Acid / Base & Ventilators

Question 1

Ph normal values

Answer 1

Acid 7.35 - 7.45 Alkalotic

Question 2

PaCO² values
ABG

Answer 2

Alkalotic 35 - 45 Acid

Acid 45 - 35 Alkalotic

Question 3

HCO³ Values

Answer 3

Acid 22 - 26 Basic

Question 4

Vomiting & Ng suction will create this state

(Acidosis/ Alkalosis)

Answer 4

Alkalosis

Question 5

Why does Vomiting and Ng suction lead to Alkalosis

Answer 5

It removes stomach juices which contain acids

Question 6

Why does diarrhea cause metabolic Acidosis

Answer 6

Because Bicarbonate is found in the intestines and removed with the diarrhea.

Think diarrhea Assidosis

Question 7

Why does renal failure cause metabolic acidosis

Answer 7

The kidneys no long put out the H² hydrogen ions which are acids.

Leaving the body with more acid

Question 8

DKA is this state

How does the body try to compensate

Answer 8

Metabolic acidosis

Kussmaul breathing
Rapid breathing to rid body of CO²

Question 9

Low & slow RR will cause

Answer 9

Respitory Acidosis

Question 10

Respiratory Alkalosis or Acidosis

Sleep apnea

Answer 10

Acidosis

Question 11

Respiratory Alkalosis or Acidosis

Head trauma “knocked out”

Answer 11

Acidosis

Question 12

Respiratory Alkalosis or Acidosis

Post operation

Answer 12

Acidosis

Question 13

Respiratory Alkalosis or Acidosis

Drugs CNS depressants
Opiods, Alcohol, Benzos

Answer 13

Acidosis

Question 14

Respiratory Alkalosis or Acidosis

Impaired gas exchange

Pneumonia

Answer 14

Acidosis

Question 15

Respiratory Alkalosis or Acidosis

Impaired gas exchange

COPD / Asthma

Answer 15

Acidosis

Question 16

Hyperventilation = Respiratory Alkalosis or Acidosis

Hypoventiliation = Respiratory Alkalosis or Acidosis

Answer 16

Alkalosis

Acidosis

Question 17

Respiratory Alkalosis or Acidosis

Panic attack

Answer 17

Alkalosis

Question 18

Most important objective data when determining if a client is hypoxic

Answer 18

Abnormal ABG

Question 19

Best diagnostic test to evaluate a patient’s oxygenation & ventilation after a traumatic brain injury

Answer 19

ABG

Question 20

Priority intervention following ABG procedure

Answer 20

Hold firm pressure at the site

Question 21

Only Ph & HCO³ need to be examined

Rule of B states

Is used for what

Answer 21

If pH and Bicarb Both go same direction, its metaBolic

If pH Bicarb go opposite direction its respitory

Question 22

As ph goes, so goes my patient, except for potassium.

What does this mean

Answer 22

If ph is low everything is low, but potassium is high

If ph is high everything is high, but potassium is low.

Question 23

Ph > 7.45 = acidic / alkalosis

DESCRIBE: HR, RR, BP

¿Seizures?
¿Calm?
¿Constipation?
¿Borborygmi?
Reflexes

Main nursing intervention?

Answer 23

Everything is High and excitable

Main Nursing Intervention: Suction for Seizures

Question 24

pH <7.35

Describe body systems

HR, RR,BP

Bowel Movements
¿Abtunded?
Reflexes
Coma or Seizure

K level

Answer 24

Everything Low

Except K, K high

Abtunded Yes, mean lethargic

Question 25

Nursing interventions for (Acidosis or Alkalosis) Ambu bag / intubation and ventilation for resp arrest

Answer 25

Acidosis <7.35

Question 26

Which acid based disorder needs a suction device by bed side. (Acidosis/ Alkalosis)

Answer 26

Alkalosis They could seize and asparate

Question 27

Kussmaul is seen with (Metabolic/Respitory) (Acidosis / Alkalosis)

Answer 27

Metabolic Acidosis Think Mac Kussmaul

Question 28

Hypoventilation is associated with (Acid / Alkalosis) Hyperventilation is associated with (Acid / Alkalosis)

Answer 28

Hypoventilation = Acidosis Hyperventilation = Alkalosis Due to retaining or expelling CO² which is acidic

Question 29

Causation & S / S will often be the opposite from eachother Exp. Diarrhea Causes (Metabolic Acidosis/ Alkalosis) the signs and symptoms of which is (Constipation/ Diarrhea)

Answer 29

Diarrhea Causes Metabolic Acidosis the signs and symptoms of which is Constipation

Question 30

Does respitory rate correlate to ventilation?

Answer 30

No. Exp. Pneumonia patient will have 50 RR but poor ventilation

Question 31

For prolonged gastric vomiting or suction metabolic (Acidosis/ Alkalosis) Everything else that is NOT LUNG selct the opposite

Answer 31

For prolonged gastric vomiting or suction metabolic Alkalosis Everything else metabolic Acidosis

Question 32

Tip: Pay attention to modifying phrase rather than original noun. Exp. A patient with vomiting who is now dehydrated Which is the focus

Answer 32

Dehydrated

Question 33

High pressure Alarm (Machine Working too Hard) Triggered by (decreased / increased) resistance to air flow Nurse intervention:

Answer 33

Increased Look for obstructions Kinks, condened water, mucus plugs

Question 34

High pressure alarm goes off on ventilator Put in order... Check Patient for mucus plugs, make pt turn, cough, deep breath, suction PRN. Kinks in tubing Condensation water in dependent tube

Answer 34

Kinks Condensation Mucus Plugs

Question 35

High pressure alarm goes off on ventilator Put in order Relieve mucus plugs: Deep breath, cough, suction, turn

Answer 35

Turn pt, cough, Deep Breath Suction

Question 36

Low pressure alarms Triggered by (decreased/increased) to airflow. Nursing intervention:

Answer 36

Decrease Look for disconnection Main tube disconnect: Reconnect unless on floor O2 sensor tube disconnect: Reconnect unless on floor

Question 37

High pressure ventilator Alarms (Disconnection/ Obstruction) Low pressure Alarms (Disconnection/ Obstruction)

Answer 37

High pressure ventilator Alarms Obstruction Low pressure Alarms Disconnection

Question 38

Doctor orders to wean patient off ventilator in AM. AM ABG Respitory Acidosis. What do you do? A. Follow orders B. Call Respiratory Therapist C. Hold order and call Dr.

Answer 38

Hold order call Dr. He already has low ventilation. Weaning off Oxygen wont help