Exam (elaborations)
NUR 546 Final Exam All Questions And Answers 2024/2025 Update
- Course
- NUR 546
- Institution
- Chamberlain College Of Nursing
NUR 546 Final Exam All Questions And Answers 2024/2025 Update
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NUR 546 Final Exam All Questions And Answers 2024/2025Update
Normal pH range 7.35-7.45
Normal PaO2 value 80-100 mm Hg
Normal PaCO2 value 35-45 mm Hg
Normal HCO3 value 22-26 mEq/L
Normal SaO2 value >94%
Respiratory system is associated with PaCO2 (Respiratory)
what ABG value?
Renal system is associated with what ABG HCO₃⁻ & H⁺ (Metabolic)
value?
Disturbance: abnormal numbers match the pH
(Metabolic disturbance causing acidosis? Lungs try to help bring the pH
back to normal (more alkalotic))
Abnormal ABGs: Disturbance (Respiratory disturbance causing alkalosis? Kidneys try to help by
bringing the pH back to normal (more acidic))
Abnormal ABGs: Compensation Compensation: abnormal number is opposite of the pH.
Respiratory Acidosis ↑PaCO₂ d/t retention in the lungs (Hypoventilation)
- CNS depression: Drugs (sedatives, opioids), alcohol, brainstem injury
- Pulmonary disease: COPD, PE, Pneumonia, pulmonary edema
Causes of Respiratory Acidosis - Respiratory muscle weakness: Paralysis, fatigue
Metabolic Acidosis ↓HCO₃⁻
Build up of acid d/t anaerobic metabolism (eg. poor perfusion, organ
failure)
- Shock- lactic acid build up
- Renal failure- uric acid build up
- DKA- accumulation of ketoacids
- Intoxication (ASA
Causes of Metabolic Acidosis overdose) Bicarbonate loss
- Diarrhea
Respiratory Alkalosis ↓PaCO₂ d/t excessive CO₂ is removed by the lungs (Hyperventilation)
- Anxiety
- Pain
Causes of Respiratory Alkalosis - Mechanical ventilator setting is too fast causing hyperventilation
Metabolic Alkalosis ↑HCO₃⁻
Loss of acid
- Stomach acid: HCl is loss to NGT suctioning/vomiting
- Drugs causing hypokalemia (eg. Thiazide diuretics) causes body to
release aldosterone → triggers excretion of potassium and H⁺ ions → acid
loss Bicarbonate excess
Causes of Metabolic Alkalosis - Antacid overdose
- NaHCO₃ overdose
Uncompensated acid base imbalances pH is abnormal, but CO₂ or HCO₃⁻ is still normal
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, respiratory acidosis & metabolic acidosis, or one imbalance leads to an
Mixed acid base imbalance states imbalance of both HCO₃⁻ & CO₂, resulting in two abnormal values
Partially compensated respiratory ↓pH< 7.35, & ↑HCO₃⁻ & ↑PaCO₂
acidosis
Partially compensated respiratory ↑pH> 7.45, & ↓HCO₃⁻ & ↓PaCO₂
alkalosis
Partially compensated metabolic acidosis ↓pH< 7.35, & ↓HCO₃⁻ & ↓PaCO₂
Partially compensated metabolic alkalosis ↑pH> 7.45, & ↑HCO₃⁻ & ↑PaCO₂
Fully compensated respiratory acidosis →pH, & ↑HCO₃⁻ & ↑PaCO₂
Fully compensated respiratory alkalosis →pH, & ↓HCO₃⁻ & ↓PaCO₂
Fully compensated metabolic acidosis →pH, & ↓HCO₃⁻ & ↓PaCO₂
Fully compensated metabolic alkalosis →pH, & ↑HCO₃⁻ & ↑PaCO₂
Uncompensated respiratory acidosis ↓pH< 7.35, & →HCO₃⁻ & ↑PaCO₂
↑RR and/or depth
-CNS depression→Narcan/reduce sedation
-Intubate or ∆ existing ventilator settings (↑RR and/or volume of each
breath)
-Suctioning
Respiratory Acidosis Tx
-Bronchodilators
-Treat pneumonia/pneumothorax
Uncompensated respiratory alkalosis ↑pH>7.45, & →HCO₃⁻ & ↓PaCO₂
Uncompensated metabolic alkalosis ↑pH> 7.45, & ↑HCO₃⁻ & →PaCO₂
Uncompensated metabolic acidosis ↓pH< 7.35, & ↓HCO₃⁻ & →PaCO₂
↓RR and/or depth
-Anxiety/pain/fever/drugs (nicotine, catecholamines)→Admin analgesics,
anxiolytics, antipyretics, stop or reverse drugs
-Need to retain CO₂ (breathe into a paper bag)
Respiratory Alkalosis Tx
-∆ ventilator settings (↓ RR and/or volume of each breath)
Need to ↓ acid (PaCO₂)/↑ base (HCO₃⁻)
(monitor for hypokalemia while acidosis is being corrected)
-Administer Sodium Bicarbonate
-Encourage Kussmaul respirations
-↑ rate on mechanical ventilator
-Diarrhea→Antidiarrheal
Metabolic Acidosis Tx -DKA→Insulin
-Dialysis (Renal failure)
Need to ↓ base (HCO₃⁻)/ ↑ acid (PaCO₂)
-D/C drugs causing imbalance (antacids, thiazide diuretics)
-D/C NGT suction
-Vomiting→ Antiemetics
Metabolic Alkalosis Tx -Acetazolamide→ Diamox
-Vitals: initial tachycardia, HTN → bradycardia & HypoTN develop as
condition worsens
-CV: V. fib can be first indication in a patient receiving anesthesia
-Neuro: initial anxiety, irritability, and confusion→ lethargy and possible
Respiratory acidosis clinical coma develop as condition worsens
manifestations -Respiratory: ineffective, shallow, rapid breathing
-Integument: pale or cyanotic
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