NR 324 Exam 1-with 100% verified solutions-2023-2024, Exams of Health sciences

Download NR 324 Exam 1-with 100% verified solutions-2023-2024 and more Exams Health sciences in PDF only on Docsity! NR 324 Exam 1-with 100% verified solutions-2023-2024 What is wrong with the body during DKA? It is too acidic Do people with COPD and other chronic respiratory illnesses hyper or hypoventilate? HYPOventilate What organs are the two regulators of acid in our body? Lungs and kidneys When will a patient display Kussmaul breathing in relation to acid-base balance? During acidosis / Normal pH range of blood 7.35-7.45 normal PaCo2 35-45 mm Hg PaO2 normal levels 80-100 Normal HCO3 levels 22-26mEq/L Ratio of carbonic acid to bicarbonate in a healthy state 1:20 Three regulatory mechanisms of acid-base regulation Buffer system respiratory system renal system Which regulatory system responds immediately? The buffer system. It is your natural neutral reaction process Which system responds in minutes and reaches its maximum effort within hours? Respiratory system Which regulatory system takes 2-3 days to respond? Renal system What type of acid-base imbalance would someone who took too much Aspirin have? Respiratory acidosis Why is a brown bag helpful for someone with respiratory alkalosis to breathe into? Because they can help return the CO2 back to their body that they lost from hyperventilating What type of meds are useful for someone in Respiratory alkalosis? Minor tranquilizers and anti-anxiety meds such as Ativan because they are hyperventilating and need help relaxing What are two common causes for metabolic acidosis? Aspirin overdose and prolonged diarrhea Systole heart contracts (first sound) diastole heart relaxes (second sound) stroke volume amount of blood ejected with each heart beat Cardiac output amount of blood pumped by each ventricle each minute. 4-8L of blood per minute. Decreased CO= something is wrong with your heart. Why do you have fatigue if you have an ineffective cardiac output? Because you have a lack of oxygenated blood flowing throughout your body. preload volume of blood in the ventricle at the end of diastole afterload tissue resistance against which the left ventricle must pump blood contractility how effectively the heart is able to contract. Blood pressure is highly individualized all arteries carry oxygenated blood except the pulmonary artery all veins carry deoxygenated blood except the pulmonary vein Why is blood in arteries bright red and blood in veins ashy arteries carry oxygenated blood, veins cary deoxygenated blood arteries vs veins arteries are deeper and thicker because they carry oxygenated blood. Veins are more superficial and thinner Sympathetic nervous system decreases HR parasympathetic increases HR Baroreceptors and chemoreceptors also help regulate HR Blood pressure = CO X SYSTEMIC VASCULAR RESISTANCE When taking a BP make sure person is sitting and arm is at chest. Make sure you have the appropriate sized cuff. EKG. Then draw labs for troponin CK-MB specific to myocardial cells and will indicated myocardial damage How often will you draw Troponin level and why? Q 1 hour, because a rise in Troponin each hour indicates an impending heart attack c-reactive protein produced by the liver, it is a nonspecific marker of inflammation. Increased in many patients with CAD . Chronic elevations are associated with unstable plaques and the oxidation of LDL which further contributes to atherosclerosis homocysteine elevated levels is a risk factor for CAD BNP another cardiac marker. Increased BNP is indicative of heart failure When drawing a lipid panel pt must be NPO lipid panel/lipoprotein LDL/HDL..elevated serium lipids are risk factors for CAD. LDL bad cholesterol HDL good cholesterol echocardiogram an ultrasound of the heart. measure the pressure within the chambers Cardiac cath/angiography They insert a catheter usually in the groin that follows the coronary artery all the way to the heart. they inject a dye to see which artery is affected or blocked. IF a coronary artery is blocked they will need bypass surgery angiography nursing implications be aware of any allergy to the dye NPO must sign consent Coronary artery disease the blockage of a coronary artery by fat or plaque buildup angina a symptom of CAD, it is chest pain due to a partial blockage a coronary artery Pt teaching for CAD avoid saturated fats. Get fat from plant sources, not animal sources. Saturated fats are bad for your heart The main cause of CAD deposits of plaque/ atherosclerosis One of the first symptoms of CAD Chest pain QRS ventricle contracts T wave rest after checking the airway, what is the first thing you will do for a patient with angina? EKG silent angina and who is it most common in? seen on EKG machine but presents no symptoms to patient. ST segment depression most common in diabetic women angina decubitus angina when lying down that is relieved when sitting up nocturnal angina pain only at night but not necessarily when person is in recumbent position printzmetal's angina common among drug users due to spasm of coronary artery. They may have transient ST segment elevation microvascular angina due to spasm of the tiniest capillaries related to myocardial ischemia Nitroglycerin to relieve chest pain. If there is no relief in 5 minutes, call 911. If there is some relief, repeat the dose every 5 mins no more than 3 times. sublingual, patch, spray, or ointment . brown bottle to protect from light and heat expires in 3 months causes orthostatic hypotension