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85 Cards in this Set
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What is the “decussation” of the corticospinal tract?
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Corticospinal tract=tract of motor nerves cross over to opposite side of body
Decussation=Crossing over of motor nerves |
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What are symptoms of a middle cerebral artery stroke ? know the consequences of left sided v. right sided cerebrovascular compromise.
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-symptoms: aphasia & hemiparesis of opposite side of body
Left side: aphasia & hemiparesis of right side of body Right side: hemiparesis of left side of body |
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What are the symptoms of vertebral-basilar insufficiency?
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-symptoms: cerebellar type dysfunction=ataxia, incoordination, symptoms are generalized not one sided, can be mistaken for drunkeness, virtigo, diplopia, dysphagia (brain stem, cerebellum, & cranial nerves affected)
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Where is the speech center in most persons? What is aphasia ?
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Speech center is in the LEFT hemisphere of the brain
Aphasia=loss of ability to understand or express speech |
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What is tissue plasminogen activator ? When is this used (which kind of stroke)?
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Clot buster
Used for ischemic strokes |
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What major neurotransmitter is imbalanced in Parkinson’s disease?
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Dopamine
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What are the 3 major symptoms characteristics of Parkinson’s disease?
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Tremor (pill rolling)
Bradykinesia (slowed ability to start and contiune movements) Cogwheel rigidity (inflexibility or stiffness) |
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What are major causes of dementia? And symptoms of dementia (the “A”s)
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Causes:
Atherosclerotic disease of cerebral vessels Symptoms: Anomia: forgetting the correct names of persons and things Amnesia: memory loss Agnosia: forgetting what ordinary objects are used for Apraxia: forgetting how to preform actions Aphasia: speech difficulty Apathy: decreased concern for surroundings and own cognitive decrease |
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What neurotransmitter is deficient in Alzheimer’s disease? What is the latest drug treatment?
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Deficit of Ach in brain
Anti-Ach-esterase meds: Tacrine, Cognex Shock and Multiple Organ Dysfunction |
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Define shock:
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condition of hemodynamic and metabolic disturbance due to inadequate blood flow and oxygen delivery to tissues of the body; systolic bp <90
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What are categories of shock; especially hypovolemic vs. cardiogenic vs. distributive v. anaphylactic v. Septic?
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Hypovolemic shock- causes include hemorrhage, dehydration, burns and trauma.
Cardiogenic causes include heart pump failure and decreased venous return. Distributive shock causes include neurogenic shock, septic shock and anaphylactic shock Septic shock is caused by systemic infection (also include fever, leucopenia, tachycardia); sepsis most commonly occurs due to lung/abdominal or urinary tract infections. |
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Stages of shock:
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Stage 1: non-progressive or compensated stage (cardiac output or total peripheral resistance are diminished); also Renin-Angiotensin Aldosterone antidiuretic hormone is activated due to low renal perfusion. Overall, decrease in BP is senses so SNS stimulates to increase BP. Pt with this stage looks Awake/alert/anxious, cool, dilated pupils, urine output reduced, thirsty.
Stage 2: progressive/decompensated shock (organ hypoperfusion, decreased arterial blood flow, kidney hypoperfusion, anaerobic metabolism which increases lactic acid) Heart and brain are the priority organs!!! Stage 3: irreversible shock (brain and heart circulation diminishes, metabolic acidosis, organ ischemia, renal failure, heart failure, clotting) |
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Signs of shock:
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Shock symptoms include hypotension, tachycardia, oliguria, cool skin, restlessness, altered LOC.
What is sepsis (septicemia)? |
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Infection induced syndrome defined as the presence of TWO or more features of systemic inflammation; fever or hypothermia, leucopenia, tachycardia and tachpnea.
What is ARDS? |
Adult respiratory distress syndrome severe hypoperfusion of lungs; pulmonary capillary permeability increases Fluid leaks out of capillaries into lung tissue pulmonary edema occurs.
Signs include: hypoxemia <60 mm, tachypnea (>30), alveolar dysfunction. |
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What is DIC?
