3.Acid -bace

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Questions and Answers

What is the best diagnostic test to evaluate patient oxygenation and ventilation after a traumatic brain injury?

  • Magnetic resonance imaging (MRI)
  • Lumbar puncture
  • Electroencephalogram (EEG)
  • Arterial blood gases (ABG) (correct)

What is the purpose of Allen's test?

  • To assess lung function
  • To evaluate the potency of the ulnar artery (correct)
  • To assess cardiac output
  • To measure intracranial pressure

What is the priority intervention following an ABG procedure?

  • Apply pressure to the puncture site (correct)
  • Assess for neurological deficits
  • Monitor blood pressure
  • Administer oxygen therapy

Based on the given blood gas values, what condition is indicated by a pH of 7.25, PaCO2 of 55, and HCO3 of 25?

<p>Respiratory acidosis uncompensated (C)</p> Signup and view all the answers

What is the role of nurses regarding providing specifics about fertility after a partial hysterectomy?

<p>Nurses cannot provide specifics about fertility after a partial hysterectomy (B)</p> Signup and view all the answers

What does a DNR (Do Not Resuscitate) order imply?

<p>No CPR and no resuscitative action should be taken (D)</p> Signup and view all the answers

What is the purpose of a living will?

<p>To outline wishes and desired medical care if the client is unable to communicate (A)</p> Signup and view all the answers

What does a Durable Power of Attorney (POA) allow for?

<p>Assigning another person to make decisions for the client if unable to do so (A)</p> Signup and view all the answers

Who can make decisions for a client as a Health Care Proxy?

<p>Another appointed individual (C)</p> Signup and view all the answers

What is the right of a client regarding treatment refusal?

<p>They can refuse treatment even if their partner disagrees (C)</p> Signup and view all the answers

Who can CPR be delegated to?

<p>Licensed nurses, LPNs, CNAs (C)</p> Signup and view all the answers

What should patients with type 2 diabetes taking Metformin avoid after certain medical procedures?

<p>Avoiding taking Metformin for 8 hours (B)</p> Signup and view all the answers

How are acid and base imbalances measured in the blood?

<p>Via pH, with values under 7.35 indicating alkalosis (D)</p> Signup and view all the answers

Which organs control acid-base balance metabolically?

<p>The kidneys and lungs (C)</p> Signup and view all the answers

What causes respiratory acidosis?

<p>Slow breathing (A)</p> Signup and view all the answers

What is the role of the lungs in controlling acid-base balance?

<p>Controlling CO2 levels through respiration (D)</p> Signup and view all the answers

What do values under 7.35 in blood pH indicate?

<p>Acidosis (B)</p> Signup and view all the answers

What is the role of bicarbonate (HCO3) and carbon dioxide (CO2) in the body?

<p>They are key players in maintaining acid-base balance (A)</p> Signup and view all the answers

What is the effect of hyperventilation on acid-base balance?

<p>Causes alkalosis (A)</p> Signup and view all the answers

How can the type of acid-base imbalance be determined?

<p>By assessing pH, PCO2, and HCO3 levels (B)</p> Signup and view all the answers

What is the essential action after ABG procedure?

<p>Apply pressure to puncture site (C)</p> Signup and view all the answers

What is the priority intervention following an ABG procedure?

<p>Administer oxygen therapy (C)</p> Signup and view all the answers

Based on the given blood gas values, what condition is indicated by a pH of 7.25, PaCO2 of 55, and HCO3 of 25?

<p>Respiratory acidosis uncompensated (C)</p> Signup and view all the answers

What is the role of the Allen's test?

<p>To determine the potency of the ulnar artery (C)</p> Signup and view all the answers

What does a pH of 7.57, PaCO2 of 25, and HCO3 of 22 indicate?

<p>Respiratory alkalosis uncompensated (A)</p> Signup and view all the answers

What is the condition indicated by a pH of 7.21, PaCO2 of 39, and HCO3 of 19?

<p>Metabolic acidosis uncompensated (A)</p> Signup and view all the answers

What is the effect of hyperventilation on acid-base balance?

<p>Causes respiratory alkalosis (C)</p> Signup and view all the answers

What is the purpose of holding firm pressure after ABGs?

