Exam 4 Study Guide: Q Flashcards
(131 cards)
causes of respiratory alkalosis
o anxiety induced hyperventilation
o poor oxygenation can induce hyperventilation
nursing interventions for a patient with respiratory alkalosis
o identify causes of anxiety
o rebreathing techniques (breathe into a paper bag or cupped hands) to retain CO2 and slow down breathing
o teach patient stress reduction
**non-rebreather mask is not a good option because the client should rebreathe some CO2
ABG values correlated with respiratory alkalosis
o PaCO2 < 35 mmHg
o pH > 7.45
S/S of respiratory acidosis
o high respiratory rate
o patient is acidic
o respiratory system is attempting to compensate by “blowing off” excess acid in the form of CO2
nursing priority of respiratory acidosis
o maintain patient’s airway
primary cause of respiratory acidosis
o primarily hypoventilation - which occurs with opioid overdose
which acid base disorder correlated with change in HCO3?
Metabolic acid base disorder correlate with changes in HCO3 (respiratory do not)
what ABG values are associated with metabolic acidosis?
o HCO3 < 22 mEq/L
o pH < 7.35
o normal PaCO2
causes of metabolic alkalosis??
o excessive oral ingestion of bicarbonate-based antacids
o vomiting and NGT suctioning
o Potassium wasting diuretics
ABG values indicate metabolic alkalosis
o pH . 7.45
o HCO3 > 26 mEq/L
o CO2 is normal
S/S of acute kidney injury (AKI)
o volume overload due to decreased urine output such as edema, JVD, SOB, hypertension, pulmonary edema and increased potassium
important interventions for a patient with CKD
o Monitor I&Os
o SPO2 > 93% and low protein diet
o monito lung sounds
what is the purpose of daily weights?
o weight is the best non-invasive indicator of fluid status
what is a good way to measure fluid retention?
1 L of H2O = 1kg
o a change in BWT is a good measure of excess fluid loss or retention
o patient education: clinical manifestations of hypervolemia such as edema
what diet should patients with fluid retention follow?
limit sodium and fluid intake
who is at risk for dehydration?
older adults
o less total body water than younger adults
what are important points with older patients at risk for dehydration
cognitively impaired
o and cannot obtain fluids independently or cannot make his or her need for fluids known
o causes poor cerebral perfusion and cerebral hypoxia, causing confusion
o increasing IVF rate would increase perfusion but rehydrating too rapidly with IVF can lead to cerebral edema
o watch for SOB when rehydrating rapidly, you may need to slow down the infusion and notify the physician
what should the nurse do when a patient has an elevated BUN with dehydration?
prepare to administer IV fluids
S/S of hypovolemia
o tachycardia
o hypotension
o concentrated urine
o flattened neck veins - could quickly lead to hypovolemic shock
o preventing injury - older adult with moderate dehydration may experience orthostatic hypotension, dangle on the bedside before ambulating
how is hypovolemia corrected
Isotonic Solutions (0.9% NS, LR)
o used for fluid volume deficit
hypervolemia interventions
o daily weights each morning before anything to eat or drink
o fluid restrictions
o monitor for edema
o edema in the lower extremities - elevate legs on a pillow or two
S/S of HYPERVOLEMIA
o tachycardia
o JVD
o edema
o crackles
o absence of adventitious sounds upon auscultation of the lungs indicates a lack of fluid overload and fluid balance in the patient’s body
S/S of HYPOCALCEMIA
o anxiety
o confusion
o irritability
o paresthesia
o positive chvostek/trousseau sign
o tetany
o twitching
o tremors
o focal numbness
o muscle spasms
o biliary colic
o dysphagia
o wheezing
o tingling around the mouth
o bronchospasms
o laryngospasms
causes of HYPOCALCEMIA
o chronic alcohol abuse is an etiology of hypocalcemia and hypomagnesemia
o parathyroid regulates calcium in the body and a thyroidectomy can affect the parathyroid increasing risk of hypocalcemia
