Med Surge Exam 4: Acid-Base Balance

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?

Smooth muscle spasms/twitching Signup and view all the answers

What is a risk factor for prostate cancer?

Prostate enlarges with age Signup and view all the answers

What is a medical management for hypercalcemia?

IV biphosphates Signup and view all the answers

What is the treatment for dysmenorrhea?

Combined oral contraceptive (Progesterone & estrogen) Signup and view all the answers

What is a manifestation of BPH?

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

What is a nursing intervention for hyponatremia?

Seizure precaution Signup and view all the answers

What is a manifestation of hypochloremia?

Irritability Signup and view all the answers

What is a complication of urolithiasis and UTI?

Pyelonephritis Signup and view all the answers

What is the definition of menopause?

12 months of no vaginal bleeding Signup and view all the answers

What is a treatment for metabolic acidosis?

Treat underlying cause Signup and view all the answers

What is the purpose of the HPV vaccine?

To prevent cervical cancer Signup and view all the answers

What is a nursing intervention for UTI?

Increased fluid intake Signup and view all the answers

What is the definition of urinary incontinence?

Involuntary or uncontrolled loss of urine in any amount Signup and view all the answers

What is the definition of cervical dysplasia?

Abnormal growth of cells on the surface of the cervix Signup and view all the answers

What is a risk factor for bladder cancer?

Not specified in the content Signup and view all the answers

What is the treatment for genital herpes?

Cannot be taken during pregnancy Signup and view all the answers

What is the definition of Condylomata Acuminate?

Anogenital warts caused by HPV Signup and view all the answers

What pH indicates acidosis?

7.30 Signup and view all the answers

What does a PCO2 level higher than 45 indicate?

Respiratory disorder Signup and view all the answers

What is the bicarbonate range (HCO3)?

22-26 Signup and view all the answers

What is a common manifestation of hypovolemia?

Tachycardia Signup and view all the answers

What indicates metabolic alkalosis?

Increased pH, increased HCO3 Signup and view all the answers

What pH level indicates respiratory alkalosis?

7.50 Signup and view all the answers

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

0.9% NaCl (isotonic saline) Signup and view all the answers

What is a sign of hypervolemia?

Hypertension Signup and view all the answers

What nursing intervention is important for a patient with hypovolemia?

Monitor intake and output closely Signup and view all the answers

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

pH lower than normal and PCO2 higher than normal 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.