NUR355 MedSurg Exam 4 With Correct Answers HCO3 range - ANSWER 22- 26 HCO3 being low means it is - ANSWER acidic CO2 range - ANSWER 35- 45 CO2 being low means it is - ANSWER alkalotic (because it is an acid) PH range - ANSWER 7.35-7.45 PH being low means it is - ANSWER acidic Respiratory acidosis - ANSWER high CO2, low PH, normal HCO3 or high Respiratory acidosis physical manifestations - ANSWER confusion, shallow and sl ow RR, decreased LOC, CNS depresses Respiratory acidosis treatment - ANSWER incentive spirometer, deep brea ths Respiratory alkalosis - ANSWER low CO2, High PH, normal HCO3 or low Respiratory alkalosis physical manifestations - ANSWER hyperventilation (deep), CP, change in LOC, tachycardia Respiratory alkalosis treatment - ANSWER rebreather Metabolic acidosis - ANSWER low HCO3, low PH, normal CO2 or low Metabolic acidosis physical manifestations - ANSWER tachypnea, Metabolic acidosis can be caused by - ANSWER DKA, CKD, K sparing diuretics Metabolic acidosis labs - ANSWER high BUN/CR, low GFR Metabolic alkalosis - ANSWER high HCO3, High PH, normal CO2 or high Metabolic alkalosis physical manifestations - ANSWER hypoventilations, muscle cramps, twitching Metabolic alkalosis labs - ANSWER low- K, Ca, Mg. High- Na, Cl, P Age related changes for hydration status - ANSWER become dehydr ated more easily Small fluid shift in elderly would - ANSWER throw them off Hypervolemia - ANSWER excess fluid Cause of hypervolemia - ANSWER CHF, renal failure, burns, water replacem ent without electrolyte replacement, SIADH-syndrome of inappropriate antidiur etic hormone What labs do you expect to see on a pt with hypervolemia - ANSWE R everything goes down. Low Cr, serum and urine down, urine sodium goes up When pt has hypervolemia fluid will end up in - ANSWER the lungs (chest xr ay) Hypovolemia - ANSWER lack of fluid Hypovolemia causes - ANSWER suctioning, diarrhea, vomiting, inapprop riate use of diuretics In older adults we can assess hypovolemia by - ANSWER cap refill, wei ght and lips (dry How do we fix hypovolemia? - ANSWER fluids with electrolytes What labs do you expect to see in hypovolemia - ANSWER everything goes up (more concentrated) How to get a urine sample - ANSWER sterile catheterization, Clean catch - ANSWER pt is cleaned prior (by self or staff) ESR and what does it tell you - ANSWER erythrocyte sedimentation rate, t ells us their might be something going on urinary if nothing else in labs is high Breast exam - ANSWER outer to inner, armpit up, circle motion Breast exams should be performed - ANSWER once a month, within five da ys of period ending GU and age related changes - ANSWER weakness and more at risk for incon tinence If a question states "which would the nurse do first?" choose - ANSWE R the assessment-type action before the interventions. If all assessments o r all interventions; think ABC's etc. Ca - ANSWER 9-10.5 Na - ANSWER 135-145 K - ANSWER 3.5-5 Cl - ANSWER 96-106 Mg - ANSWER 1.3-2 P - ANSWER 2.8-4.5