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NUR 2392 / Multidimensional Care II: Acid-Base Imbalances Exam Questions and Answers 2024, Exams of Nursing

Exam questions and answers related to acid-base imbalances, including the role of chemical and metabolic buffers, signs and symptoms of acidosis and alkalosis, and interventions for treating these conditions. It also covers topics such as egd procedures, risk factors for acid-base imbalances, and the functions of the lungs and kidneys in maintaining ph balance.

Typology: Exams

2023/2024

Available from 02/15/2024

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Download NUR 2392 / Multidimensional Care II: Acid-Base Imbalances Exam Questions and Answers 2024 and more Exams Nursing in PDF only on Docsity! 1 NUR 2392 / Multidimensional Care II Exam Questions and Answers 2024 1. ABG (Arterial Blood Gas) measures - the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery - acid base imbalance 2. When chemical/metabolic buffers can not prevent blood pH changes what is the second line of defense? - respiratory system 3. how does the respiratory system buffer? - hyperventilation/hypoventilation 4. alkalosis - decrease in free hydrogen ion level of the blood and an arterial blood pH above 7.45 5. s/s dehydration - tachycardia, - hypotension, - increased thirst, - decreased urine output, - poor skin turgor, - dry mucous membranes, - flattened neck veins 6. education on fluid overload - low salt diet, when to call the doctor, avoid canned foods, check food labels for sodium amount (reduce to 2-4 g/day) 7. what does calcium do for the body lOMoAR cPSD|37463924 - blood clotting and cell membrane stability 8. risk factors for acid-base imbalance - impaired breathing conditions, - older age, - certain drugs (diuretics and aspirin), - kidney failure, - diabetes mellitus, - diarrhea, - pancreatitis, - fever 9. Normal - pH: 7.40 - CO2: 40 - HCO3: 24 10. pt is suffering from fever, HR 128, BP 80/46. what fluid balance do you suspect - hypovolemia 11. NG tube suction causes what acid base imbalance - metabolic alkalosis 12. main sign hiatal hernia - dysphagia 13. EGD pre and post procedure - Pre-EGD nursing care involves inserting one or two large-bore IV catheters if they are not in place, Keep the patient NPO for 4 to 6 hours before the procedure, consent form before the EGD after the physician informs about the procedure. - Post- EGD nursing care involves monitoring vital signs, heart rhythm, and oxygen saturation frequently until they return to baseline. In addition, frequently assess the patient's ability to swallow saliva. do not allow the patient to have food or liquids until the gag reflex is intact 14. normal pH range - 7.35-7.45 15. priority assessment for acidosis lOMoAR cPSD|37463924 36. pH#high H#low - alkalotic 37. If you kick up the pH what goes down - the acidosis 38. too much Co2 retained - respiratory acidosis 39. too much Co2 excreted - respiratory alkalosis 40. too much acid - Metabolic acidosis 41. too much base - alkalosis 42. Acids: - release hydrogen ions when dissolved in water 43. Bases: - bind with hydrogen ions in solutions 44. buffers: - critical in maintaining normal body fluid p 45. body fluid chemistry: - -bicarbonate ions (HCO3) - -Relationship between CO2 and hydrogen ions - -Calculation of free hydrogen ion level 46. Acids cause: - -incomplete breakdown of glucose lOMoAR cPSD|37463924 - -breakdown of protein and fats - -destruction of cells 47. Bicarbonate: - -weak base - -major buffer of extracellular fluid (ECF) - -From intestinal absorption of ingested bicarbonate into ECF - -From kidney absorption and breakdown of carbonic acid - -Level is typically 20 times greater than that of carbonic acid - -70-80% is excreted in the stool 48. What can cause metabolic acidosis? - -diabetic ketoacidsosi - -renal failure - -diarrhea - -Ileostomy - -Hyperthyroidism - -Pancreatitis - -Liver failure - -Dehydration - -Seizure activity - -Ethanol intoxication - -Aspirin toxicity 49. Laboratory assessment of Metabolic