In respiratory alkalosis -️️- pH is high and PaCO2 is low
- Caused by:
* HYPERVENTILATION
* Hypoxemia from acute pulmonary disorders
* Pain
* Fear/anxiety
* Salicylate or Nicotine overdose
* Increased metabolism
- Compensation rarely occurs due to aggressive treatment for hypoxemia
In ...
NSG 320: Exam 1-Questions with Correct Answers/ Verified/ Latest
Update 2024/2025
In respiratory alkalosis - ✔️✔️- pH is high and PaCO2 is low
- Caused by:
* HYPERVENTILATION
* Hypoxemia from acute pulmonary disorders
* Pain
* Fear/anxiety
* Salicylate or Nicotine overdose
* Increased metabolism
- Compensation rarely occurs due to aggressive treatment for hypoxemia
In respiratory acidosis - ✔️✔️"When you're on acid, you're relaxing and HYPOventilating"
- pH is low and PaCO2 is high
- Caused by:
* HYPOVENTILATION
* Respiratory failure
* Asthma attacks
* COPD
* Chest injury or trauma
* Pulmonary edema
* Medications
* Obstructive sleep apnea
- Compensation may occur when kidneys conserve HCO3 and secrete H into urine
In metabolic alkalosis - ✔️✔️- pH and HCO3 are high and PaCO2 is high or normal
- Caused by:
* Vomiting
* Gastric suction
,* Extracellular fluid deficit
* Dehydration
* Circulatory shock
* Loop or thiazide diuretic use
* Hypokalemia
* Ingestion of baking soda
- Compensation occurs if CO2 is retained or HCO3 is excreted
In metabolic acidosis - ✔️✔️- Kussmaul respirations
- pH and HCO3 are low and the PaCO2 is low or normal
- Caused by:
* Fasting/starving
* Cardiac arrest
* Sepsis
* Trauma
* Seizures
* Renal failure
* Severe diarrhea
- Compensation may occur during exhaling increase CO2
Normal values for ABG - ✔️✔️- pH: 7.35 - 7.45
- PaCO2: 35 - 45 mm Hg
- HCO3 (Bicarbonate): 22 - 26 mEq/:
- PaO2: 80 - 100 mm HG
- SaO2: >95%
- Base excess: +/- 2.0 meQ/L
Hypothyroidism - ✔️✔️- Deficiency of thyroid hormone that causes a general slowing of
the metabolic rate
- Iodine deficiency is most common cause
*Thyroid cannot make T3+T4 WITHOUT iodine*
Primary hypothyroidism - ✔️✔️- Caused by destruction of thyroid tissue or defective
hormone synthesis
- Most common cause is atrophy to thyroid gland which can be caused by Hashimoto's
thyroiditis or Graves' disease
Secondary hypothyroidism - ✔️✔️- Caused by pituitary disease TSH secretion or
hypothalamic dysfunction with decreased-releasing hormone (TRH) secretion
Clinical manifestations of hypothyroidism - ✔️✔️- Slow and low
- Decreased body processes
- Decreased cardiac contractility and output
- Increased serum cholesterol and triglyceride levels
- Anemia
Diagnostic studies consistent with hypothyroidism - ✔️✔️- TSH higher than 4.5
Interprofessional mgmt for hypothyroidism - ✔️✔️- Thyroid replacement
- Monitor for CV disease
- Monitor HR, report higher than 100 BMP
- Monitor for chest pain, weight loss, nervousness, tremors, and/or insomnia
- Monitor thyroid levels and adjust dosage
, - Nutrition therapy for weight loss
- Patient and caregiver teaching
Patient and caregiver teaching for hypothyroidism - ✔️✔️- Discuss importance of thyroid
hormone therapy
- Discuss need for lifelong therapy
- Take thyroid medication in morning BEFORE food
- Do not switch medication brands
- Emphasize need for warm environment due to cold intolerance
- Teach measures to prevent skin breakdown
- Avoid sedatives
- Discuss measures to prevent constipation
- Avoid enemas due to vagal stimulation
Nursing mgmt with hypothyroidism - ✔️✔️- Diagnoses:
* Activity intolerance related to weakness and fatigue
* Constipation related to GI hypomotility
* Impaired memory realated to hypometabolism
- Overall goals
* Experience relief of symptoms
* Maintain a euthyorid state
* Maintain positive self-image
* Comply with lifelong thyroid therapy
Hyperthyroidism - ✔️✔️- Hyperactivity of the thyroid gland with sustained increase in
synthesis and release of thyroid hormones
- Causes:
* Graves' disease
* Toxic nodular goiter
* Thyroiditis
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