NUR 2392 Multidimensional Care II
MDC II Exam 2 Review
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
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
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
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
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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