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Disseminated intravascular coagulation (clotting and anti-clotting activities of the body, abnormal platelet aggregation, abnormal clotting/coagulation factors, widespread bleeding
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Bone marrow & 3 types of blood cells “born” in bone marrow:
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bone marrow produces RBC, WBC, and Platelets, in the bone marrow cells are first in its immature stage (stem cells) waiting for a stimulus to turn into RBC, WBC, or platelets.
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Hematocrit (definition and normal values)
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Hematocrit=the percentage of RBCs in a portion of blood volume, so only the RBCs, no hgb or plasma NORMAL VALUES: Male= 41-53% Female=36-46%
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Hemoglobin what its made of, and normal values
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Hemoglobin is a protein molecule in RBCs that carries oxygen, it is made up of 4 protein molecules (called globulin) that are connected to together. Each globulin chain contains an important central structure called the heme molecule. Embedded within the heme molecule is iron that transports the oxygen and carbon dioxide in our blood. The iron contained in hemoglobin is also responsible for the red color of blood
Normal values: male=13.5-17.5 g/dl female=12.0-16.0 g/dl |
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What is erythropoetin ? what stimulates its secretion ?
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erythropoietin is a hormone made in the kidney, when the kidney “senses” low O2 in the blood stream it secretes erythropoietin which stimulates bone marrow to make more of the stem cells into RBCs
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What does the body need for erythropoesis?
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In order for erythropoesis to occur, the body needs the nutrients from the DIET: protein, iron, folic acid, vitamin B12, the body needs these things to make IMMATURE RBCS called RETICULOCYTES-nucleated RBCS they kind of function as “stand ins” for RBCs and are not as effective as RBCs.
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Define anemia & major causes of anemia & signs of anemia
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a condition in which there is a deficit in number of circulating RBCs.
Signs/Sx of all anemias: fatigue, pallor (conjunctiva, palms), weakness, palpitations, SOB, tachycardia CHRONICthinning or spoon shape nails (koilonychia), sore tongue and mouth (stomatitis), pica: bizarre cravings for starch or ice or dirt or chalk, hair thinning |
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What are the meaning of terms normocytic/normocchromic, mycrocytic/hypochromic, megaloblastic/hyperchromic
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NORMOCYTIC/NORMOCYTIC: rbcs size and color are normalanemia due to blood loss MICROCYTIC/ HYPOCHROMIC : rbc size is smaller than normale and paler than normal due to inadequate development in bone marrow ie. Iron deficiency
MEGALOBLASTIC anemias : rbc size is larger than normal due to malformation while developing in bone marrow/ color normal ie. Vitamin B12 deficiency, folic acid deficiency |
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What kind of anemia develops with lack of IRON in diet ?
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Iron deficiency anemia
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What kind of anemia develops with blood loss?
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IRON DEFICIENCY
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Why might retculocytes appear in the bloodstream in high amounts?
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THEY ARE PREMATURELY RELEASED FROM BONE MARROW TO FILL IN FOR MATURE RBCS DURING HEMORRHAGE.
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What other lab tests are most important in iron deficiency anemia?
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Hgb LOW, Hct LOW, MCV LOW/microcytic, MCH low/hypochromic, MCHC RBCs small and pale, serum ferritin low, serum Fe++ low, TIBC high
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Why would a stool hemoccult be important in iron deficiency anemia?
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TO CHECK FOR GI BLEEDING (MELENA)
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What happens to MCV in anemia due to lack of vitamin B12?
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macrocytic/megaloblastic
MCV is high = |
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What happens to MCV in anemia due to lack of Folic acid?
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MCV is high = macrocytic/megaloblastic
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What happens to patients with sickle cell anemia who develop hypoxia?
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Hgb STRUCTURE CHANGES, TURNS RBCS INTO SICKLE-SHAPED CELLS, HEMOLYSIS OCCURS OFTEN, CAUSING JAUNDICE AND CHRONIC ANEMIA
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What is a vaso-occlusive crisis?
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SICKLING OF LARGE AMOUNTS OF RBCS THAT CAUSES ISCHEMIA, LEADING TO ANY ORGAN INFARCTIONS; EXTREMELY PAINFUL
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What is polycythemia?
