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171 Cards in this Set
- Front
- Back
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Interpret: pH 7.28, PaCO2 56mm Hg, HCO3 25mEq/L, SaO2 89%
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respiratory acidosis
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Interpret: pH 7.28, paCO2 43, HCO3 20, SaO2 96%
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metabolic acidosis
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Interpret: 7.50, paCO2 36, HCO3 27, SaO2 97%
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metabolic acidosis
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Interpret: ph 7.35, PaCO2 42, HCO3 26, SaO2 95%
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normal
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Interpret: pH 7.48, PaCO2 33, HCO3 24, SaO2 96%
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respiratory alkalosis
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Interpret: pH 7.36, PaCO2 44, HCO3 24, SaO2 98%
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normal
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pH 7.49, PaCO2 30, HCO3 23, SaO2 96%
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Respiratory Alkalosis
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Can be caused by overuse or abuse of antacids or baking soda.
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Metabolic Alkalosis
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Can be caused by prolonged vomiting or nasogastric suction
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Metabolic Alkalosis
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The signs are related to hypokalemia and hypocalcemia rather than the state itself
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Metabolic Alkalosis
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treatment of Metabolic Alkalosis involves
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identifying the underlying cause and managing it as quickly as possible
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Caused by excessive loss of carbon dioxide through hyperventilation
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Respiratory Alkalosis
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rapid shallow respirations
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hyperventilation
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A patient with this would have rapid shallow respirations, light headedness, confusion, increased heartrate, and weak/thready pulse
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Respiratory Alkalosis/hyperventilation
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Mechanical ventilation and high altitudes as well as deep breathing during pulmonary examination can cause:
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Respiratory Alkalosis
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Respiratory alkalosis is treated by
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having the patients hold their breath or rebreathe their own carbon dioxide (PaCO2) w/ the use of a rebreathing mask or plain paper bag. Underlying cause must also be treated
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results from too much acid or too little bicarbonate in the body
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Acidosis
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Can be caused by uncontrolled diabetes mellitus and end stage renal failure
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Metabolic Acidosis
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The GI tract is rich in
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bicarbonate
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Severe diarrhea or prolonged nasointestinal suction can cause
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Metabolic Acidosis
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Serum potassium tends to increase in the presence of:
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Metabolic Acidosis
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Primary cause of this is respiratory problems
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Respiratory Acidosis
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Carbon dioxide is not adequately "blown off" during expiration, causing a build up of carbon dioxide in the blood
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Respiratory Acidosis
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Carbon dioxide mixes w/ water to create a weak _____ in the body, thus increasing the ____ of the blood
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acid/acidity
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caused by hypoventilation, usually as a result of an acute flare up of chronic respiratory disease, drugs, or neurological problems
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Respiratory Acidosis
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Patients with chronic respiratory disease may have chronic _________________
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Respiratory Acidosis
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signs and symptoms involve the central nervous system and musculoskeletal system, altered mental status, progressing from confusion and lethargy to stupor and coma
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Respiratory Acidosis
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Lungs are unable to get rid of excess carbon dioxide, and respiratorions become more depressed and shallow as muscle weakness worsens
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Respiratory Acidosis
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caused by too little acid in the body or too much base
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alkalosis
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alkalosis divided into two types:
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respiratory and metabolic
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Too much acid in the body or too little base:
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acidosis
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acidosis can be divided into two types
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respiratory (caused by problems occuring in the respiratory system) and metabolic (caused by problems in the rest of the body)
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The lab test used to evaluate acid base balance
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ABG (arterial blood gas)
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ABGs use a blood sample taken from:
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arteries rather than veins: femoral, brachial, and radial are most often used
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the cells of the body function best when the body _________ , __________ and _____________ are within a very narrow range
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fluids, electrolytes, and hydrogen
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An acid is a substance that releases a __________ ______
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hydrogen ion
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A common acid in the body that is found in the stomach is:
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hydrochloric acid (HCI)
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A base is a substance that:
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binds hydrogen
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A common base in the body is
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bicarbonate (HCO3-) aka alkali
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Acids are formed as end products of:
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glucose, fat and protein metabolism and are called "fixed acids"
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An acid that can change is called:
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weak acid i.e. carbonic acid, can change to become bicarbonate (a base)
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A pH of lower than _____ or higher than ____ is usually fatal
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6.9 / 7.8
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Lymph is this type of fluid
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insterstitial
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the water that surrounds the body's cells
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insterstitial
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the plasma of the blood is considered:
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insterstitial
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fluids that are those in specific compartments of the body, such as cerebrospinal fluid, digestive juices, and synovial fluid in joints
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transcellular
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the primary control of water in the body is through:
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pressure sensors in the vascular system, which stimulate or inhibit the release of ADH (antidiuretic hormone) from the pituitary gland
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What happens if fluid pressures within the vascular system decrease?
