NSG 223 Exam 2- NSG223 - Exam 2 Study Guide
Signs and symptoms of metabolic acidosis (Ans- headache, confusion, drowsiness, ⬆RR and depth, nausea, and vomiting
Peripheral vasodilation and ⬇cardiac output when pH<7
⬇BP, cold and clammy skin, dysrhythmias, and shock
Chronic with CKD
What is the cardinal feature of metabolic acidosis?(Ans- A decrease in the serum bicarbonate level
Hyperventilation, with a resulting decrease in PaCO2, is an expected compensatory reaction to which acid--base disorder?(Ans- Metabolic acidosis
What is the most common blood-borne disease in the United States, and is the leading cause of liver cancer in many countries?(Ans- Hepatitis C
What could be considered the least dangerous of the hepatitis infections, causes abdominal pain, jaundice, nausea, and vomiting that can occasionally last for months?(Ans- Hepatitis A
Main prevention methods for hepatitis infections?(Ans- strict adherence to infection control (Standard Precautions and Safe Injection Practices)
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Pathophysiology of PE (Ans- blood clot, thrombus, emboli (air, fat, amniotic fluid, septic [bacterial]), or A-fib
What happens when a thrombus completely or partially obstructs a pulmonary artery or its branches?(Ans- Alveolar dead space is increased which leads to impaired gas exchange
What results in an increase in pulmonary vascular resistance—a reaction that compounds the V./Q. imbalance?(Ans- Substances released from the clot and surrounding area cause blood vessels and bronchioles to constrict
Clinical manifestations of PE (Ans- Depends on size of thrombus and area of pulmonary artery occluded by the thrombus
Dyspnea (most frequent symptom) Chest pain (sudden) Anxiety, fever, tachycardia, apprehension, cough, diaphoresis, hemoptysis, and syncope Tachypnea (most frequent sign)
Obstruction of the pulmonary artery results in?(Ans- Dyspnea, sudden substernal pain, rapid and weak pulse, shock, syncope, and sudden death.
Prevention of PE (Ans- Active leg exercises to avoid venous stasis, early ambulation, anti- embolism stockings, compression devices, feet rest on floor/chair (dependent position, not dangled). Avoid prolonged use of IV catheters and crossing legs.
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Treatment goal of PE (Ans- To dissolve (lyse) the existing emboli and prevent new ones from forming
Treatment of PE (Ans- Improve respiratory and vascular status, anticoagulation therapy, thrombolytic therapy, and surgical intervention
Emergency management of PE (Ans- Nasal oxygen, IV infusion lines, vasopressor therapy for hypotension unrelieved by IV fluids, ECG for dysrhythmias, blood draw (CBC, electrolytes, coagulation), Foley catheter, IV morphine/sedatives
Surgical management of PE (Ans- Embolectomy Inferior vena cava (IVC) filtration
Clinical manifestations of ARDS (Ans-
- Arterial hypoxemia that does not respond to supplemental oxygen
- Rapid onset of severe dyspnea (<72 hours after precipitating event)
- Increased alveolar dead space
- Decreased pulmonary compliance ("stiff lungs," difficult to ventilate).
(hallmark)
Concentration of oxygen and ventilator settings are determined by?(Ans- The patient's status (ABG, pulse ox, bedside pulmonary function testing)
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