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TOO MANY RBCS, occurs when erythropoietin is constantly stimulated
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Why would a patient with severe COPD develop polycythemia?
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LOW OXYGEN CONENT OF BLOOD IS SENSED BY KIDNEY
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What are the signs of deficient number of platelets?
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THROMBOCYTOPENIA; BLOOD WON’T CLOT, EASY BRUISING, SPONTANEOUS BLEEDING (NOSE BLEEDS)
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Aside from enough platelets, what other conditions/substances are needed for adequate clotting?
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FUNCTIONING LIVER, VITAMIN K FROM DIET, FUNCTIONING COAGULATION CASCADE
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What stimulates the intrinsic vs. extrinsic pathways of the coagulation cascade?
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INTRINSIC=BLOOD TURBULENCE; EXTRINSIC=VESSEL TRAUMA
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What is the action of vitamin D under normal conditions?
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Vitamin D allows for Calcium absorption in the stomach
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In ESRD without treatment (otherwise known as uremia), how would the following conditions occur : azotemia, anemia, hypertension, osteoporosis, metabolic acidosis, hyperkalemia, mental confusion, peripheral neuropathy.
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Azotemia=high BUN, high levels of blood urea, causes peripheral neuropathy, burning and encephalopathy, brain function decreases= confusion
ANEMIA=renal erythropoietin decreased HTN=hyper renin secretion OSTEOPOROSIS= renal failuresynthesis of vitamin D deficient, no vitamin Dno GI absorption of calcium, low calcium absorptionlow calcium blood levelsstimulates parathyroid glands (HYPERPARATHYROIDISM)PTHstimulates osteoclastic activitybone breakdown (osteoporosis) METABOLIC ACIDOSIS=metabolic disturbances K+, H+, Na+, hyperglycemia, hyperuricemia |
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Define oliguria in terms of urine output per hour and urine output per day.
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Oliguria=low urine output less than 400 cc/day
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What is needed yearly in men over age 50 for prevention of prostate cancer?
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Yearly digital rectal exam (DRE) and PSA blood test
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What is BPH/ what is the PSA test?
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BPH=benign prostatic hyperplasia, prostate gland increases in size with age, which can impede the flow of urine
PSA: prostate surface antigen, this test can help determine if the male is experiencing any growth of the prostate, more PSA=hyperplasia of the prostate |
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Define nephrolithiasis/ what are symptoms?
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Nephrolithiasis= kidney stones (stones=”calculus”) causes of kidney stone formation in urinary tract or kidney; combination of: genetics, altered urine pH, certain bacterial organisms: proteus, high blood calcium levels or uric acid levels
S/S: EXTREMELY painful, back pain into groin, stone irritates ureter or urethra mucosa, patient must pass stone thru ureter, bladder, urethra, other treatments: lithotripsy, surgery |
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In septic shock or any other kind of shock, what are the key signs and symptoms experienced by the patient?
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Cool, pale extremities
• High or very low temperature, chills • Lightheadedness • Low blood pressure, especially when standing • Low or absent urine output • Palpitations • Rapid heart rate • Restlessness, agitation, lethargy, or confusion • Shortness of breath • Skin rash or discoloration |
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What is UROSEPSIS?
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When an UTI spreads into the bloodstream and causes a systemic infection What are the signs of this syndrome? Rapid heartbeat, rapid respirations, temperature, high WBC count
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How do you know the difference between CYSTITIS and PYELONEPHRITIS?
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Cystitis= Urinary Tract Infecion, infection of the lower urinary tract: bladder and urethra, most commonly caused by the bacteria E.Coli from the bowel, females at most risk because of the female anatomy (close proximity of urethra to rectum) makes them more susceptible to UTIs than male, common with indwelling catheters
UTI: local infection, NO FEVER, S/Sx: burning on peeing (dysuria), urgency, frequency, present bacteria and WBCs in urine (bacteruria and pyuria) Pyelonephritis: infection of the kidney, usually from an ascending infection from UTI in lower urinary tract, FEVER, CHILLS, ABDOMINAL and BACK PAIN, costovertebral angle tenderness |
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What are the consequences to the body of loss of protein in the urine?
