Nursing Exam 2 Study Guide
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Questions and Answers

What are the physical signs and symptoms of metabolic acidosis?

  • Abdominal pain (correct)
  • Decreased level of consciousness (correct)
  • Abnormal heartbeat (correct)
  • Low BP (correct)
  • Kussmaul respirations (correct)

    • What are the causes of hyperchloremic acidosis? (Select all that apply)

  • Laxative abuse (correct)
  • Cardiac arrest
  • Lack of insulin
  • Severe blood infection
  • Diarrhea (correct)

    • What are the lab findings associated with metabolic acidosis?

  • PaO2 below 80
  • PaCO2 normal (uncompensated) below 35 (compensated)
  • HCO3 below 21 (correct)
  • pH below 7.35 (correct)

    • What are the signs and symptoms of metabolic alkalosis?

    <p>Numbness and tingling</p> Signup and view all the answers

    What are the causes of respiratory acidosis?

    <p>All of the above</p> Signup and view all the answers

    What are the signs and symptoms of respiratory acidosis?

    <p>pH below 7.35</p> Signup and view all the answers

    Phlebitis is inflammation of a vein.

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

    Infiltration occurs when an IV catheter becomes dislodged and IV fluids enter subcutaneous tissue around the puncture site.

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

    What is the normal lab value of potassium?

    <p>3.5-5.0 mEq/L</p> Signup and view all the answers

    What are the signs and symptoms of hyperkalemia? (Select all that apply)

    <p>Life-threatening cardiac dysrhythmias</p> Signup and view all the answers

    What are the treatments for hyperkalemia? (Select all that apply)

    <p>Restrict dietary potassium intake</p> Signup and view all the answers

    What are the three main types of body fluid?

    <p>Intracellular fluid, extracellular fluid, and transcellular fluid</p> Signup and view all the answers

    What is the most common type of transfusion reaction?

    <p>Febrile nonhemolytic reaction</p> Signup and view all the answers

    What are the signs and symptoms of a febrile nonhemolytic reaction? (Select all that apply)

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

    Which type of anemia is characterized by a deficiency of vitamin B12?

    <p>Megaloblastic anemia</p> Signup and view all the answers

    What is the most common assessment for generalized malnutrition?

    <p>Prealbumin assessment</p> Signup and view all the answers

    Which of the following conditions is NOT a non-modifiable risk factor for decreased perfusion?

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

    Decreased peripheral perfusion can result in myocardia infarction, stroke, and shock.

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

    ACE inhibitors are typically used to treat hyperkalemia.

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

    What are the common side effects of ACE inhibitors? (Select all that apply)

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

    Which of the following conditions is NOT a potential complication of untreated hypertension?

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

    What is NOT a common nursing intervention for patients on ACE inhibitors?

    <p>Monitor sodium levels</p> Signup and view all the answers

    Losartan is a type of ACE inhibitor.

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

    What is the best way to administer enalapril when it's being given for chronic management?

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

    Captopril has the shortest half-life of which medication?

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

    Calcium channel blockers block the binding of calcium ions to their receptors in smooth muscle cells.

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

    Clonidine is a beta-adrenergic blocker.

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

    What is the primary mechanism of action for diuretics in treating hypertension?

    <p>Reduced blood volume</p> Signup and view all the answers

    What is the drug of choice for first-line treatment of uncomplicated hypertension?

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

    What is the primary function of the heart in contributing to blood pressure?

    <p>Cardiac output</p> Signup and view all the answers

    What is the term used to describe the resistance the blood encounters as it flows through the blood vessels?

    <p>Vascular resistance</p> Signup and view all the answers

    The renin-angiotensin-aldosterone system (RAAS) is a hormone system that participates in managing blood pressure.

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

    What is the main reason why hypertension is often called the 'silent killer'?

    <p>It often has no noticeable symptoms.</p> Signup and view all the answers

    Which of the following is NOT a recommended lifestyle modification for managing hypertension?

    <p>Increasing salt intake</p> Signup and view all the answers

    Study Notes

    Exam 2 Study Guide

    • Material Covered: Potter & Perry Chapter 42 (Fluid and Electrolytes), Ignatavicius Chapter 3 (Overview of Health Concepts for Medical-Surgical Nursing), and Lilley Chapters 22 and 54 (Antihypertensive and Anemia Drugs).

    Values to Know!

