NUR 326 Exam 1, Exam 2, Exam 3
- Nursing Process
- Acid/Base
Answer ADPIE Assessment Diagnosis (nursing) Planning Interventions Evaluation of Outcomes
Answer
- questions
- Discuss the pathophysiology of the four different types of acid-base imbal- ances
Answer
Metabolic Acidosis
Shock Lactic acidosis Ketoacidosis* Excessive intake of acids ETOH, ASA* Over elimination of HCO3 Diarrhea Underproduction of HCO3 Kidney failure, impaired liver
- Metabolic Acidosis Manifestations
Answer pH < 7.35
Drowsiness, confusion, dizzy, HA, Coma “BP, Dysrhythmias
‘K+ “HCO3
Warm flushed dry skin N/V/D Abdominal pain Deep rapid respirations
- Discuss the pathophysiology of the four different types of acid-base imbal- ances
Answer
Respiratory Acidosis
Resp. depression Inadequate chest expansion Airway obstruction Pneumonia COPD, emphysema Severe pneumonia Pulmonary edema Mechanical hypoventilation 1 / 4
- Resp. Acidosis Manifestations
Answer pH < 7.35
Hypotension, Ventricular Fibrillation Lethargy, Dizzy, Confusion , Coma, HA, Seizures Hypoventilation, Hypoxia
‘PCO2
Warm, flushed ,dry skin Possible ‘K+
- Discuss the pathophysiology of the four different types of acid-base imbal- ances
Answer
Metabolic Alkalosis
Antacids* Blood transfusion Sodium bicarbonate* TPN Prolonged vomiting* NGT suctioning* Thiazide diuretics*
- Metabolic Alkalosis Manifestations
Answer pH > 7.45
Confusion, HA, Seizures, Paresthesias Muscle cramping and twitching Weakness Tachycardia, Dysrhythmias Hypoventilation N/V, anorexia Hypokalemia
- 1st, 2nd, and 3rd spacing
Answer normal
can still be pulled back in cannot be reversed
- Discuss the pathophysiology of the four different types of acid-base imbal- ances
Answer
Respiratory Alkalosis 2 / 4
Hyperventilation* Fear, anxiety,
High altitudes Shock Early-stage pulmonary problems
- Respiratory Alkalosis Manifestations
Answer pH > 7.45
Dizzy, confusion, HA Tachycardia, dysrhythmias N/V/ Epigastric pain Tetany, Paresthesias, Seizures Hyperventilation
- Prioritize interventions for patients who have acid-base imbalances
Answer Pre- vent risk factors of health conditions and situations that can cause acid-base imbalances. A few examples include
Healthy eating habits Safe weight loss Smoking prevention or cessation Poison control measures Safe food handling
treat underlying cause of imbalances supportive care (Ox, vent, dialysis, IV fluids) Monitor VS, electrolytes, kidney fct, and LOC Continuous cardiac monitoring
- Regulation of Acid-Base
Answer buffers respiratory system renal system
Buffers more effective in acid excess
- Heart Failure
Answer
- questions
- Left-sided HF
- Left Symptoms 3 / 4
Answer Left-sided HF (most common) from left ventricular dysfunction (e.g., MI hypertension, CAD, cardiomyopathy)
Answer Symptoms are due to blood backing up
Answer Backup of blood into the left atrium and pulmonary veins Pulmonary congestion Pulmonary edema
cyanosis, slow cap refill, SOB ^HR, ^RR, ^BP, low ox, ^metabolism
can lead to renal failure excess fluid will enlarge liver
- Right-sided HF
- Right symptoms
Answer Right-sided HF from left-sided HF, cor pulmonale, Backup of blood into the right atrium and venous systemic circulation
Answer Symptoms
Answer
Jugular venous distention Hepatomegaly, splenomegaly Vascular congestion of GI tract Peripheral edema
- Relate the pathophysiologic mechanisms associated with HF to the clinical manifestations
and complications
Answer Fatigue Dyspnea, orthopnea, paroxysmal nocturnal dyspnea Persistent, dry cough, unrelieved with position change or over-the-counter cough suppressants Tachycardia
Restlessness, confusion, decreased memory Chest pain (angina) Atrial fibrillation (most common dysrhythmia)
Dependent edema
Answer
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