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EDEMA
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What does PROTEINURIA usually indicate?
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Protein in the urine usually indicates glomerular injury (nephrotic syndrome)
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Define Nephrotic syndrome and the signs of this syndrome.
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Nephrotic syndrome=glomerular injury with protein loss
High amount of protein in urine, normally urine should contain very minimal protein (up to 150mg/day) Signs: systemic problems=plasma protein losslower albumin in bloodlower colloid osmotic pressureEDEMA |
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What is the organism most commonly involved in glomerulonephritis?
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Streptococcus
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What do each of these hormones do?
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Renin stimulates angiotensiogen which then is converted to angiotensin I and then to angiotensin converting enzyme (ACE) which is then converted to angiotensin II. ANGIOTENSIN stimulates secretion of aldosterone from adrenal gland ALDOSTERONE acts on distal tubule and collecting duct to reabsorb water, the added fluid in blood increases BP
Erythropoetin stimulates the bone marrow to produce RBCs when there is low O2, more RBCs, more O2 |
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What stimulates ERYTHROPOETIN secretion from kidney ?
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In response to low O2 in bloodstream, kidney secretes erythropoietin which stimulates bone marrow to make RBCs (erythrocytes)
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What stimulates RENIN secretion from the kidney ?
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the kidney is the main sensor of low BP, at the glomerulus:juxtaglomerular apparatus secretesRENIN (secreted by kidney if BP going thru glomerulus is LOW
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3 Categories of azotemia or renal dysfunction; and causes
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pre-renal / intrarenal/ post-renal
Pre-renal: lack of sufficient circulation to kidney, ischemia to kidney ie. Hemorrhage Causes occur BEFORE THE KIDNEY, kidney itself is not problem, some condition which causes ischemia to kidney usually is causative Ie. Pt who sustains a severe hemorrhagesuffers ischemia to kidneykidney circulation decreasedorgan dysfunctions BUN will be high Intra-renal: toxic or traumatic injury to kidney ie. Drugs Injury to nephrons or injury to kidney itself, occurs within the kidney Ie. Many drugs are NEPHROTOXIC, which means they can harm the nephrons like NSAIDS BUN HIGH, serum creatinine high Post-renal: obstruction of urine flow out which can cause back up of toxic urine into kidneys ie. Kidney stone, enlarged prostate causes are problems which occur “after the kidney”, any problem which obstructs free flow of urine out of body, such as ureteral obstructions, kinked ureter, prostatic hypertrophy, bladder tumor which blocks urine outflow |
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What is azotemia ?
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azotemia refers to HIGH BUN, BUN=blood urea nitrogen, waste products in bloodstream are UREA-NITROGEN based products, high BUN means that kidney is dysfunctioning
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What does serum creatinine indicate? (do not need to memorize normal value)
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The serum creatinine level gives us an idea of how well the glomerulus is filtering creatinine(muscle breakdown product in the bloodstream which is excreted in the urine if it is filtered at the glomerulus, so if the level is high then it means that the kidney is not filtering correctly) gauge of kidney function
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Pathway of urine “pee” and process of urine concentration in each part
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Glomerulus (filtration mainly occurs leaving a filtrate to go on to proximal tubule) and bowman’s capsuleproximal tubule(70% of filtrate is REABSORBED into bloodstream)loop of henle(descending limb: ABSORPTION if water into bloodstream, Ascending limb: impermeable to water, Na is transported out into blood)distal tubule(affected by aldosterone and ADH, aldosterone will cause enhanced Na+ reabsorption and K+ secretion, ADH will enhance water reabsorption into bloodstreamcollecting duct(ADH causes water REABSORPTION into bloodstream, IF bloodstream is acidic, the kidney will secret H+ INSTEAD of K+calyxrenal pelvisureter
