Exam 2

• 3 components that regulate acid-base balance

  pH, HCO3, PaCO2
• Normal range for pH


  7.35-7.45
• Respiratory acidosis _____ is retained

  CO2
• Metabolic alkalosis ______ is retained

  HCO3
• T or F: respiratory alkalosis involves CO2 loss


  True
• The body has built-in mechanisms to compensate for acid-base imbalance(s). This mechanism, considered a long-term regulator of acid-base balance, is the last and slowest to respond to changes in pH:

  A.Kidneys

  B.Lungs

  C.Chemical buffers

  D.Brain

  A
• 2nd system that responds to acid base imbalances

  Respiratory
• Major diagnostic tool for evaluating acid-based oxygenation

  Arterial blood gases (ABGs)
• PaCO2 range


  35-45 mmHg
• HCO3 range


  22-26 mEq/L
• What test measures the difference between negatively charged and positively charged electrolytes in the blood?

  Anion Gap
• Normal value range for an anion gap test

  5-13 mmol/L
• The nurse is reviewing a patient's arterial blood gas results. Which of the following values should the nurse study first?

  A. PaCO2

  B. HCO3

  C. Compensation

  D. pH

  D
• pH < 7.35 = __________

  acidosis
• pH > 7.45 = ____________

  alkalosis
• Full compensation is evident when the pH is within normal range and the PaCO2 and HCO3 are both abnormal.

  A. True

  B. False

  A
• A patient has the following arterial blood gases: pH 7.50, PaCO2 50, HCO3 38. Which of the following signs may this patient exhibit as a compensatory mechanism?

  A. Hyperventilation

  B. Hypoventilation

  C. Hyperkalemia

  D. Constipation

  B
• A patient is admitted to the emergency department for respiratory alkalosis. The nurse records the following assessment data:

  Patient febrile with a temperature

  of 102.8°F.Lungs clear to auscultation. Abdomen nontender. No edema noted.

  No complaints of pain. Respiration 26 breaths/min.

  
  

  Which data is the probable cause of respiratory alkalosis?

  A. Temperature

  B. Abdomen nontender

  C. Clear lung sounds

  D. No edema

  A
• Which assessment is most important for the nurse to perform on a patient who is developing severe anxiety that can affect acid-base balance?

  A. Respiratory rate

  B. Heart rate

  C. Intake Output

  D. Temperature

  A
• Causes of metabolic acidosis (4)


  renal failure, ketoacidosis, severe diarrhea, aspirin toxicity
• Causes of metabolic alkalosis (4)

  prolonged vomiting, gastric suctioning, loop diuretic use, antacid use
• Causes of respiratory acidosis (4)


  COPD, asthma, cystic fibrosis, MS
• Pulmonary toilet examples (3)

  incentive spirometry, turning & deep breathing, suctioning
• When is pulmonary toileting used?

  respiratory acidosis
• Causes of respiratory alkalosis (2)

  hyperventilation (anxiety, fear), mechanical ventilationF
• What system is completely dependant on carbohydrate glucose?

  neurological
• Regulatory defenses (3)


  Chemical/protein buffers, respiratory system, kidneys
• How long does it take the kidneys to respond to an acid base imbalance?

  3-5 days
• What are the major diagnostic tools used to evaluate acid-base oxygen?

  Arterial blood gases (ABGs)
• Normal range for PaCO2

  35-45 mmHg
• Normal range for HCO3

  22-26 mEq/L
• How is an anion gap calculated?


  (Sodium + Potassium) - (Chloride + Bicarb)
• What is the anion gap used for?

  To detect metabolic acidosis
• T or F: compensation is happening when PaCO2 and bicarb both have a change in value

  True
• The nurse would identify which body systems as directly involved in the process of normal gas exchange? (Select all that apply)

  A. Neurologic system

  B. Endocrine system

  C. Pulmonary system

  D. Immune system

  E. Cardiovascular system

  F. Hepatic system

  A, C, E
• What expands/contracts the lungs, forcing air in and out?

  Diaphragm
• What part of the respiratory tract has no cilia and is the starting point for digestion?

  Mouth
• What carries air the alveolI?

  Bronchioles
• Where does gas exchange occur?

  Alveoli
• What allows air to pass beyond the larynx to L and R bronchi, cartilage protects the esophagus?

  Trachea