<p>To prevent bleeding from the puncture site (C)</p> Signup and view all the answers

What is the effect of a PaCO2 level of 55 on acid-base balance?

<p>Causes respiratory acidosis (D)</p> Signup and view all the answers

What is the role of bicarbonate (HCO3) in the body?

<p>Buffering excess hydrogen ions (B)</p> Signup and view all the answers

What is the role of a Health Care Proxy (POA) in making decisions for a client?

<p>They can make decisions for a client, overriding family members, and can be changed at any time (C)</p> Signup and view all the answers

What rights do clients have regarding refusal of treatment?

<p>They have the right to refuse treatment, even if their partner disagrees, and can leave the hospital against medical advice under certain conditions (A)</p> Signup and view all the answers

What is the effect of hypoventilation on acid-base balance?

<p>Leads to acidosis (C)</p> Signup and view all the answers

What condition is indicated by blood pH values under 7.35?

<p>Acidosis (B)</p> Signup and view all the answers

What is the role of the kidneys in controlling acid-base balance?

<p>The kidneys control acid-base balance metabolically (D)</p> Signup and view all the answers

What is the effect of fast breathing on acid-base balance?

<p>Leads to alkalosis (C)</p> Signup and view all the answers

What is the recommended action for suspected abuse of a client?

<p>Immediate protection of the client, separate interviews, evidence collection, and safety planning (D)</p> Signup and view all the answers

What is the role of disease management recommendations for chronic diseases like diabetes and COPD?

<p>Include communication and education (C)</p> Signup and view all the answers

What is the effect of taking Metformin for 8 hours after certain medical procedures for patients with type 2 diabetes?

<p>To prevent lactic acidosis (C)</p> Signup and view all the answers

How are acid and base imbalances measured in the blood?

<p>Via pH, with values under 7.35 indicating acidosis and above 7.45 indicating alkalosis (D)</p> Signup and view all the answers

What is the purpose of a living will?

<p>To outline desired medical care if the client becomes unable to communicate (A)</p> Signup and view all the answers

What does a DNR (Do Not Resuscitate) order imply?

<p>No resuscitative measures, including CPR (A)</p> Signup and view all the answers

What is the role of bicarbonate (HCO3) and carbon dioxide (CO2) in the body?

<p>HCO3 acts as a buffer to maintain blood pH, while CO2 regulates breathing rate (C)</p> Signup and view all the answers

What causes respiratory acidosis?

<p>Hypoventilation leading to retention of CO2 and decreased blood pH (C)</p> Signup and view all the answers

What is the effect of hyperventilation on acid-base balance?

<p>Leads to respiratory alkalosis due to decreased CO2 and increased blood pH (C)</p> Signup and view all the answers

What is the best diagnostic test to evaluate patient oxygenation and ventilation after a traumatic brain injury?

<p>Arterial Blood Gas (ABG) analysis (A)</p> Signup and view all the answers

Who can CPR be delegated to?

<p>Trained healthcare professionals and designated first responders (C)</p> Signup and view all the answers

What is the role of the lungs in controlling acid-base balance?

<p>Adjusting breathing rate to control carbon dioxide levels and blood pH (B)</p> Signup and view all the answers

What is the priority intervention following an ABG procedure?

<p>Applying pressure to the puncture site to prevent bleeding (C)</p> Signup and view all the answers

What is the right of a client regarding treatment refusal?

<p>The client has the right to refuse treatment, even if it may result in harm (C)</p> Signup and view all the answers

Explain the purpose of the Allen's test and how it is performed.

<p>The purpose of the Allen's test is to determine the patency of the ulnar artery. It is performed by having the client make a fist to occlude the radial artery, then opening the palm to check for lack of blood flow. Releasing the pressure on the ulnar artery should result in the palm regaining its color in about 15 seconds or less.</p> Signup and view all the answers

What is the essential action after ABG procedure and why is it important?

<p>The essential action after ABG procedure is to apply pressure to the puncture site. This is important to prevent bleeding and hematoma formation.</p> Signup and view all the answers

What are the priority interventions following ABG procedure and why are they important?

