Med Surge Exam 4: Acid-Base Balance
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Questions and Answers

What is the normal serum potassium level?

  • 5.0 (correct)
  • 3.5
  • 4.0
  • 4.5
  • What is the primary method of cervical cancer diagnosis?

  • Routine screening (pap smear) (correct)
  • Urinalysis to detect infection or blood
  • Colposcopy with biopsy
  • Digital rectal exam
  • What is a common cause of hypomagnesemia?

  • Diarrhea (correct)
  • Hypertension
  • Constipation
  • Kidney disease
  • What is a characteristic of hypocalcemia?

    <p>Smooth muscle spasms/twitching</p> Signup and view all the answers

    What is a risk factor for prostate cancer?

    <p>Prostate enlarges with age</p> Signup and view all the answers

    What is a medical management for hypercalcemia?

    <p>IV biphosphates</p> Signup and view all the answers

    What is the treatment for dysmenorrhea?

    <p>Combined oral contraceptive (Progesterone &amp; estrogen)</p> Signup and view all the answers

    What is a manifestation of BPH?

    <p>Weak urine stream/decreased force</p> Signup and view all the answers

    What is a nursing intervention for hyponatremia?

    <p>Seizure precaution</p> Signup and view all the answers

    What is a manifestation of hypochloremia?

    <p>Irritability</p> Signup and view all the answers

    What is a complication of urolithiasis and UTI?

    <p>Pyelonephritis</p> Signup and view all the answers

    What is the definition of menopause?

    <p>12 months of no vaginal bleeding</p> Signup and view all the answers

    What is a treatment for metabolic acidosis?

    <p>Treat underlying cause</p> Signup and view all the answers

    What is the purpose of the HPV vaccine?

    <p>To prevent cervical cancer</p> Signup and view all the answers

    What is a nursing intervention for UTI?

    <p>Increased fluid intake</p> Signup and view all the answers

    What is the definition of urinary incontinence?

    <p>Involuntary or uncontrolled loss of urine in any amount</p> Signup and view all the answers

    What is the definition of cervical dysplasia?

    <p>Abnormal growth of cells on the surface of the cervix</p> Signup and view all the answers

    What is a risk factor for bladder cancer?

    <p>Not specified in the content</p> Signup and view all the answers

    What is the treatment for genital herpes?

    <p>Cannot be taken during pregnancy</p> Signup and view all the answers

    What is the definition of Condylomata Acuminate?

    <p>Anogenital warts caused by HPV</p> Signup and view all the answers

    What pH indicates acidosis?

    <p>7.30</p> Signup and view all the answers

    What does a PCO2 level higher than 45 indicate?

    <p>Respiratory disorder</p> Signup and view all the answers

    What is the bicarbonate range (HCO3)?

    <p>22-26</p> Signup and view all the answers

    What is a common manifestation of hypovolemia?

    <p>Tachycardia</p> Signup and view all the answers

    What indicates metabolic alkalosis?

    <p>Increased pH, increased HCO3</p> Signup and view all the answers

    What pH level indicates respiratory alkalosis?

    <p>7.50</p> Signup and view all the answers

    What is a key solution used in the medical management of hypovolemia?

    <p>0.9% NaCl (isotonic saline)</p> Signup and view all the answers

    What is a sign of hypervolemia?

    <p>Hypertension</p> Signup and view all the answers

    What nursing intervention is important for a patient with hypovolemia?

    <p>Monitor intake and output closely</p> Signup and view all the answers

    What indicates a respiratory disorder according to pH and PCO2 relationship?

    <p>pH lower than normal and PCO2 higher than normal</p> Signup and view all the answers

    Study Notes

    Acid-Base Balance

    • Normal pH range: 7.35-7.45; acidosis occurs below 7.35 and alkalosis above 7.45.
    • PCO2 normal range: 35-45 mmHg; changes indicating respiratory disorders when opposite to pH.
    • Respiratory acidosis: pH < 7.35, PCO2 > 45 mmHg.
    • Respiratory alkalosis: pH > 7.45, PCO2 < 35 mmHg.
    • HCO3 normal range: 22-26 mEq/L; indicates metabolic disorders when in the same direction as pH.

