Lecture 2 Drill

8/4/2019 Lecture 2 Drill

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ANALYZING

ARTERIAL BLOODGAS RESULTS


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POINTS TO REMEMBER:

1. In ACIDOSIS, the pH is DOWN.

2. In ALKALOSIS, the pH is UP.

3. The RESPIRATORY FUNCTIONindicator is the PCO2.

4. The METABOLIC FUNCTION indicator is

the HCO3.


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STEPS:STEP 1

Look at the blood gas report.

Look at thepH. Is the ph UP or DOWN? If

Up=ALKALOSIS,Down= ACIDOSIS.


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STEP 2

Look at the PCO2. Is it up or down? Ifthe PCO2 reflects an opposite

response to the pH, then you knowthat the condition is a RESPIRATORYIMBALANCE. If the PCO2 does not

reflect an opposite response to thepH, then move to step 3.


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STEP 3

Look at the HCO3concentration. Does the

HCO3 concentration reflect acorresponding response withthe pH? If it does, then thecondition is a METABOLICIMBALANCE.


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EXAMPLE:

pH = 7.37

PaCO2 = 52

HCO3= 29mmHg

Answer:


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pH = 7.37 ACID PaCO2 = 52 Acid

HCO3= 29mmHg AlkalosisAnswer:

METABOLIC ACIDOSISComplete Compensatory

ANSWER:


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STEP 4

Remember:

COMPENSATION has OCCURRED if thepH is in a normal range of 7.35-7.45. if thepH is NOT within NORMAL range, look atthe respiratory or metabolic functionindicators.


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RESPIRATORY IMBALANCES:

If a condition is a respiratory imbalance,look at the HCO3 concentration to

determine the state of compensation.

If the HCO3 is NORMAL, then thecondition is UNCOMPENSATED.

If the HCO3 is ABNORMAL, then thecondition is PARTIAL COMPENSATION.


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EXAMPLE:

pH = 7.30 PaCO2 = 56

HCO3= 29mmHg

Answer:


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ANSWER:

pH = 7.30 PaCO2 = 56

HCO3= 29mmHg

Answer:

RESPIRATORY ACIDOSIS(P.COMPENSATORY)


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METABOLIC IMBALANCE

If the condition is a METABOLICIMBALANCE, look at the PCO2 todetermine the state of compensation.

If the PCO2 is NORMAL, then thecondition is UNCOMPENSATED.

If the PCO2 is ABNORMAL, then thecondition is a PARTIAL COMPENSATION.


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EXAMPLE

pH = 7.30 PaCO2 = 43

HCO3= 21mmHg

Answer:


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ANSWER

pH = 7.30 PaCO2 = 43 N

HCO3= 21mmHg

Answer:

UNCOMPENSATED METABOLICACIDOSIS


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DRILL


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GROUPINGFerolin,

Selina C.

Almanzor,

Kessa MarieD.

Viloan, Dan

Louie M.

Beglilio,

Jamie B.

Eramis Army

Joy A.

Ortega, Rey

Mart P.

Paderes,

AnnaTess B.

Paciente,

Kyle T.

Amualla,

Marife Julia

A.

Bolivar, May

Rozel M.

Ceriales,

Joanne Fe

C.

Sanogal,

Alene Joy T.

Velos,

Queenie

Kaye B.

Solayman,

Farisha

Mae D.

Larisma,

Bea

Andrea R.

Vallejo,Ar

pha Omar

F.

Gomez,

Erwin S.

Bantala,

Abdel Haq D.

Sanang,

Almira M.

Verano,

Karen Joy

F.

Salcedo,

Ralph Elton

S.

Quionez,

V.

Parnes,

Jonalie P.

Maniquis,

Irene M.

Pagaduan,

Lady Anne

M.

Mostrales,

Kelvin Doyle

C.

Bisabis,

Michel B.

Bagsican,

Mae A.

Aquino Jr.,

Arnold L.

Demerin,

Herma

Grace B.

Nazaire,

Rose A.

Parcon,

Krystyl

Myca C.


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PRACTICE QUESTIONS:

1. A nurse plans care for a client withChronic Obstructive PulmonaryDisease, knowing that the client ismost likely to experience what type ofimbalance?

a. Respiratory Acidosis

b. Respiratory Alkalosis

c. Metabolic Acidosis

d. Metabolic Alkalosis


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ANSWER

a. Respiratory Acidosisb. Respiratory Alkalosis

c. Metabolic Acidosisd. Metabolic Alkalosis


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2. A nurse reviews the blood gas results of

a client with Guillain-Barr syndrome.The nurse analyzes the results anddetermines that the client isexperiencing respiratory acidosis.