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more adh is released and water is retained
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what happens if fluid pressures increase in the vascular system?
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less ADH is released and kidneys eliminate more water
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active transport depends on what for energy?
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presence of adequate cellular adenosin triphosphate
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The most common examples of active transport
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sodium potassium pumps
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located in the cell membranes, these pumps cause _____ to move out of the cells and ________ to move into the cells when needed
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sodium / potassium
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No energy is expanded to specifically move substances and general body movements aid movement
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passive transport
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three passive transport systems
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diffusion, filtration and osmosis
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if you pour cream into your coffee this is an example of
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diffusion, filtration and osmosis
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The force that water exerts:
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water pushing pressure aka hydrostatic pressure
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important for the movement of water, nutrients, and waste products in the capillaries
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filtration
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serve as semipermeable membranes allowing water and smaller substances to move from the vascular system to the interstitial fluids, but larger molecules and red blood cells remain inside the walls
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capillaries
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fluids that have the same osmolarity as the blood
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isotonic ie 0.9% saline solution
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often used as a solution for intravenous IV therapy due to its isotonic nature
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0.9% saline solution
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older adults are more prone to fluid deficits because:
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diminished thirst reflex and less effective kidney function
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adults loose as much as _____ of sensible and insensible fluid each day
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2500 ml
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____________ are losses which the person is aware, like urination
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sensible losses
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losses which occur w/out the person recognizing, like perspiration and water lost through respiration and feces
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insensible losses
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the process when fluid from the intravascular space moves into the interstitial fluid space
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third spacing
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Which people are most at risk for life threatening complications that can result from dehydration or fluid excess?
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elderly (both) and infants (deficit due to intake and excretion of a large portion of their body fluids daily)
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occurs when there is not enough fluid in the body, especially in the blood (intravascular area)
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dehydration
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most common form of dehydration
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hypovolemia
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occurs when a patient is hemorrhaging or when fluids from other parts of the body are lost, like vomiting, diarrhea, severely draining wounds, profuse diaphoresis
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dehydration
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burns, liver cirrosis and extensive trauma are conditions in which _________ is common
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3rd spacing
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thirst, rapid weak pulse, low blood pressure, decreased tears, dry skin, dry mucous membranes all all signs and symptoms of:
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dehydration
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poor skin turgor, increased temp, decreased urine output, darker urine, constipation, WEIGHT LOSS, also increased BUN, hematocrit and specific gravity
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dehydration
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if dehydration is not treated what occurs:
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organ function decreases and fails, i.e. brain kidneys and heart
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this manifests in an older person as altered mental status, lightheadedness and syncope due to inadequate circulatory volume and therefor oxygen supply to the brain
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dehydration
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How would you intervene for a patient with dehydration?
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push isotonic fluids that have the same osmolarity as blood
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most reliable indicator of fluid loss or gain
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weight gain
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types of bowel sound
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hyperactive, hypoactive and absent
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What O2 administration restrictions are there for a patient w/ a history of COPD because otherwise they may loose the stimulus to breathe and suffer respiratory arrest
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no more than 2 L per minute
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frequently administered to rapidly rid the body of excess water
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diruretic like Lasix (Furosemide)
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conditions that place patients at high risk for hyponatremia
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NPO, diaphoresis, diuretics, gastrointestinal suction, syndrome of inappropriate antidiurectic hormone, excessive ingestion of hypotonic fluids, fresh nearwater drowning, decreased aldosterone
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complications of hypernatremia
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mental status changes, siezures, muscle twitches and contractions leading to skeletal muscle weakness and possibly respiratory failure
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what other tests may flag hypernatremia besides serum sodium level?
