NUR 2392 / NUR2392 Exam 2 Review (Latest 2021 / 2022): Multidimensional Care II / MDC 2 - Rasmussen | Qwivy

NUR 2392 Multidimensional Care II

MDC II Exam 2 Review

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1. How does the EKG change for a patient with metabolic acidosis?

- Peaked T waves

- Wide QRS

- Prolonged PR interval

2. Treatment for Metabolic Acidosis

- administer sodium bicarbonate

▪ insulin (if cause is DKA)

▪ fluid/electrolyte replacement (remember some causes are

dehydration/diarrhea)

▪ treat underlying cause...

3. Question will ask which intervention is NOT included in treatment for

Metabolic Acidosis

a) Mechanical ventilation

b) Treat underlying cause

c) Fluid replenishment

d) I & O

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4. Nursing Interventions for Metabolic Acidosis

- ▪ Monitor ABGs, electrolytes (especially potassium)

▪ Monitor neuro status for decline

▪ Monitor I&O

▪ Perform skin assessment

▪ Seizure precautions

▪ Provide periods of rest

▪ Provide oral care

5. Causes of Metabolic Acidosis

- overproduction of hydrogen ions

aspirin toxicity

▪ kidney failure, liver failure, pancreatitis

▪ diarrhea (ACI-dosis sounds like ASS)

▪ dehydration

▪ ingestion of acids: ethanol, methanol, salicylate acid

▪ lactic acidosis

▪ diabetic ketoacidosis, starvation

▪ hypermetabolism: excessive exercises, seizures, fever, hypoxia

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6. S/S of Metabolic Acidosis

(acidosis has similar s/s no matter if met. or resp.)

- Vital Signs, think LOW & SLOW

Kussmaul respirations

▪ bradycardia, thready weak pulse

▪ hypotension

▪ hypoxia

Electrolyte Imbalances

▪ hyperkalemia

▪ hyperglycemia (if the cause is DKA)

Skin

▪ warm, flushed, dry (due to vasodilation)

CNS depression, think LOW and SLOW

▪ lethargy

▪ confusion

▪ stupor

▪ coma

▪ Headache

Musculoskeletal, think LOW and SLOW

▪ hyporeflexia

▪ muscle weakness

▪ flaccid paralysis

Cardiac

▪ heart dysrhythmias (due to hyperkalemia)

▪ increased cardiac output

▪ EKG changes - tall T waves, wide QRS, prolonged PR interval

7. Causes of Respiratory Alkalosis

- excessive loss of CO2 from hyperventilation (tachypnea)

▪ fear

▪ anxiety

▪ shock

▪ high altitude

▪ fever

▪ embolism

▪ aspirin toxicity

▪ salicylate toxicity

▪ mechanical ventilation: improper vent settings

▪ early-stage acute pulmonary problems

8. PaCO2 normal range

- 45-35

acidic-basic

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9. S/S of Respiratory Alkalosis

this will be a SATA question

(alkalosis has similar s/s no matter if met. or resp.)

- Vital Signs

▪ Tachycardia

▪ Tachypnea

▪ Normal or low BP (hypotension)

▪ Fever (if that's a cause)

▪ Increased rate and depth of ventilation (fast RR)

Electrolytes

▪ Hypocalcemia

▪ Hypokalemia

CNS Excitement

▪ increased activity

▪ anxiety

▪ irritability

▪ tetany

▪ seizures

Musculoskeletal

▪ Hyperreflexia:

- Positive Chvostek's sign

- Positive Trousseau's sign

▪ Muscle cramps/weakness/twitching

▪ Parathesia

Cardiac

▪ Changes in EKG (arrthythmias)

10. HCO3- (bicarbonate) normal range

- 21-28 mEq/L

acidic-basic

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Category Exam (elaborations)
Authors Qwivy.com
Pages 15
Language English
Tags NUR 2392 / NUR2392 Exam 2 Review (Latest 2021 / 2022): Multidimensional Care II / MDC 2 - Rasmussen | Qwivy
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