Med Surge Exam 4: Acid-Base Balance

Study Notes

pH ranges: 7.35-7.45
pH lower than 7.35: Acidosis
pH higher than 7.45: Alkalosis
Pco2 ranges: 35-45
If PCO2 is going in an opposite direction than pH, it indicates a Respiratory disorder (Respiratory acidosis)
Respiratory acidosis: pH less than 7.35 and Pco2 higher than 45
Respiratory Alkalosis: pH greater than 7.45 and Pco2 less than 35

Diffusion: Fluids move from extracellular to intracellular
Hypovolemia manifestations: Tachycardia, Tachypnea, dehydration, Low bp, Orthostatic hypotension
Hypovolemia medical management: IV isotonic solution 9% NS
Hypovolemia nursing interventions: Fall precaution, Assist with ambulation, Monitor weight, Skin turgor assessment
Hypervolemia manifestations: Hypertension, Rapid peripheral pulses, Respiratory symptoms, Crackles in lungs
Hypervolemia medical management: Fluid restriction
Hypervolemia complications: Weight gain of 2lbs in 3 days
Hypervolemia nursing interventions: Monitoring weight, Calculating/monitoring strict I & Os, Fall precaution

Hypokalemia: Serum potassium level < 5.0
Hyperkalemia manifestations: ECG changes, Tall peaked T waves, Abdominal cramps, Muscle weakness, Diarrhea, Arrhythmia
Hyperkalemia interventions: Calcium gluconate IVP, Calcium administration, IV dextrose and insulin administration
Hypomagnesemia level: < 1.6
Hypomagnesemia cause: Diarrhea
Hypomagnesemia nursing management: Referral to alcohol abstinence programs
Calcium normal values: 8.2-10.2
Calcium and potassium are heart sensitive

Hypocalcemia manifestations: Smooth muscle spasms/twitching, Positive Trousseau and Chvostek sign
Hypercalcemia manifestations: Decreased deep tendon reflexes
Hypercalcemia medical management: IV biphosphates, Calcitonin

Metabolic acidosis treatment: Treat underlying cause, Antidiarrheals
Metabolic acidosis nursing management: Decreased cardiac output related to severe metabolic state
Metabolic acidosis nursing interventions: Monitor hemodynamic status

UTI manifestations: Dysuria (painful urination and burning), Dark foul-smelling urine
UTI nursing intervention: Increased fluid intake 2-3 liters per day

Bladder cancer risk factor: Smoking
Dysmenorrhea treatment: Combined oral contraceptive (Progesterone & estrogen)
Black cohosh: Menopause
Cervical cancer diagnosis: Routine screening (pap smear)
Cervical cancer treatment: Colposcopy with biopsy
BPH manifestation: Weak urine stream/decreased force
BPH medications: Anticholinergic
BPH diagnosis: Digital rectal exam, Urinalysis to detect infection or blood
Prostate cancer risk factor: Prostate enlarges with age
Prostate cancer teaching: Signs of infection/fever
Testicular cancer normal finding: Testicles are darker in skin color than the rest of the body
HPV increases the risk of: Cervical cancer
HPV diagnosis: Pap test, Colposcopy
HPV nursing intervention assessment: Presence of genital warts
HPV teaching: Prevention vaccine recommended for age 15-26
Genital herpes manifestations: Fever, Headache
Genital herpes medication: Cannot be taken during pregnancy
Chlamydia may be asymptomatic but may result in: Dysuria
Gonorrhea risk factors: Low socioeconomic status, History of STI and PID, Multiple sex partners
Menopause classification: 12 months of no vaginal bleeding
Urolithiasis (kidney stone) and UTI complication: Pyelonephritis
Turp procedure: Surgical procedure that involved cutting away a section of the prostate BPH
Cervical dysplasia: Abnormal growth of cells on the surface of the cervix (caused by HPV)
Condylomata Acuminate: Anogenital warts caused by HPV
Syphilis medication: Penicillin