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serum osmolarity increased, fluid imbalance, affected BUN, hematocrit, and urine specific gravity
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The most common electrolyte in the ICF compartment
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potassium
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Norm: potassium
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3.5 - 5 mEq/L
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Potassium is especially important for:
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cardiac muscle, skeletal muscle and smooth muscle function
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Drugs that increase excretion of potassium
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Lasic, Lanoxin, and prednisone
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A major danger of low potassium
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dysrhythmia which can lead to cardiac arrest
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Another name for the gastrointestinal tract
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GI tract / alimentary tube
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The GI tract is part of what system?
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digestive
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The path of the GI tract includes:
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extends from the mouth to the anus and consists of the oral cavity, pharynx, esophagus, stomach, small intestine and large intestine
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another name for the large intestine
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colon
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Where does digestion begin?
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in the oral cavity and continues to the stomach and small intestine
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Most absorption of nutrients takes place:
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in the small intestine
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Where is the majority of water from digested food reabsorbed?
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large intestine
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What is an indigestible material that is eliminated from the large intestine?
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cellulose
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What are the boundaries of the oral cavity?
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hard and soft palates superiorly, the cheeks laterally, and the floor of the mouth inferiorly
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What resides in the oral cavity?
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teeth and tongue and openings of the ducts of the salivary glands
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What is the role of teeth in digestion?
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physical breakup of food into smaller pieces to create more surface area for chemical digestion brought about by enzymes
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Roots of the teeth attach to:
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sockets in the jawbones (mandible and maxillae)
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what covers the jawbones and surrounds the base of the crowns
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gums or gingiva
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Tooth sockets are lined with:
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periodontal membrane (ligament) or dense fibrous connective tissue which cements the roots of teeth
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The tongue is made of ______________ muscle innervated by the ____________________ nerve (also called the _______________ cranial nerve)
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skeletal / hypoglosseal / 12th
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The papillae on the upper surface of the tongue contains:
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taste buds, innervated by the facial annd glossopharangeal nerves (seventh and ninth cranial)
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Why is the tongue important for chewing?
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keeps food between the teeth
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what is the first step in swallowing?
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elevation of the tongue
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What are the three pairs of salivary glands?
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parotid, submandibular, and sublingual
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What is the purpose of the salivary glands?
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bring saliva to the oral cavity
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The presence of anything in the mouth increases the rate of secretion. This is an example of what kind of response?
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parasympathetic / mediated by the facial and glossopharangeal nerves
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What is the enzyme that functions in the mouth and what is its purpose?
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amylase, digests starch to maltose
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The muscular tube that is a passageway for food exiting the oral cavity and entering the esophagus:
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the pharynx
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Part of the pharanxy that contracts as part of the swallowing reflex, and is regulated by:
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constrictor muscles / medulla and pons
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Closes the nasopharynx while the epiglottis closes to open the larynx
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the uvula
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Length of the esophagus
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about 10 inches
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The circular smooth muscle that relaxes to permit food to enter the stomach and then contracts to prevent the back up of stomach contents:
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LES - lower esophageal sphincter
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this may allow gastric juice to splash up into the esophagus:
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incomplete closure of the LES
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The stomach is located in:
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upper left abdominal quadrant, left of the liver and in front of the spleen
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Other than digestion, what else does the stomach serve as?
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reservoir for food so that digestion may take place gradually
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What forms the upper curve of the stomach?
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the fundus
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The opening between the duodenum and the stomach
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the pyloric sphincter
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folds in the mucosa of the stomach
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rugae
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the glands of the stomach are
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gastric pits
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Gastric juice is made up of:
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water, mucus, pepsinogen, hydrochloric acid, gastric lipase, and intrinsic factor
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helps form a bolus and protect the mucosal lining
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mucus
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an inactive enzyme that is changed to active pepsin by hydrochloric acid:
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pepsinogen
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begins the digestion of proteins to polypeptides
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pepsin
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what is the name and pH of the acid that kills most microorganisms that enter the stomach?