    • Electrolytes:

      • Sodium (Na+): 136-145 mEq/L (136-145 mmol/L)
      • Potassium (K+): 3.5-5.0 mEq/L (3.5-5 mmol/L)
      • Chloride (Cl-): 98-106 mEq/L (98-106 mmol/L)
      • Total CO2 (CO₂ total content): 22-30 mEq/L (22-30 mmol/L)
      • Bicarbonate (HCO₃): Arterial 21-28 mEq/L (21-28 mmol/L), Venous 24-30 mEq/L (24-30 mmol/L)
      • Total calcium (Ca2+): 9.0-10.5 mg/dL (2.25-2.62 mmol/L)
      • Ionized calcium (Ca2+): 4.5-5.6 mg/dL (1.05-1.3 mmol/L)
      • Magnesium (Mg2+): 1.3-2.1 mEq/L (0.65-1.05 mmol/L)
      • Phosphate: 3.0-4.5 mg/dL (0.97-1.45 mmol/L)
      • Anion gap: 6 +/- 4 mEq/L (6 +/- 4 mmol/L)

    • Arterial Blood Gases:

      • pH: 7.35-7.45
      • PaCO2: 35-45 mm Hg (4.7-6 kPa)
      • PaO2: 80-100 mm Hg (10.7-13.3 kPa)
      • O2 saturation: 95%-100% (0.95-1.00)
      • Base excess: -2 to +2 mm Eq/L (mmol/L)

    Metabolic Acidosis - Signs and Symptoms

    • Physical Symptoms:
      • Kussmaul respirations
      • Decreased level of consciousness (fatigue, headache, confusion)
      • Abnormal heartbeat (caused by hypokalemia)
      • Abdominal pain (nausea & vomiting)
      • Low BP
    • Lab Findings:
      • pH below 7.35
      • HCO₃ below 21

    Metabolic Alkalosis – Signs and Symptoms

    • Physical Symptoms:
      • Lightheadedness
      • Numbness and tingling (fingers, toes, circumoral)
      • Muscle cramps
      • Decreased level of consciousness
      • Dysrhythmias
    • Lab Findings:
      • pH above 7.45
      • PaCO2 below 35
      • HCO₃ normal (uncompensated) above 28 (compensated)

    Other Important Information

    • Metabolic Acidosis:
      • Chain reaction - acidosis stresses the body, dehydration worsens it, and low potassium disrupts the heart.
      • Metabolic acidosis → dehydration (from fluid loss)
      • Dehydration → hypokalemia (from potassium loss)
      • Hypokalemia → arrhythmias (from disrupted heart signals)
    • Respiratory Acidosis & Alkalosis: Defined by pH, PaCO2, and HCO3 levels, different causes, and conditions
    • Hyperchloremic Acidosis: Loss of HCO3 in GI tract (diarrhea, laxative abuse)
    • Renal Tubular Acidosis: Kidneys unable to excrete acids
    • Lactic Acidosis: Sepsis, shock, cardiac arrest
    • Diabetic Acidosis: Type 1 Diabetes Mellitus; glucose can't enter cells due lacking insulin.
    • Causes and symptoms of each disorder are explained in the document.
    • Phlebitis vs. Infiltration: Causes, symptoms, and treatments are described for both.
    • Hyperkalemia: Causes, symptoms, and treatment(including lab values and procedures)
    • Blood Transfusion Reactions: Types (Febrile non-hemolytic, acute hemolytic, allergic, severe allergic, TRALI, TACO) with symptoms and treatment steps.
    • Chronic Diarrhea: Causes - inflammatory bowel disease, infections, medications - and foods that can help alleviate it.
    • Normal values of arterial blood gas(PH, Partial pressure of oxygen (PaO2), Partial pressure of carbon dioxide (PaCO2), HCO3 etc): Explained in document.
    • Nursing interventions for blood transfusion reactions: Detailed interventions & signs/symptoms for each type of reaction.
    • Conditions associated with chronic diarrhea: Malabsorption disorders, infections (like C diff), and lactose intolerance - and their specific symptoms are mentioned.
    • Side effects of various drugs: Including anticoagulants (bleeding), opioids (respiratory depression), ace inhibitors (cough, hyperkalemia), calcium channel blockers, and diuretics (hypokalemia).

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    Exam 2 Study Guide PDF

    Description

    Prepare for your upcoming nursing exam with this comprehensive study guide covering important concepts from Potter & Perry Chapter 42 on Fluid and Electrolytes, Ignatavicius Chapter 3 on Health Concepts for Medical-Surgical Nursing, and Lilley Chapters 22 and 54 on Antihypertensive and Anemia Drugs. Test your knowledge of key electrolyte values and arterial blood gases to ensure your success.

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