<p>The priority interventions following ABG procedure include applying pressure to the puncture site and holding firm pressure. These interventions are important for preventing bleeding, hematoma formation, and ensuring proper wound healing.</p> Signup and view all the answers

Explain the interpretation of the blood gas values pH 7.25, PaCO2 55, and HCO3 25.

<p>The interpretation of these values indicates respiratory acidosis with uncompensated status.</p> Signup and view all the answers

Interpret the blood gas values pH 7.57, PaCO2 25, and HCO3 22.

<p>These values indicate respiratory alkalosis with uncompensated status.</p> Signup and view all the answers

What does the blood gas values pH 7.21, PaCO2 39, and HCO3 19 indicate?

<p>These values indicate metabolic acidosis with uncompensated status.</p> Signup and view all the answers

Interpret the blood gas values pH 7.32, PaCO2 55, and HCO3 42.

<p>These values indicate respiratory acidosis with partially compensated status.</p> Signup and view all the answers

Explain the significance of the blood gas values and the term 'alkalosis' in the provided context.

<p>The blood gas values and the term 'alkalosis' indicate an imbalance in the acid-base status towards the alkaline side, which can have physiological implications.</p> Signup and view all the answers

What is the purpose of evaluating blood gases in the context of traumatic brain injury?

<p>The purpose of evaluating blood gases in the context of traumatic brain injury is to assess and manage the patient's oxygenation and ventilation status, which are crucial for brain tissue perfusion and recovery.</p> Signup and view all the answers

Explain the potential implications of uncorrected acid-base imbalances in the context of patient care.

<p>Uncorrected acid-base imbalances can lead to physiological disturbances and complications, affecting various organ systems and overall patient stability.</p> Signup and view all the answers

Explain the role of nurses in educating a client about exercise after surgery and providing post-care education.

<p>Nurses can educate the client about post-care and exercise after surgery to promote recovery and prevent complications.</p> Signup and view all the answers

What information can nurses provide to a client who underwent a partial hysterectomy and wants to know if they can still have children with one ovary left?

<p>Nurses cannot provide specific information about fertility after surgery and should refer the client to a healthcare provider for detailed guidance.</p> Signup and view all the answers

How should a nurse handle a client who is anxious about an upcoming surgery and wants to cancel it due to perceived risks?

<p>The nurse should educate the client about the procedure and risks, provide support, and encourage the client to discuss concerns with the healthcare team.</p> Signup and view all the answers

What are advanced directives and what is their purpose?

<p>Advanced directives are legal documents that outline desired medical care if a client becomes unable to verbalize their wishes. A living will is a signed document that outlines wishes and desired medical care if the client is unable to communicate.</p> Signup and view all the answers

Explain the four types of advanced directives and their implications.

<p>The four types are full code, chemical code, ADNI, and DNR. Each type specifies the level of resuscitative measures to be taken in case of a medical emergency.</p> Signup and view all the answers

Can a client with a DNR order receive oxygen via a nasal cannula for comfort measures?

<p>Yes, if it's clearly stated as comfort measures only and not resuscitative measures.</p> Signup and view all the answers

What should healthcare providers do if a client arrives at the ER unconscious and there are no advanced directives available?

<p>In the absence of advanced directives, healthcare providers should provide full treatment and life-saving measures.</p> Signup and view all the answers

What does a Durable Power of Attorney (POA) entail?

<p>It means assigning another person, called a health care proxy or surrogate, to make decisions for the client if they are unable to do so themselves.</p> Signup and view all the answers

What are the specific conditions and drugs associated with respiratory acidosis and respiratory alkalosis?

<p>Specific conditions associated with respiratory acidosis include asthma, chronic obstructive pulmonary disease (COPD), and pneumonia. Specific drugs associated with respiratory acidosis include opioids, sedatives, and anesthetics. Specific conditions associated with respiratory alkalosis include anxiety, fever, and hyperventilation. Specific drugs associated with respiratory alkalosis include aspirin and other salicylates.</p> Signup and view all the answers

What are the key players in maintaining acid-base balance in the body and how do they contribute to it?

<p>Bicarbonate (HCO3) and carbon dioxide (CO2) are the key players in maintaining acid-base balance in the body. Bicarbonate acts as a buffer, helping to regulate pH, while carbon dioxide plays a role in controlling respiration and influencing the acid-base balance.</p> Signup and view all the answers

What are the immediate actions required for mandatory reporting of suspected abuse of a client?