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hydrochloric acid, pH of 1 to 2
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What is the hormone that is stimulated at the sight or smell of food and stimulates the production of gastric juice?
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gastrin
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What are the three layers of the stomach?
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circular, longitudinal and oblique (all smooth muscle)
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The thick liquid that food is changed into in the stomach
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chyme
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allows small amounts of chyme to pass into the duodenum and contracts to prevent back up of intestinal contents
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pyloric sphincter
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what are most readily digested by the stomach?
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carbohydrates followed by proteins and fats
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About 1 inch in diameter and approx 10 feet long
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small intestine
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within the abdominal cavity the small intestine is encircled by what?
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the colon (large intestine)
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The small intestine extends from the ____________ to the __________ of the colon
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stomach / cecum
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The first 10 inches of the small intestine is the ___________
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duodenum
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The entrance of the common bile duct and pancreatic duct is:
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the pepatopancreatic ampulla (ampulla of Vater)
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The small intestine is made up of:
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duodenum, jejunum, and ileum
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Digestion is completed here:
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small intestine
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end products of digestion are abosrbed into ________ and __________
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blood and lymph
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bile from this place and enzymes from this place function in the small intestine:
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liver and pancrease
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When chyme enters the duodenum, the intestinal mucosa produces the enzymes sucrase, maltase and lactase to:
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complete the digestion of disaccharides to monosaccharides
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When chyme enters the duodenum, the intestinal mucosa produces the enzyme peptidases to:
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complete digestion of proteins to amino acids
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When chyme enters the duodenum, the intestinal mucosa produces nucleosidases and phosphatases to:
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complete nucleotide digestion
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Folds in the mucosa and microscopic folds in the cell membranes of the free surface of the intestinal epithelial cells
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villi and microvilli
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Within each villus is a capillary network and a lymph capillary called a
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lacteal
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What water soluable nutrients are absorbed into the blood in the capillary networks of the small intestine?
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monosacharides, amino acids, minerals, water soluable vitamins
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What are absorbed into the lymph in the lacteals of the small intestine?
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fat soluable vitamins and fatty acids and glycerol
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The large intestine extends from ______ to ___________
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ileum / anus
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Length of the large intestine
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5 feet long and 2.5 inches diameter
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First part of the large intestine
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cecum
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at the junstion of the ilium and the cecum
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ileocecal valve
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prevents back up of colon contents into the small intestine
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ileocecal valve
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Where does the appendix attach within the large intestine?
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cecum
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what are the parts of the colon:
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cecum, ascending, transverse and descending colon, rectum, and anal canal
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temporarily stores and then eliminates undigestible material
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colon
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absorbs significant amounts of water and minerals as well as the vitamins prodices by the normal bacterial flora
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colon
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spinal cord reflex over which voluntary conctrol may be exerted to accomplish elimination of feces
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defacation reflex
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propels feces into the rectum
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peristalsis
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accessory organs of digestion
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liver, gallbladder and pancreas
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has a large right lobe and a smaller left lobe
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liver
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fills the right and center of the upper abdominal cavity
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liver
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receives oxygenated blood by way of the hepatic artery
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liver
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pathway by which oxygenated blood arrives in the liver, and blood from the abdominal digestive organs and spleen is brought prior to returning to the heart
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hepatic portal circulation
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permits the liver to regulate blood levels of nutrients and removes potentially toxic substances such as alcohol from the blood
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hepatic port circulation
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Only digestive function of the liver
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production of bile by the hepatocytes (liver cells)
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bile flows through small bile ducts, converges into larger ones, and leaves the liver by way of
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common hepatic duct
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carries bile to the duodenum
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common bile duct
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bile is made of mostly:
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water and bile salts
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excretory function of bile
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carry bilirubin and excess cholesterol to the intestines for elimination in feces
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digestive function of bile is accomplished via bile salts which:
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emulsify fats in the small intestine
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a type of mechanical digestion in which large fat globules are broken into smaller globules but not chemically changed
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emulsification
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