Glomerulus=capillaries which are more permeable than other capillaries in the body, the bowman’s capsule surrounds these capillaries, FILRATION occurs at glomerulus, plasma proteins remain in blood, filtering of other elements. Proximal tubule=60-80% of glomerular filtrate is REABSORBED back into bloodstream when filtrate is in the proximal tubule, remaining 20-30% of filtrate proceeds to LOOP OF HENLE Loop of Henle=2 parts: Ascending and Descending Limb Major function: concentrates tubule fluid to urine Descending limb: major action=reabsorption of water back into bloodstream, urea into tubule Ascending limb: major action=reabsorption of Na+, K+, and Cl-, urea into tubule |
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Functions of the nephron:
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- Filters the blood
- Some blood constituents are reabsorbed back into blood: TUBULAR REABSOPTION - Some remain in nephron tubules and become urine: TUBULAR SECRETION |
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Know your basic structure of the nephron & urinary tract anatomy basic structures of the urinary tract:
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males and females) kidney, ureter, urinary bladder, urethra (males): prostate gland (females): uterus
Nephron: basic filtering unit of the kidney, it’s selective meaning it keeps some constituents of bloodstream and allows excretion of some |
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Know all the functions of the multi-talented kidney & what happens when the kidney dysfunctions
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Normal Functions of the kidney:
1. Filters water from bloodstreamurine excretion 2. Senses changes in blood pressuredrop in BP the kidney stimulates Renin 3. Senses needs for rbcshypoxia stimulates erythropoietin 4. Senses and attempts to correct acid base imbalances in blood: can conserve HCO3, kick out extra H+ 5. Involved in production of vitamin D 6. Can be called upon to make glucose (gluconeogenesis) |
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Most common microorganisms which causes HIV-related pneumonia
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Streptococcus pneumonia; induce cough, chills, green/yellow sputum bloody sputum; rales and crackles are heard; need sputum sample and antibiotic treamtment.
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3 major pathological processes occurring in asthma & kinds of medications effective for asthma
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Asthma is a hyperactive airway disease. There are extrinsic triggers (allery to antigen such as dusk, pollen, etc.). Intrinsic triggers (respiratory infection). During asthma, bronchiols inflame, bronchiospams occur, mucous produces and the constricted bronchiols restrict oxygen entry.
Meds include sympathetic bronchodilators (beta adrenergic agonists) such as Albuterol which is short acting or Salmeterol/Metaproterenol which are long acting. Also, anticholinergic bronchodilator inhalers (Cromolyn- used to prevent exercise-induces asthma). Also, anti-inflammatory drugs (Prednisone, leukotriene, corticosteroids). Combo drugs include ADVAIR and COMBIVENT. |
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What is “cor pulmonale”?
When pulmonary vasoconstriction causes RHF. |
Right ventricle pushed against high pressure and hypertrophies and fails.
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What are the 2 major conditions involved in COPD? What are their pathophysiological processes?
Symptoms of each condition. What does “Blue Bloater” v. “Pink Puffer“ mean ? Why do they have these nicknames? |
Chronic bronchitis and emphesema. Chronic bronchitis is inflammation of the bronchioles, cough, dyspnea, hypoxia (due to hypertrophy), cyanosis, mucous, infections, susceptible to RHF; blue bloater; these patients have difficulty getting air into their lungs, they are short of breath and have DECREASED O2. They get edema due to venous backup from right heart failure.
Emphesema is alveoli distention, barrel chest (high residual air volume in lungs) filled with retained CO2, hypercapnea (too much Co2 retained), hypoxia, prolonged expiration, pink puffer. PO2 is ok up until late in the disease. These pts have a difficult time getting air and CO2 out of lungs (recoil destroyed); these pts purse lip breathe. |
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What are the most common causes of each of the following lung sounds: stridor, crackles, wheezes?
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Pneumonia indicates CRACKLES or rales (inflammation of alveoli).
Tracheitis causes constriction of trachea which induces STRIDOR (this type of patient need intubation). Asthma causes WHEEZES and reduced breath sounds and coughs (constriction of airway due to a trigger). |
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Define pneumothorax, what is the most common cause of pneumothorax, and how would the persons lungs sound?
