1. Which
system is more powerful when compensating?
-
Kidneys: can result in rapid
changes in ECF composition.
Fully triggered for
imbalance of several hours to days.
2. How to
evaluate that treatment is working for respiratory acidosis?
-
Maintains adequate gas
exchange
-
Arterial pH above 7.2 and
closer to 7.35
-
PaO2 level above 90 mmHg or
at least 10 mm Hg higher than their admission level
-
PaCO2 levels below 45 mmHg
or at least 15 mm Hg below their admission level
3. Alkalosis
pathophysiology
-
Alkalosis is a decrease in
the free hydrogen ion level of the blood and is reflected by an arterial blood
pH above 7.45.
4. Metabolic
Alkalosis: Base excess in what?
-
Excessive intake
bicarbonates, carbonates, acetates, citrates
5. Cause
of acid deficit?
-
Prolonged vomiting, excess
cortisol, hyperaldosteronism, thiazide diuretics, prolonged NG suction, loss of
gastric fluids.
6. Hallmark
of base excess acidosis?
-
ABG result with ↑ pH and ↑
bicarbonate level with normal O2 and CO2 levels
7. What
is citrate?
-
citrate is an anticoagulant
used in blood products that is rapidly metabolized in the liver
8. The
nurse is reviewing the standing orders for a patient who was admitted for
evaluation of chest pain. The patient has a history of chronic obstructive
pulmonary disease (COPD) and his laboratory results and assessment reveal that
he has mild respiratory acidosis. The nurse would question which order?
A. Encourage oral fluids
B. Keep head of bed elevated
C. Oxygen therapy at 4 L/min as needed
D. Bedrest with bathroom privileges only
RATIONALE:
The bedrest order will help the patient conserve
energy. The upright position (mid-Fowler's to high-Fowler's position) helps
increase lung expansion. Increasing fluid intake may reduce the thickness of
lung secretions and assist in their removal. Oxygen therapy helps promote gas
exchange for patients with respiratory acidosis. However, use caution when
giving oxygen to patients with COPD and CO2 retention as evidenced by a high
Paco2 level. The only breathing trigger for these patients is a decreased
arterial oxygen level. Giving too much oxygen to these patients decreases their
respiratory drive and may lead to respiratory arrest.
9. acidosis
vs alkalosis (picture)
10. A patient
is brought to the ed with respiratory depression the patient has a history of
COPD what acid-based balance is most likely
-
respiratory acidosis
11. What
can happen when blood is rapidly administered?
Category | Exam (elaborations) |
Release date | 2021-09-11 |
Pages | 11 |
Language | English |
Comments | 0 |
Sales | 0 |
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