Acidosis - -pH<7.35 - -Bicarbonate <21 mEq/L - -PaO2 normal - -PaCO2 normal or slightly decreased - -Serum potassium high* 50. Clinical manifestations of metabolic acidosis - -Kussmaul's breathing >20bpm - -weak - -confused - -hypotension - -cardiac changes (due to hyperkalemia)** - -nausea - -vomiting 51. Nursing interventions metabolic acidosis lOMoAR cPSD|37463924 - -hydration - -antidiarrheal medications - -monitor electrolytes (potassium) - -Renal failure (intake output, monitor diet, may need dialysis) - -Neuro status (seizure precautions - -DKA (patient will need insulin drip) - -Bicarbonate (only with low serum level) - -Watch for respiratory distress (patient may need to be ventilated) 52. Clinical manifestations of metabolic alkalosis - >Respiratory changes: -increased rate and depth of ventilation (RA) - -decreased respiratory effort associated with skeletal muscle weakness (MA) - >Neuromuscular Changes: hyperflexia, muscle cramping, twitching, skeletal muscle weakness. - >Cardiovascular changes: increased HR, normal or low blood pressure, increased digitalis toxicity. - >CNS changes: increased activity, anxiety, positive chvostek's and trosseau's sign, paresthesias. 53. Nursing interventions for metabolic alkalosis - -treat the cause - -watch for respiratory distress - -if vomitting administer anti emetics (Zofran, phenergan) - -Stop NG suctioning - -Stop or alter dose of diuretic - -May administer Diamox (watch for hypokalemia) 54. Respiratory Alkalosis defined by - -ABG result with high pH coupled with low CO2 level - -O2 and bicarbonate usually normal 55. isotonic solutions - increase intravascular volume - used to treat fluid volume deficits 56. hypertonic solutions - increases extracellular volume - used as a volume expander 57. hypotonic solutions lOMoAR cPSD|37463924 - drug therapy, - rehydration (sodium), - dialysis, - cardiac monitoring (look for changes in T waves and QR intervals), - loop diuretics, stop thiazides 71. interventions for fluid overload - drug therapy (loop diuretics), - nutrition therapy (fluid and sodium restriction), - monitoring (weight, ECG, output, electrolyte levels), - assess for pulmonary edema every 2 hours, - repositioning every 2 hours 72. Side effects of thiazide diuretics - hypokalemia, - hypercalcemia, - hypomagnesemia 73. s/s metabolic acidosis - cardiac changes (tall T waves), - confusion, - weakness, - low BP, - Bradycardia, - Decreased level of consciousness, - Decreased reflexes, - Alterations in skin (warm, flushed dry skin) 74. s/s resp alkalosis - low or normal BP, - tachypnea, - confused, - tired, - tachycardia, - muscle cramps, - hypocalcemia (Positive Chvostek's sign, Positive Trousseau's sign, Hyperreflexia), - EKG changes, - tetany, - Increased respiratory rate 75. aspirin toxicity acid base imbalance lOMoAR cPSD|37463924 - resp. alkalosis and metabolic acidosis 76. metabolic acidosis - pH: 7.32 - HCO3: 20 - CO2: 37 77. DKA causes what acid base imbalance - metabolic acidosis 78. partially compensated resp. acidosis - pH: 7.28 - HCO3: 30 - CO2: 55 79. uncompensated resp. acidosis - pH: 7.30 - HCO3: 26 - CO2: 58 80. compensated metabolic alkalosis - pH: 7.45 - CO2: 50 - HCO3: 30 81. compensated resp. acidosis - pH: 7.36 - CO2: 60 - HCO3: 38 82. partially comp. resp. alkalosis - pH: 7.69 - CO2: 28 - HCO3: 19 83. Arterial blood pH - 7.35-7.45 84. Venous blood pH lOMoAR cPSD|37463924 - 7.31-4.41 85. CSF pH - 7.32 86. Pancreatic fluid pH - 7.8-8.0 87. what can cause hypokalemia - n/v, - diarrhea 88. Chvostek's sign is what electrolyte imbalance - hypocalcemia 89. anxiety attack causes what acid base imbalance - resp. alkalosis 90. surgery and IV pain meds causes what acid base imbalance - resp. acidosis 91. end stage liver cancer causes what acid base imbalance - metabolic acidosis 92. choking causes what acid base imbalance - resp. acidosis 93. tx for resp. acidosis - encourage oral fluids, - HOB elevated, - bedrest, - bronchodilators, - O2, - mechanical ventilation, - treat underlying infections 94. tx for rep. alkalosis