NR324 / NR-324: Adult Health I Exam 1 (Latest 2020 / 2021) Chamberlain College of Nursing

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NR324 / NR-324: Adult Health I Exam 1 (Latest 2020 / 2021) Chamberlain College of Nursing What is wrong with the body during DKA? - ✔✔It is too acidic Do people with COPD and other chronic r... espiratory illnesses hyper or hypoventilate? - ✔✔HYPOventilate What organs are the two regulators of acid in our body? - ✔✔Lungs and kidneys When will a patient display Kussmaul breathing in relation to acid-base balance? - ✔✔During acidosis / Normal pH range of blood - ✔✔7.35-7.45 normal PaCo2 - ✔✔35-45 mm Hg PaO2 normal levels - ✔✔80-100 Normal HCO3 levels - ✔✔22-26mEq/L Ratio of carbonic acid to bicarbonate in a healthy state - ✔✔1:20 Three regulatory mechanisms of acid-base regulation - ✔✔Buffer system respiratory system renal system Which regulatory system responds immediately? - ✔✔The buffer system. It is your natural neutral reaction process Which system responds in minutes and reaches its maximum effort within hours? - ✔✔Respiratory system Which regulatory system takes 2-3 days to respond? - ✔✔Renal system What type of acid-base imbalance would someone who took too much Aspirin have? - ✔✔Respiratory acidosis Why is a brown bag helpful for someone with respiratory alkalosis to breathe into? - ✔✔Because they can help return the CO2 back to their body that they lost from hyperventilating What type of meds are useful for someone in Respiratory alkalosis? - ✔✔Minor tranquilizers and anti-anxiety meds such as Ativan because they are hyperventilating and need help relaxing What are two common causes for metabolic acidosis? - ✔✔Aspirin overdose and prolonged diarrhea Common cause for metabolic alkalosis: - ✔✔prolonged vomiting or gastric suction ---you are eliminating acid from the body for a prolonged period of time. The kidneys compensate by dumping...lungs hypoventilate to keep CO2 When you auscultate cardiac sounds what are you hearing? - ✔✔The valves opening and shutting What is the major purpose of the cardiac system? - ✔✔to supply the body with oxygenated blood Ejection fraction - ✔✔the amount of blood ejected per minutes. It is >65mL per minute. You need an effective cardiac output and ejection fraction to ensure the hear is working well. If cardiac output is insufficient, what does this mean? - ✔✔you do not have enough o2 in your body what are the three layers of the heart - ✔✔epicardium- outer layer ,myocardium-middle layer, endocardium-inner layer why is the left ventricle thicker? - ✔✔because it does most of the pumping of blood to the body. It is 2-3x thicker than the R ventricle. What artery supplies the heart's oxygen and nutrients? - ✔✔The coronary artery (right and left) What happens when blood flow to a coronary artery is obstructed? - ✔✔Angina Complete occlusion of coronary artery lead to ... - ✔✔heart attack/ myocardial infarction partial occlusion of coronary artery - ✔✔angina SA node - ✔✔where all the elecrtical activity in the heart starts. Primary pacemaker what is the direction of electric flow to heart? - ✔✔SA node-->AV node---->bundle of His---->purkinje fibers What is the relationship between sodium and potassium and your heart? - ✔✔Sodium and potassium are positively charged and provide the "electricity" to your heart. As the move in and out of your heart, they create electricity. The heart will never contract without them. How do you measure the electricity of the heart? - ✔✔EKG Systole - ✔✔heart contracts (first sound) diastole - ✔✔heart relaxes (second sound) stroke volume - ✔✔amount of blood ejected with each heart beat Cardiac output - ✔✔amount of blood pumped by each ventricle each minute. 4-8L of blood per minute. Decreased CO= something is wrong with your heart. Why do you have fatigue if you have an ineffective cardiac output? - ✔✔Because you have a lack of oxygenated blood flowing throughout your body. preload - ✔✔volume of blood in the ventricle at the end of diastole afterload - ✔✔tissue resistance against which the left ventricle must pump blood contractility - ✔✔how effectively the heart is able to contract. Blood pressure - ✔✔is highly individualized all arteries carry oxygenated blood except - ✔✔the pulmonary artery all veins carry deoxygenated blood except - ✔✔the pulmonary vein Why is blood in arteries bright red and blood in veins ashy - ✔✔arteries carry oxygenated blood, veins cary deoxygenated blood arteries vs veins - ✔✔arteries are deeper and thicker because they carry oxygenated blood. Veins are more superficial and thinner Sympathetic nervous system - ✔✔decreases HR parasympathetic - ✔✔increases HR Baroreceptors and chemoreceptors - ✔✔also help regulate HR Blood pressure = - ✔✔CO X SYSTEMIC VASCULAR RESISTANCE When taking a BP - ✔✔make sure person is sitting and arm is at chest. Make sure you have the appropriate sized cuff. If you get a bad BP reading what should you do? - ✔✔Check other extremities first. If heart rate is high and blood pressure is low, what is most likely happening? - ✔✔Hypovolemic shock- the patient is losing blood somewhere in the body What do you use if you cannot auscultate a blood pressure? - ✔✔doppler pulse pressure - ✔✔the difference between systolic and diastolic What are two reasons HTN is more common in older adults? - ✔✔Blood vessels are less elastic, and valves become thicker and more stiff and do not work as well beta adrenergic (spelling? ) receptors - ✔✔responsible for vasoconstriction Orthostatic HTN in older adults - ✔✔very common... do not get them up too fast, let them dangle their feet on the edge of the bed first. thready pulses - ✔✔+1 bounding pulses - ✔✔+4 normal pulses - ✔✔+2 Troponin - ✔✔a cardiac enzyme that will continue to rise in a patient who is having a heart attack What lab will tell you the difference between MI and angina? - ✔✔Troponin level. If troponin is normal, it is angina. If troponin is high, it is a heart attack First thing they will do for a patient with chest pain in ER - ✔✔EKG. Then draw labs for troponin CK-MB - ✔✔specific to myocardial cells and will indicated myocardial damage How often will you draw Troponin level and why? - ✔✔Q 1 hour, because a rise in Troponin each hour indicates an impending heart attack c-reactive protein - ✔✔produced by the liver, it is a nonspecific marker of inflammation. Increased in many patients with CAD . Chronic elevations are associated with unstable plaques and the oxidation of LDL which further contributes to atherosclerosis homocysteine - ✔✔elevated levels is a risk factor for CAD BNP - ✔✔another cardiac marker. Increased BNP is indicative of heart failure When drawing a lipid panel pt must be - ✔✔NPO [Show More]

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