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Large area of AIRLESS lung tissue; air in pleural space presses on lung tissue inhibiting lung alveoli from inflating. In order to cure this, use a chest tube to suck out fluid. NO breath sounds are heard.
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Definition of atelectasis; post-op occurrence most common- medical intervention to prevent atelectasis;
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encourage post-op client to cough & deep breath with incentive spirometer
Definition- collapse of a small number of alveoli. Caused by obstruction; non-inflation of alveoli due to accumulation of secretions. Also caused by compression; pressure against alveoli inhibiting them to open. Tell patient to use inceptive spirometer; nurse should suction patient with tracheostomy to prevent secretion build up. |
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Classic Symptoms in tuberculosis\ what is the TB Mantoux test
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TB is transmitted via droplet infection in cough/sneeze; wear gloves and mask. Symptoms include unremitting cough, weight loss, night sweats, ill feeling, hemoptysis. X-ray will show a tubercle lesion aka ghon’s focus; destroyed lung tissue surrounded by inflammation.
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Pneumonia- most common organism in community acquired pneumonia, symptoms
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Pneumonia is inflammation of alveoli, causing a consolidation of a region of lung tissue. Rales or crackles are heard with this condition. Most common bacterial organism is streptococcus pneumonia. Symptoms include fever, chills, yellow/green sputum, cough, bloody sputum. Antibiotic treatment is necessary.
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What happens with hyperventilation to CO2 and blood pH?
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Decreases CO2; respiratory alkalosis occurs. PCOs is less than 35 and pH increases (>7.45).
According to ABG values, how would you know if someone is progressing toward RESPIRATORY FAILURE? PO2=decreasing towards 50mmHg PCO2=increasing towards 50mmHg |
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What happens with hypoventilation to CO2 and blood pH?
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Blood pH is regulated by lungs and kidneys. Hypoventilation or slowed breathing increases CO2. In respiratory acidosis, the respiratory system fails to remove CO2 from body fluids as fast as it is produced by cells; caused by interference with breathing (COPD)—PCO2 >45 mmHg.
ADDITIONAL INFO: Acidosis (<3.75)or a fever indicates a high affinity for oxygen is LESS than normal. Alkalosis(>7.45) or hypothermia indicates affinity for oxygen is HIGHER than normal. When PO2 decreases to 60-70, hgb affinity for oxygen plummets. |
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KNOW NORMAL ABG values
ABGs are the concentrations of oxygen and CO2 in the bloosdstream. |
CO2 is involved in calculation of blood pH and HCO3 concentration.
PaO2: pressure of oxygen in the arterial blood (90-100) PaCO2: pressure of carbon dioxide in arterial blood (35-45) HCO3: amount of bicarbonate ion in the blood (22-25) SaO2: saturation of Hgb with oxygen (95-100) |
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Major stimulus for breathing in normal individuals
CO2 concentration in the blood. |
The chemoreceptors in blood vessels are responsive to CO2 in the blood. CO2 stimulates the respiratory center in the brain; The respiratory center in MEDULLA is stimulated by Co2 accumulation in blood.
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Why would Hgb be called a “selfish” molecule?
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The oxygen-hemoglobin dissociation curve – what conditions decrease hemoglobin’s affinity for oxygen and what conditions increase hemoglobin’s affinity for oxygen
Oxygen diffusion occurs from HIGH to LOW concentration—lungs to blood, then blood to tissue cells. Hemoglobin affinity for oxygen required a HIGH oxygen concentration. As oxygen concentration of the bloodstream decreases, Hgb affinity for oxygen diminishes. At PaO2 60 mmHg, oxy-hgb affinity DROPS. For instance, when you have a high fever/acidosis/high CO2, hgb drops oxygen quicker. Alkalosis or hypothermia affinity for oxygen is higher. |
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Why would Hgb be called a “selfish” molecule?
