Exam 4: PNR 206/ PNR206 (Latest 2024/ 2025 Updates
STUDY BUNDLE WITH COMPLETE SOLUTIONS) Medical-
Surgical Nursing II | Questions and Verified Answers|
100% Correct| Grade A- Fortis
Normal Body pH - ANSWER7.35-7.45
Normal pCO2 range - ANSWER35-45
Normal pHCO3 range - ANSWER22-36
Ratio of bicarbonate to carbonic acid - ANSWER20:1
acids - ANSWERcompounds that form hydrogen ions when dissolved in water
bases - ANSWERcompounds that reduce the concentration of hydrogen ions in a
solution
buffers - ANSWERA substance that consists of acid and base forms in a solution and
that minimizes changes in pH when extraneous acids or bases are added to the
solution.
acid sources - ANSWERincomplete glucose breakdown
cell destruction
bicarbonate ( main buffer of ECF)
1st line of defense against changes in the amount of free hydrogen ions -
ANSWERbuffers
chemical buffers - ANSWERpaired mistures
usually a weak base and acid salt
two most common are bicarbonate and phosphate
protien buffers - ANSWERthe most common buffer
albumin and hemoglobin are examples
when hydrogen increases in the blood some excess hydrogen binds to the
hemoglobin in the RBCs
the second line of defense in acid base imbalance - ANSWERrespiratory system
ways the respiratory system reacts in acid base imbalance - ANSWERhyperventilation
hypo-ventilation
breathing controls the amount of CO2 in the lungs and arterial blood
,what does hypo-ventilation do - ANSWERit increases the CO2 in the respiratory tract
and the arterial blood creating an acidic state
what does hyperventilation do - ANSWERit decreases the CO2 in the respiratory tract
and the arterial blood creating an alkaline state
the third line of defense in acid base imbalances - ANSWERthe renal system
ways the renal system reacts in acid base imbalance - ANSWERmovement of
bicarbonate
formation of acids
formation of ammonium
compensation - ANSWERbody attempts to correct blood pH changes
fatal blood pH - ANSWER>6.9 or <7.8
faster of the compensatory mechanisms - ANSWERrespiratory, but it is also easily
overwhelmed
more powerful of the compensatory mechanisms - ANSWERrenal, but can take hours
to days to start working
respiratory compensation - ANSWERchanges in pulmonary ventilation correct the pH
of the body fluids by expelling or retaining CO2. if there is a co2 excess, pulmonary
ventilation increases to expel co2 and bring the blood pH back up to normal. if there
is a co2 deficiency, ventilation is reduced to allow co2 to accumulate in the blood
and lower the pH to normal
renal compensation - ANSWERan adjustment of pH by changing the rate of H+
secretion by the renal tubules. the kidneys are slower to respond to pH imbalances
but better at restoring a fully normal pH. in acidosis, the rate of H+ secretions
increase as well as additional ammonia to buffer the added H+. In alkalosis, the
bicarbonate concentration and pH of the urine are elevated. This is partly because
there is so much HCO3- and not enough H+ in the tubular fluid to neutralize all the
HCO3- in the filtrate
respiratory compensation for acidosis - ANSWERhyperventilate
decrease H+ blow off CO2
Inhibits chemo-receptors
Metabolic Compensation for acidosis - ANSWERhold HCO3 in blood
bind HCO3 to H+
strong and long lasting
excrete H+
Respiratory Compensation for alkalosis - ANSWERhypo-ventilation
, increase H+ and hold onto CO2
stimulate chemo-receptors
Metabolic compensation for alkalosis - ANSWERrelease HCO3 from blood
detach HCO3 from H+
takes a long time to happen
hold onto H+
Metabolic acidosis - ANSWERDecrease in pH caused by an increase in non-carbonic
acids or a decrease in bicarbonate from lactic acidosis, renal failure or diabetic
ketoacidosis
A complication can be hyperkalemia which can lead to arrhythmias
Respiratory acidosis - ANSWER(Increased PaCO2 and Decreased pH) Result of hypo-
ventilation. Accompanied by hyperkalemia & Hypercalcemia. Neurological
impairment
metabolic acidosis causes - ANSWERRelative gain in H+ (MUDPILES = Methonal,
Uremia, DKA, Paraldehyde/Phosphates, Iron/Ischemia/Isoniazides, Lactic Acidosis,
Ethanol, Salicyclic acid/Starvation) or actual loss of HCO3 (renal failure, diarrhea)
respiratory acidosis causes - ANSWER-hypoventilation
-atelectasis (obstruction of small airways often caused by retained mucus)
-pneumonia
-cystic fibrosis
-respiratory failure
-airway obstruction
-chest wall injury
-drug overdose with respiratory depressant
-paralysis of respiratory muscles caused by various neurological alterations
-head injury
-obesity
combined metabolic and respiratory acidosis - ANSWERcan occur at the same time.
