolic acidosis signs and symptoms - ANSWER: bradycardia, hypotension,
thready pulse, CNS depression, hyporeflexia, kussmal resp (with resp
compensation), warm, flushed, dry skin.
Metabolic acidosis treatment - ANSWER: hydration and medication to treat
underlying problems (DKA - give insulin).
Metabolic alkalosis causes - ANSWER: antacids, blood transfusion, sodium
bicarbonate, total parenteral nutrition (TPN), prolonged vomiting, nasogastric
suctioning, hypercortisolism, hyperaldosteronism, Loop/Thiazide diuretics.
Metabolic Alkalosis s/s - ANSWER: anxiety, irritability, tetany, seizures, POSITIVE
CHVOSTEK, POSITIVE TROUSSEAU, parathesis, hyperreflexia, muscle
cramping/twitching, skeletal muscle weakness, Tachycardia, norm/low BP,
increased Digoxin toxicity, decreased respiratory effort (muscle weakness).
, metabolic alkalosis treatment - ANSWER: restore fluid/electrolyte imbalances
Respiratory acidosis cause - ANSWER: Opioids, anesthetics, electrolyte imbalance,
inadequate chest expansion, muscle weakness, airway obstruction, alveolar-
capillary block.
Respiratory acidosis s/s - ANSWER: bradycardia, hypotension, thready pulse, CNS
depression, hyporeflexia, ineffective respirations, pale-to-cyanotic dry skin.
Respiratory acidosis treatment - ANSWER: (Assess airway) Improve gas exchange,
drug therapy (bronchodilators, anti-inflammatory), oxygen therapy (lowest flow
possible), ventilation.
Respiratory alkalosis cause - ANSWER: Hyperventilation (fear, anxiety), mechanical
ventilation, salicylate toxicity, high altitudes, early-stage acute pulmonary issues.
respiratory alkalosis s/s - ANSWER: anxiety, irritability, tetany, seizures, POSITIVE
CHVOSTEK, POSITIVE TROUSSEAU (hypocalcemia), parathesis, hyperreflexia,
muscle cramping/twitching, skeletal muscle weakness, Tachycardia, norm/low BP,
increased Digoxin toxicity, hyperventilation
respiratory alkalosis treatment - ANSWER: restore fluid/electrolyte imbalances
How do acid/base imbalances affect electrolytes - ANSWER: - Potassium levels
increase in acidosis as the body attempts to maintain electroneutrality during
buffering.
- Potassium is elevated in acute respiratory acidosis and normal/low in chronic
respiratory acidosis when kidney compensation is present
- Alkalosis = hypocalcemia and hypokalemia
- Acidosis = HYPERkalemia
alkalosis - ANSWER: hypocalcemia and hypokalemia
acidosis - ANSWER: HYPERkalemia
Upper GI consists of - ANSWER: mouth, pharynx, esophagus, stomach, and
duodenum.
Barret's Epithelium - ANSWER: premalignant; columnar epithelium that develops in
lower esophagus
Zollinger-Ellison syndrome (dumping syndrome) - ANSWER: happens in PT with
gastrectomy, from rapid emptying of food contents into the small intestine.
Dumping syndrome S/S - ANSWER: nausea, distension, cramping pains, diarrhea
within 15 minutes after eating