<p>The immediate actions required for mandatory reporting of suspected abuse of a client include providing immediate protection for the client, conducting separate interviews, collecting evidence, and developing safety planning.</p> Signup and view all the answers

What is the recommended time frame for patients with type 2 diabetes taking Metformin to avoid taking it after certain medical procedures to prevent lactic acidosis?

<p>Patients with type 2 diabetes taking Metformin should avoid taking it for 8 hours after certain medical procedures to prevent lactic acidosis.</p> Signup and view all the answers

What does pH measurement in blood indicate, and what values indicate acidosis and alkalosis?

<p>pH measurement in blood indicates the acidity or alkalinity of the blood. Values under 7.35 indicate acidosis, while values above 7.45 indicate alkalosis.</p> Signup and view all the answers

How do the lungs control CO2 levels and what are the consequences of hypoventilation and hyperventilation?

<p>The lungs control CO2 levels through respiration. Hypoventilation leads to an increase in CO2 levels, causing respiratory acidosis, while hyperventilation leads to a decrease in CO2 levels, causing respiratory alkalosis.</p> Signup and view all the answers

What are the specific compensatory mechanisms and factors to consider when determining if a client is experiencing compensated or uncompensated acid-base imbalances?

<p>When determining if a client is experiencing compensated or uncompensated acid-base imbalances, specific compensatory mechanisms and factors to consider include assessing pH, PCO2, and HCO3 levels. Compensatory mechanisms may involve the respiratory system or the metabolic system.</p> Signup and view all the answers

What is the role of a Health Care Proxy (POA) and what are the rights of clients in relation to treatment refusal and leaving the hospital against medical advice?

<p>A Health Care Proxy (POA) can make decisions for a client, overriding family members, and can be changed at any time. Clients have the right to refuse treatment, even if their partner disagrees, and can leave the hospital against medical advice under certain conditions.</p> Signup and view all the answers

What are the delegation options for CPR and who can perform CPR?

<p>Delegation of CPR is possible to licensed nurses, LPNs, CNAs, and physical therapy assistants, among others. CPR can be performed by individuals who have received proper training and certification.</p> Signup and view all the answers

What are the disease management recommendations for chronic diseases like diabetes and COPD?

<p>Disease management recommendations for chronic diseases like diabetes and COPD include communication and education, which are essential components for effective management and control of these conditions.</p> Signup and view all the answers

Flashcards

Health Care Proxy (POA)

A legal document allowing a designated person to make healthcare decisions, which can override family.

Patient's Right to Refuse Treatment

The right to refuse medical intervention and to leave a medical facility, even against advice, under certain conditions.

Mandatory Reporting of Abuse

Legal obligation to report suspected cases, prioritizing the immediate safety of the individual.

Delegation of CPR

The assignment of responsibilities related to cardiopulmonary resuscitation by a professional

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Metformin and Lactic Acidosis

To avoid this condition, patients on Metformin should temporarily discontinue the medication following certain procedures.

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Chronic Disease Management

Communication and education are key recommendations.

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Acidosis

pH < 7.35 indicates this condition.

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Alkalosis

pH > 7.45 indicates this condition.

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HCO3 and CO2

Two key components in maintaining the body's acid-base balance.

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Lungs Role in Acid-Base Balance

Organ system that regulates CO2 levels.

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Kidneys Role in Acid-Base Balance

Organ system that regulates acid-base balance metabolically.

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Respiratory Acidosis

Caused by slow breathing.

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Respiratory Alkalosis

Caused by fast breathing.

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Assessing Acid-Base Imbalances

Process of checking pH, PCO2, and HCO3 to diagnose.