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The oxygen-hemoglobin dissociation curve – what conditions decrease hemoglobin’s affinity for oxygen and what conditions increase hemoglobin’s affinity for oxygen
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Know how pulmonary anatomy is divided into : thoracic cage, pleural membrane, pleural space (a vaccuum) and lung lobes/ know histological anatomy of alveolus- capillary membrane and exchange which occurs at pulm capillary
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There must be NEGATIVE intra thoracic pressure. Pleural space is space between pleural membrane (no air or fluid). It needs to act as a vacuum in order for lung tissue to expand into it. If fluid gets into it, pleural effusion occurs. If air gets into it, pneuomothorax occurs. Fluid is between alveoli and capillary—if CO2 is coming in alveoli and O2 is leaving edema/pneumonia occurs and crackles are heard. Normally exchange: arterial blood is red (blood high in O2) capillary diffusion (O2 given over to tissues and tissues release CO2) vein (blood low in O2, blood high in CO2); venous blood is deoxygenated and a “bluish” color.
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The number of lobes of the right v left lungs- where do you listen to the RML ?
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Number of lobes on the right is THREE (lower, middle, upper). The number of lobes on the left is TWO (upper and lower). Have patient lift their right arm and listen with stethoscope in axillary region to ascultate the RML.
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Anatomy of the right v left bronchus and how this relates to aspiration
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Right is straighter; RML or RLL are the most common regions that aspiration occurs. Left is more curved. Aspiration pneumonia in an inflammation of the alveoli due to the patient accidentally inhaling food particles or liquid into trachea vs. esophagus- common in unconscious, poor gag reflex, or dysphagia.
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he key ACID-BASE CHEMICAL EQUATION
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CO2 + H2O <--> H2CO3 <--> HCO3- + H+
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How do lungs & kidneys regulate acid-base balance?
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Lungs: they increase CO2 through hypoventilation, decrease CO2 through hyperventilation
Kidneys: can excrete or retain H+ and HCO3- if in excess in blood or if needed by the blood |
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What is hypoventilation and what happens to CO2 ?
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INCREASES in blood
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Arterial Blood Gases: Normal value of blood pH, pCO2, pO2, HCO3-
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Blood pH: 7.35-7.45
pCO2: 35-45 mmHg pO2: 90-100 mmHg HCO3-: 22-25 mEg/liter SaO2: 95-100% |
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Respiratory Acidosis:
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-failure of the respiratory system to remove or exhale CO2
-caused by: any interference with breathing ie: COPD-condition when cannot expel CO2 adequately, resp muscle weakness, suffocation -H+ accumulates, need to reasorb HCO3- and excrete H+ -clinical manifestations: cyanosis, shallow or labored breathing, disorientation, dysrhythmia, hypercapnea -ABGs: pCO2 > 45mmHg (increased) blood pH<7.35 (decreased) -medical intervention: intubation, mechanical ventilation |
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Respiratory Alkalosis:
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-loss of CO2 from lungs faster than produced
-caused by: breathing too fast ie: anxiety, hyperventilation, pneumonia -HCO3- accumulates, need to reasorb H+ and excrete HCO3- -clinical manifestations: feeling light headed, paresthesias, altered consciousness, muscle spasms -ABGs: pCO2<35mmHg (decreased) bloodpH >7.45 (increased) -medical intervention: decrease client’s breathing rate, increase CO2 (rebreathing) |
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Metabolic Acidosis:
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-abnormal accumulation of acids, or abnormal loss of bases
-caused by: lactic acidosis, diabetes, renal failure, prolonged diarrhea or vomiting (loss or bicarb) -decreased HCO3- lungs try to blow off CO2 -clinical manifestations: kussmal breathing, disorientation, coma, dysrhythmias, hypotension -ABGs: blood pH<7.35 (decreased) HCO3- <22 (decreased) -medical intervention: IV bicarb |
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Metabolic Alkalosis:
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-loss of H+ or addition of base to body fluid
-caused by: excess bicarb ingestion, vomiting of excess gastric acid -increased HCO3- lungs attempt to retain CO2 by slowing breathing -Also, kidney reasorbs H+ (instead of K+=hypokalemia occurs with metabolic alkalosis) -clinical manifestations: dysrhythmias, paresthesias, light headed, muscle weakness -ABGs: blood pH >7.45 (increased) HCO3- >26 (increased) |