uncorrected acute respiratory acidosis always leads to poor oxygenation and lactic
acidosis. is more severe than either metabolic/respiratory acidosis. cardiac arrest is
an example of a problem leading to combined
electrolyte values in metabolic acidosis - ANSWERhyperkalemia (increase in K)
no change in Ca
no change or increased in Cl
electrolyte values in respiratory acidosis - ANSWERhyperkalemia (increase in K)
no change in Ca
Cl can be either increased or decreased
electrolyte values in combined acidosis - ANSWERhyperkalemia
STUDY BUNDLE WITH COMPLETE SOLUTIONS) Medical-
Surgical Nursing II | Questions and Verified Answers|
100% Correct| Grade A- Fortis
Normal Body pH - ANSWER7.35-7.45
Normal pCO2 range - ANSWER35-45
Normal pHCO3 range - ANSWER22-36
Ratio of bicarbonate to carbonic acid - ANSWER20:1
acids - ANSWERcompounds that form hydrogen ions when dissolved in water
bases - ANSWERcompounds that reduce the concentration of hydrogen ions in a
solution
buffers - ANSWERA substance that consists of acid and base forms in a solution and
that minimizes changes in pH when extraneous acids or bases are added to the
solution.
acid sources - ANSWERincomplete glucose breakdown
cell destruction
bicarbonate ( main buffer of ECF)
1st line of defense against changes in the amount of free hydrogen ions -
ANSWERbuffers
chemical buffers - ANSWERpaired mistures
usually a weak base and acid salt
two most common are bicarbonate and phosphate
protien buffers - ANSWERthe most common buffer
albumin and hemoglobin are examples
when hydrogen increases in the blood some excess hydrogen binds to the
hemoglobin in the RBCs
the second line of defense in acid base imbalance - ANSWERrespiratory system
ways the respiratory system reacts in acid base imbalance - ANSWERhyperventilation
hypo-ventilation
breathing controls the amount of CO2 in the lungs and arterial blood
,what does hypo-ventilation do - ANSWERit increases the CO2 in the respiratory tract
and the arterial blood creating an acidic state
what does hyperventilation do - ANSWERit decreases the CO2 in the respiratory tract
and the arterial blood creating an alkaline state
the third line of defense in acid base imbalances - ANSWERthe renal system
ways the renal system reacts in acid base imbalance - ANSWERmovement of
bicarbonate
formation of acids
formation of ammonium
compensation - ANSWERbody attempts to correct blood pH changes
fatal blood pH - ANSWER>6.9 or <7.8
faster of the compensatory mechanisms - ANSWERrespiratory, but it is also easily
overwhelmed
more powerful of the compensatory mechanisms - ANSWERrenal, but can take hours
to days to start working
respiratory compensation - ANSWERchanges in pulmonary ventilation correct the pH
of the body fluids by expelling or retaining CO2. if there is a co2 excess, pulmonary
ventilation increases to expel co2 and bring the blood pH back up to normal. if there
is a co2 deficiency, ventilation is reduced to allow co2 to accumulate in the blood
and lower the pH to normal
renal compensation - ANSWERan adjustment of pH by changing the rate of H+
secretion by the renal tubules. the kidneys are slower to respond to pH imbalances
but better at restoring a fully normal pH. in acidosis, the rate of H+ secretions
increase as well as additional ammonia to buffer the added H+. In alkalosis, the
bicarbonate concentration and pH of the urine are elevated. This is partly because
there is so much HCO3- and not enough H+ in the tubular fluid to neutralize all the
HCO3- in the filtrate
respiratory compensation for acidosis - ANSWERhyperventilate
decrease H+ blow off CO2
Inhibits chemo-receptors
Metabolic Compensation for acidosis - ANSWERhold HCO3 in blood
bind HCO3 to H+
strong and long lasting
excrete H+
Respiratory Compensation for alkalosis - ANSWERhypo-ventilation
, increase H+ and hold onto CO2
stimulate chemo-receptors
Metabolic compensation for alkalosis - ANSWERrelease HCO3 from blood
detach HCO3 from H+
takes a long time to happen
hold onto H+
Metabolic acidosis - ANSWERDecrease in pH caused by an increase in non-carbonic
acids or a decrease in bicarbonate from lactic acidosis, renal failure or diabetic
ketoacidosis
A complication can be hyperkalemia which can lead to arrhythmias
Respiratory acidosis - ANSWER(Increased PaCO2 and Decreased pH) Result of hypo-
ventilation. Accompanied by hyperkalemia & Hypercalcemia. Neurological
impairment
metabolic acidosis causes - ANSWERRelative gain in H+ (MUDPILES = Methonal,
Uremia, DKA, Paraldehyde/Phosphates, Iron/Ischemia/Isoniazides, Lactic Acidosis,
Ethanol, Salicyclic acid/Starvation) or actual loss of HCO3 (renal failure, diarrhea)
respiratory acidosis causes - ANSWER-hypoventilation
-atelectasis (obstruction of small airways often caused by retained mucus)
-pneumonia
-cystic fibrosis
-respiratory failure
-airway obstruction
-chest wall injury
-drug overdose with respiratory depressant
-paralysis of respiratory muscles caused by various neurological alterations
-head injury
-obesity
combined metabolic and respiratory acidosis - ANSWERcan occur at the same time.
uncorrected acute respiratory acidosis always leads to poor oxygenation and lactic
acidosis. is more severe than either metabolic/respiratory acidosis. cardiac arrest is
an example of a problem leading to combined
electrolyte values in metabolic acidosis - ANSWERhyperkalemia (increase in K)
no change in Ca
no change or increased in Cl
electrolyte values in respiratory acidosis - ANSWERhyperkalemia (increase in K)
no change in Ca
Cl can be either increased or decreased
electrolyte values in combined acidosis - ANSWERhyperkalemia