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Study Notes

Health Care Proxy and Patient Rights Summary

  • A Health Care Proxy (POA) can make decisions for a client, overriding family members, and can be changed at any time.
  • Clients have the right to refuse treatment, even if their partner disagrees, and can leave the hospital against medical advice under certain conditions.
  • Mandatory reporting of suspected abuse requires immediate protection of the client, separate interviews, evidence collection, and safety planning.
  • Delegation of CPR is possible to licensed nurses, LPNs, CNAs, and physical therapy assistants, among others.
  • Patients with type 2 diabetes taking Metformin should avoid taking it for 8 hours after certain medical procedures to prevent lactic acidosis.
  • Disease management recommendations for chronic diseases like diabetes and COPD include communication and education.
  • Acid and base imbalances are measured in blood via pH, with values under 7.35 indicating acidosis and above 7.45 indicating alkalosis.
  • Bicarbonate (HCO3) and carbon dioxide (CO2) are key players in maintaining acid-base balance in the body.
  • The lungs control CO2 levels through respiration, with hypoventilation leading to acidosis and hyperventilation leading to alkalosis.
  • The kidneys control acid-base balance metabolically, with vomiting causing alkalosis and diarrhea causing acidosis.
  • Respiratory acidosis is caused by slow breathing, while respiratory alkalosis is caused by fast breathing, with specific conditions and drugs associated with each.
  • Assessing pH, PCO2, and HCO3 levels helps determine if a client is experiencing compensated or uncompensated acid-base imbalances, with specific compensatory mechanisms for each.

Health Care Proxy and Patient Rights Summary

  • A Health Care Proxy (POA) can make decisions for a client, overriding family members, and can be changed at any time.
  • Clients have the right to refuse treatment, even if their partner disagrees, and can leave the hospital against medical advice under certain conditions.
  • Mandatory reporting of suspected abuse requires immediate protection of the client, separate interviews, evidence collection, and safety planning.
  • Delegation of CPR is possible to licensed nurses, LPNs, CNAs, and physical therapy assistants, among others.
  • Patients with type 2 diabetes taking Metformin should avoid taking it for 8 hours after certain medical procedures to prevent lactic acidosis.
  • Disease management recommendations for chronic diseases like diabetes and COPD include communication and education.
  • Acid and base imbalances are measured in blood via pH, with values under 7.35 indicating acidosis and above 7.45 indicating alkalosis.
  • Bicarbonate (HCO3) and carbon dioxide (CO2) are key players in maintaining acid-base balance in the body.
  • The lungs control CO2 levels through respiration, with hypoventilation leading to acidosis and hyperventilation leading to alkalosis.
  • The kidneys control acid-base balance metabolically, with vomiting causing alkalosis and diarrhea causing acidosis.
  • Respiratory acidosis is caused by slow breathing, while respiratory alkalosis is caused by fast breathing, with specific conditions and drugs associated with each.
  • Assessing pH, PCO2, and HCO3 levels helps determine if a client is experiencing compensated or uncompensated acid-base imbalances, with specific compensatory mechanisms for each.

Health Care Proxy and Patient Rights Summary

  • A Health Care Proxy (POA) can make decisions for a client, overriding family members, and can be changed at any time.
  • Clients have the right to refuse treatment, even if their partner disagrees, and can leave the hospital against medical advice under certain conditions.
  • Mandatory reporting of suspected abuse requires immediate protection of the client, separate interviews, evidence collection, and safety planning.
  • Delegation of CPR is possible to licensed nurses, LPNs, CNAs, and physical therapy assistants, among others.
  • Patients with type 2 diabetes taking Metformin should avoid taking it for 8 hours after certain medical procedures to prevent lactic acidosis.
  • Disease management recommendations for chronic diseases like diabetes and COPD include communication and education.
  • Acid and base imbalances are measured in blood via pH, with values under 7.35 indicating acidosis and above 7.45 indicating alkalosis.
  • Bicarbonate (HCO3) and carbon dioxide (CO2) are key players in maintaining acid-base balance in the body.
  • The lungs control CO2 levels through respiration, with hypoventilation leading to acidosis and hyperventilation leading to alkalosis.
  • The kidneys control acid-base balance metabolically, with vomiting causing alkalosis and diarrhea causing acidosis.
  • Respiratory acidosis is caused by slow breathing, while respiratory alkalosis is caused by fast breathing, with specific conditions and drugs associated with each.
  • Assessing pH, PCO2, and HCO3 levels helps determine if a client is experiencing compensated or uncompensated acid-base imbalances, with specific compensatory mechanisms for each.

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