Podcast
Questions and Answers
Which condition would most likely lead to respiratory alkalosis?
Which condition would most likely lead to respiratory alkalosis?
- Severe dehydration
- Prolonged gastric vomiting
- Underventilation
- Overventilation (correct)
What nursing action should be taken if the ventilator triggers a high pressure alarm due to a kinked tube?
What nursing action should be taken if the ventilator triggers a high pressure alarm due to a kinked tube?
- Unkink the tube (correct)
- Change the ventilator
- Increase ventilator settings
- Suction the airway
In which situation would you likely select metabolic acidosis as the correct answer?
In which situation would you likely select metabolic acidosis as the correct answer?
- Inadequate gas exchange (correct)
- Loss of stomach acids
- Severe respiratory infection
- Prolonged gastric suctioning
Which of the following actions is appropriate for a low pressure alarm caused by disconnected tubing?
Which of the following actions is appropriate for a low pressure alarm caused by disconnected tubing?
Which factor could indicate that a patient is under-ventilating?
Which factor could indicate that a patient is under-ventilating?
What does 'wean' refer to in the context of ventilator management?
What does 'wean' refer to in the context of ventilator management?
If a patient is experiencing respiratory acidosis, what is likely true about their ventilation settings?
If a patient is experiencing respiratory acidosis, what is likely true about their ventilation settings?
Which of the following is a common cause of metabolic alkalosis?
Which of the following is a common cause of metabolic alkalosis?
What should be assessed to determine if a patient's ventilator is too high?
What should be assessed to determine if a patient's ventilator is too high?
What type of acid-base imbalance results from excessive loss of bicarbonate?
What type of acid-base imbalance results from excessive loss of bicarbonate?
What does it indicate when both pH and bicarbonate levels are in the same direction?
What does it indicate when both pH and bicarbonate levels are in the same direction?
What will occur to potassium levels when the pH rises?
What will occur to potassium levels when the pH rises?
Which of the following symptoms is NOT typically associated with acidosis?
Which of the following symptoms is NOT typically associated with acidosis?
What breathing pattern is associated with severe metabolic acidosis?
What breathing pattern is associated with severe metabolic acidosis?
In a patient with respiratory acidosis, which sign or symptom is least likely to be present?
In a patient with respiratory acidosis, which sign or symptom is least likely to be present?
How does a decrease in pH affect the body’s systemic functions?
How does a decrease in pH affect the body’s systemic functions?
Which factor is indicative of metabolic acidosis based on the rule of the B's?
Which factor is indicative of metabolic acidosis based on the rule of the B's?
Which symptom is likely to occur with respiratory alkalosis?
Which symptom is likely to occur with respiratory alkalosis?
What is the normal range for PaO2 levels?
What is the normal range for PaO2 levels?
Which of the following features would not align with symptoms of metabolic alkalosis?
Which of the following features would not align with symptoms of metabolic alkalosis?
Study Notes
Acid Base Principles
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Rule of B's: If pH and bicarbonate (HCO3) are both in the same direction, it's metabolic. If they are in different directions, it's respiratory.
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Normal values: PaO2 (partial pressure of oxygen in arterial blood) - 80-100 mmHg; SaO2 (oxygen saturation) - 95-100%
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Acidosis: pH down; causes the body to slow down (e.g., bradycardia, lethargy, coma)
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Alkalosis: pH up; causes the body to speed up (e.g., tachycardia, tremors, hyperreflexia)
Potassium Levels
- Acidosis: Potassium levels ↑ (up)
- Alkalosis: Potassium levels ↓ (down)
Kussmaul Breathing:
- Deep and labored breathing pattern, often associated with metabolic acidosis, especially diabetic ketoacidosis (DKA) and kidney failure.
Ventilators
- High Pressure Alarms: Triggered by increased resistance to airflow.
- Causes: kinked tubing, water in tubing, mucus in airway.
- Nursing actions: Unkink the tubing, empty the water, encourage the patient to turn, cough, and deep breathe (TCDB); suction only if TCDB is ineffective.
- Low Pressure Alarms: Triggered by decreased resistance to airflow.
- Causes: Disconnection of tubing.
- Nursing actions: Check where the tubing is (contamination risk). If the tubing is on the floor, replace it; If the tubing is on the patient’s chest, clean with alcohol wipes and re-attach.
Ventilator Settings
- Respiratory alkalosis: Overventilation, ventilator settings may be too high.
- Respiratory acidosis: Underventilating, ventilator settings may be too low.
Weaning
- The process of gradually decreasing ventilator support to allow the patient to breathe independently.
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