Which of the following validates thenurses findings?

1. pH 7.50, Pco2 52 mmHg

2. pH 7.35, Pco2 40 mmHg

3. pH 7.25, Pco2 50 mmHg

4. pH 7.50, Pco2 30 mmHg


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1. pH 7.50, Pco2 52 mmHg

2. pH 7.35, Pco2 40 mmHg

3. pH 7.25, Pco2 50 mmHg

4. pH 7.50, Pco2 30 mmHg

ANSWER


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3. A nurse reviews the arterial blood gasresults of a client and notes the following:pH 7.45, Pco2 of 30mmHg and HCO3 of22 meQ/L. The nurse analyzes theseresults as indicating:

a. Metabolic Acidosis, compensated

b. Metabolic Alkalosis, uncompensated

c. Respiratory Alkalosis, compensated

d. Respiratory Acidosis, uncompensated


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ANSWER

a. Metabolic Acidosis, compensated

b. Metabolic Alkalosis, uncompensated

c. Respiratory Alkalosis, compensatedd. Respiratory Acidosis, uncompensated


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4. A client is scheduled for blood to be

drawn from the radial artery for ABGdetermination. Before the blood isdrawn, an Allens test is performed to

determine the adequacy of the:a. Popliteal circulation

b. Ulnar circulation

c. Femoral circulationd. Carotid circulation


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ANSWER

a. Popliteal circulation

b.Ulnar circulationc. Femoral circulation

d. Carotid circulation


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5. A nurse is caring for a client with

Nasogastric tube that is attached to a lowsuction. The nurse monitors the clientknowing that the client is at risk for whichacid-base disorder?



c. Metabolic Acidosisd. Metabolic Alkalosis


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ANSWER




d.Metabolic Alkalosis


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6. A nurse caring for a client with an

ileostomy understands that the client isat most risk for developing which acid-base disorder?

a. Respiratory Acidosisb. Respiratory Alkalosis




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ANSWER






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7. A nurse is caring for a client with diabeticketoacidosis (DKA) and documents that the

client is experiencing Kussmauls respirations.Based on this documentation, which of thefollowing did the nurse observe?

a. Respirations that are abnormally deep, regular& increase in rate.

b. Respirations that are regular but abnormallyslow.

c. Respirations that are labored and increased indepth and rate

d. Respirations that cease for several seconds.


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ANSWER

a. Respirations that are abnormally

deep, regular & increase in rate.

b. Respirations that are regular but

abnormally slow. - bradypneac. Respirations that are labored and

increased in depth and rate -

hyperpnead. Respirations that cease for several

seconds. - apnea


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8. A nurse understands thatexcessive use of oral antacids

containing bicarbonate can resultin which acid-base disturbance?

a. Respiratory alkalosis

b. Respiratory acidosis

c. Metabolic acidosis

d. Metabolic alkalosis


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ANSWER

a. Respiratory alkalosis

b. Respiratory acidosis

c. Metabolic acidosis

d. Metabolic alkalosis


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9. A nurse is caring for a client with renalfailure. Blood gas results indicate a pH

of 7.30, a pC02 of 32mmHg and abicarbonate concentration of 20 mEq/L.The nurse has determined that the clientis experiencing metabolic acidosis.Which of the following laboratory valueswould the nurse expect to note?

a. Sodium level of 145 mEq/L

b. Magnesium level of 5.2 mEq/Lc. Potassium level of 5.2 mEq/L

d. Phosporus level of 4.0 mg/dL


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ANSWER

a. Sodium level of 145 mEq/L N

b. Magnesium level of 5.2 mEq/L - N

c. Potassium level of 5.2 mEq/L

d. Phosporus level of 4.0 mg/dL - N


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10. A nurse is caring for a client who is onmechanical ventilator. Blood gas results

indicate a pH of 7.50 and pC02 of 30mmHg. The nurse has determined thatthe client is experiencing respiratory

alkalosis. Which laboratory value wouldmist likely be noted in this condition?

a. Sodium level of 145 mEq/L

b. Potassium level of 3.0 mEq/Lc. Magnesium level of 2.0 mg/dL

d. Phosporus level of 4.0 mg/dL


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ANSWER

a. Sodium level of 145 mEq/L - N

b. Potassium level of 3.0 mEq/L

c. Magnesium level of 2.0 mg/dL - N

d. Phosporus level of 4.0 mg/dL - N


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-END OFDRILL


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GRADE EQUIVALENT (CLASS STANDING)

SCORE GRADE

1- 5 = 65

6 = 757 = 80

8 = 859 = 90

10 = 95


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CONGRATULATIONS!

Lecture 2 Drill

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