NUR 425 CC Exam 2 Prediction Questions – COMPLETE SOLUTION

NUR 425 CC Exam 2 Prediction Questions – COMPLETE SOLUTION Which of the following is the body's first line of defense against an acid-base imbalance? A) Respiratory buffers B) Chemical and protein buffers C) Renal b ...

NUR 425 CC Exam 2 Prediction Questions – COMPLETE SOLUTION Which of the following is the body's first line of defense against an acid-base imbalance? A) Respiratory buffers B) Chemical and protein buffers C) Renal buffers D) Ventricular buffers - ✔✔B In regards to acid-base imbalance, what does "compensation" mean? - ✔✔It is the body's attempt to correct the acid-base imbalance Which of the following places a patient at risk for a state of acidosis? (SELECT ALL THAT APPLY) a. A patient with severe anxiety b. A patient rescued from a drowning c. A patient who consumed an entire bottle of Tums d. A patient with severe diarrhea e. A patient with kidney failure - ✔✔B,D,E In general, respiratory alkalosis is due to what? - ✔✔Breathing too quickly and/ or deeply Which of the following values is associated with "alkalosis"? (SELECT ALL THAT APPLY) a. ph: 7.5 b. CO2: 30 c. HCO3: 20 d. CO2: 45 e. HCO3: 45 - ✔✔A,B,E How will the kidneys compensate if for a patient in respiratory acidosis - ✔✔the kidneys will retain HCO3 and/or excrete H+ to inc the pH How will the kidneys compensate if for a patient in respiratory alkalosis - ✔✔the kidneys will excrete HCO3 and/or excrete H+ to dec the pH How will the lungs compensate if for a patient in metabolic alkalosis - ✔✔the lungs will dec breathing rate/ depth to retain CO2 to dec the pH How will the lungs compensate if for a patient in metabolic acidosis - ✔✔the lungs will inc breathing rate/ depth to blow off more CO2 to inc the pH potential causes for: respiratory acidosis - ✔✔opioid OD, pulmonary embolism, brainstem injury inhibiting respiratory drive, oversedation potential causes for: respiratory alkalosis - ✔✔extreme anxiety, initial response to hypoxia, severe pain, high altitude potential causes for: metabolic acidosis - ✔✔shock (lactic acid), DKA, untreated chronic kidney disease, diarrhea potential causes for: metabolic alkalosis - ✔✔vomiting, thiazide or loop diuretics, antacid OD, constant NGT suctioning Interpret this ABG: pH 7.24 PaCO2 50 HCO3 25 - ✔✔uncompensated respiratory acidosis When we see that a PaCO2 is high >45, what is happening in the body to cause this? - ✔✔The patient is breathing slow and/or shallow --A high PaCO2 level means that the patient is breathing slow and/or shallow. They are hypoventilating. Something is wrong with the patient's ability to breath effectively to blow off adequate amounts of CO2 that it should. Interpret this ABG: pH 7.49 PaCO2 30 HCO3 24 - ✔✔uncompensated respirator alkalosis When we see that a PaCO2 is low <35, what is happening in the body to cause this? - ✔✔The patient is breathing fast and/or deep. --When the patient has a low CO2 level <35, the patient is breathing faster and/or deeper to blow off extra CO2. This is hyperventilation. Although we can see this with extreme fear and anxiety, we can also see it in earlier compensatory states where a patient is trying to breath deeper and faster because they feel like they are not getting enough oxygen - such as in early stages of hypoxia. Interpret this ABG: pH 7.52 PaCO2 38 HCO3 30 - ✔✔uncompensated metabolic alkalosis When we see that a HCO3 is low <22, what is happening in the body to cause this? - ✔✔The kidney's are excreting too much HCO3 --When you see on an ABG that the HCO3 is < 22, that means that the kidney's are excreting more HCO3 than usual or retaining extra H+. This can occur with disturbances such as shock, renal failure, DKA, or even severe diarrhea. The body will also hold onto extra H+ and/or excrete more HCO3 to compensate when it senses that there is not enough acid in the body (too alkalotic). Interpret this ABG: pH 7.31 PaCO2 38 HCO3 20 - ✔✔uncompensated metabolic acidosis interpret the ABG: pH 7.13 PaCO2 57 HCO3 18 - ✔✔mixed acidosis interpret the ABG: pH 7.60 PaCO2 30 HCO3 32 - ✔✔mixed alkalosis interpret the ABG: pH 7.54 PaCO2 22 HCO3 12 - ✔✔partially comp. resp alkalosis interpret the ABG: pH 7.18 PaCO2 28 HCO3 16 - ✔✔partially comp met acidosis interpret the ABG: pH 7.28 PaCO2 53 HCO3 31 - ✔✔partially comp resp acidosis interpret the ABG: pH 7.65 PaCO2 88 HCO3 41 - ✔✔partially comp met alkalosis interpret the ABG: pH 7.35 PaCO2 48 HCO3 30 - ✔✔fully comp resp acidosis interpret the ABG: pH 7.44 PaCO2 33 HCO3 18 - ✔✔fully comp resp alkalosis interpret the ABG: pH 7.36 PaCO2 30 HCO3 14 - ✔✔fully comp met acidosis interpret the ABG: pH 7.43 PaCO2 50 HCO3 31 - ✔✔fully comp met alkalosis ABG reads: pH: 7.28 PaCO2: 52 HCO3: 25 - ✔✔uncompensated respiratory acidosis -7.28 is out of normal range -> not "fully compensated" by kidneys bec