    Metabolic Acidosis & Alkalosis

    • Metabolic acidosis: Decreased pH, PCO2, and HCO3.
    • Metabolic alkalosis: Increased pH, PCO2, and HCO3.

    Fluid Balance Disorders

    • Hypovolemia:

      • Manifestations: tachycardia, tachypnea, dehydration, low blood pressure, orthostatic hypotension.
      • Management: IV isotonic solution (0.9% normal saline).
      • Nursing interventions: fall precautions, assist with ambulation, monitor weight, skin turgor assessment.
    • Hypervolemia:

      • Manifestations: hypertension, rapid peripheral pulses, respiratory symptoms, pulmonary crackles.
      • Management: fluid restriction.
      • Complication: weight gain of 2 lbs in 3 days.
      • Nursing interventions: monitor weight, strict intake/output monitoring, fall precautions.

    Electrolyte Imbalances

    • Hypokalemia:

      • Serum potassium level: < 3.5 mEq/L.
    • Hyperkalemia:

      • Manifestations: ECG changes (tall peaked T waves), abdominal cramps, muscle weakness, diarrhea, arrhythmias.
      • Interventions: calcium gluconate IV, calcium administration, IV dextrose with insulin.
      • Causes: inhibited aldosterone secretion leading to cardiac dysrhythmias.
    • Hypomagnesemia:

      • Level < 1.6 mEq/L; common cause is diarrhea.
      • Nursing management includes referral to alcohol abstinence programs.
    • Calcium Levels:

      • Normal range: 8.2-10.2 mg/dL; affects heart sensitivity.
    • Hypocalcemia:

      • Manifestations: smooth muscle spasms, positive Trousseau's and Chvostek's signs.
    • Hypercalcemia:

      • Manifestations: decreased deep tendon reflexes.
      • Management: IV bisphosphonates and calcitonin.
    • Hyponatremia:

      • Causes: diuretics; manifestations include seizure potential.
      • Nursing interventions focus on seizure precautions.
    • Hypernatremia:

      • Management: limit sodium intake and monitor daily weight.
    • Hypochloremia:

      • Manifestations include irritability, hypotension, and tetany.

    Metabolic Acidosis Management

    • Treatment focuses on addressing underlying causes and using antidiarrheals.
    • Nursing interventions: monitor hemodynamic status, especially cardiac output.

    Urinary Disorders

    • UTI:

      • Manifestations: dysuria and dark, foul-smelling urine.
      • Nursing intervention: increase fluid intake to 2-3 liters daily.
    • Urinary Incontinence:

      • Characterized by involuntary or uncontrolled loss of urine.

    Reproductive Health

    • Bladder Cancer: Major risk factor is smoking.

    • Dysmenorrhea: Treated with combined oral contraceptives (estrogen and progesterone).

    • Cervical Cancer: Diagnosed through routine pap smears; treatment typically involves colposcopy and biopsy.

    • BPH:

      • Manifestations: weak urine stream, decreased force.
      • Diagnosis: digital rectal exam and urinalysis.
      • Medications: anticholinergics.
    • Prostate Cancer: Risk increases with age; teaching includes signs of infection.

    • Testicular Cancer: Normal finding includes darker testicles.

    • HPV: Associated with increased risk of cervical cancer and diagnosed via pap tests and colposcopy. Teaching emphasizes vaccination for prevention.

    STI Treatment

    • Genital Herpes: Manifestations include fever and headache; avoid medication during pregnancy.
    • Chlamydia: Can be asymptomatic but may lead to dysuria.
    • Gonorrhea: Risk factors include low socioeconomic status and history of STIs.

    Miscellaneous

    • Menopause: Classified after 12 months without vaginal bleeding.
    • Urolithiasis Complication: Kidney stones may lead to pyelonephritis.
    • TURP Procedure: Surgery to remove part of the prostate due to BPH.
    • Cervical Dysplasia: Abnormal cervical cell growth typically linked to HPV.
    • Condylomata Acuminata: Anogenital warts caused by HPV.
    • Syphilis Treatment: Managed with penicillin.

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    Description

    This quiz covers acid-base balance, pH ranges, and respiratory disorders. It includes questions on pH levels, PCO2 ranges, and HCO3 ranges, as well as how to identify acidosis and alkalosis.

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