Jeopardy

• ARDS has a PaO2/FIO2 of less than 200
• Injury/exudative phase is which increased capillary permeability occurs.
• Peak inspiratory pressures on the ventilator indicate a decreased lung compliance
• Expected ABG values for PaO2, PaCO2 & pH in later stages of ARDS is:

  
  

  • PaO2 <80
  • PaCO2 >45
  • pH <7.35
• Three of the four criteria for ARDS according to the Berlin definition:

  
  

  • Within one week or worsening symptoms
  • Bilateral lung capacities
  • Non-cardiogenic pulmonary edema, or P/F ratio <200
• Abnormal PaO2 caused by PNA, pulmonary edema, PE.

  
  

  • Hypoxemic respiratory failure
• The three components needed for respiration

  
  

  • Ventilation
  • Oxygenation
  • Perfusion
• Decrease perfusion to the lung tissue

  Pulmonary embolism
• High levels of oxygen being administered wont help if this is the problem.

  
  

  Hypoventilation
• Pulmonary edema and pulmonary fibrosis cause impaired _____ in the alveoli.

  Oxygenation
• First step after ETT is placed in a client with resp. failure.

  Assess the client to check placement
• Mode of volume - controlled + pressure ventilation that provides the highest amount of support. 


  Assist - control (AC)
• A patient is biting on the tube will cause:

  High pressure
• Every breath the patient takes over the set rate on the SIMV is at this tidal volume (VT).

  Clients own tidal volume
• Clients are on this mode prior to extubation.

  CPAP (continuous positive airway pressure)
• • PaO2 80
  • pH 7.29
  • PaCO2 55
  • HCO3 24

  Respiratory acidosis (uncompensated)
• • PaO2 is normal
  • pH is acidotic
  • PaCO2 is low
  • HCO3 is low

  Partially compensated metabolic acidosis
• Prolonged hypoventilation is likely to cause this acid-base imbalance

  Respiratory acidosis
• Prolonged vomiting is likely to cause this acid-base imbalance

  Metabolic alkalosis
• • pH: 7.19
  • PaO2: 54
  • PaCO2: 59
  • HCO3: 28
  • One system is the problem and the other is compensating.

  Respiratory acidosis with metabolic/renal compensation
• Urine output in the oliguric/anuric stage of AKI

  <400 mL
• In AKI, this is electrolyte usually high and this electrolyte is usually low

  Potassium and sodium
• In AKI, patients may have this acid-base imbalance

  Metabolic acidosis
• You are assessing a client with crackles in the bases, PaCO2 low, RR 30. Lasix is not working. The next step to fix the underlying cause is to :

  HD catheter/start dialysis
• The nurse may give this for a K+ of 6.4 to use the GI tract.

  Kayelalate
• Clients in DKA have started burning this a fuel source and creating ketone bodies in the process.

  Fat
• Clients in DKA will most likely show a ____ pH and a ___ HCO3.

  Low and Low
• Before starting in insulin drip, nurses need to check this electrolyte.

  Potassium
• In a client with DK, the nurse starts D5 .45% NaCl when the blood glucose decreases to ___?

  250 mg/dL
• The provider orders insulin to run at 0.1 unit/kg/hour. The client weighs 149.6 lb. How many units will the client received in the first hour?

  6.8 units