*NURSING > EXAM > NUR2755 / NUR 2755 MULTIDIMENSIONAL CARE IV / MDC 4 EXAM 2 REVIEW (LATEST 2020 / 2021) RASMUSSEN (All)

NUR2755 / NUR 2755 MULTIDIMENSIONAL CARE IV / MDC 4 EXAM 2 REVIEW (LATEST 2020 / 2021) RASMUSSEN

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1. George Kent is a 54-year-old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productiv... e cough with yellow-green sputum. He has difficulty in communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has a tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg. How would you interpret this? a) Respiratory Acidosis, Uncompensated b) Respiratory Acidosis, Partially Compensated c) Metabolic Alkalosis, Uncompensated d) Metabolic Acidosis, Partially, Compensated Question 1 Explanation: The patient has respiratory acidosis (raised carbon dioxide) resulting from an acute exacerbation of chronic obstructive pulmonary disease, with partial compensation. 2. Carl, an elementary student, was rushed to the hospital due to vomiting and a decreased level of consciousness. The patient displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. He appears to be dehydrated—his eyes are sunken and mucous membranes are dry—and he has a two week history of polydipsia, polyuria, and weight loss. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 23 mm Hg, and HCO3 12 mmol/L; other results are Na+ 126 mmol/L, K+ 5 mmol/L, and Cl- 95 mmol/L. What is your assessment? a) Respiratory Acidosis, Uncompensated b) Respiratory Acidosis, Partially Compensated c) Metabolic Alkalosis, Uncompensated d) Metabolic Acidosis, Partially Compensated Question 2 Explanation: The student was diagnosed having diabetes mellitus. The results show that he has metabolic acidosis (low HCO3 -) with respiratory compensation (low CO2). 3. A cigarette vendor was brought to the emergency department of a hospital after she fell into the ground and hurt her left leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she started complaining that she is still in pain and now experiencing muscle cramps, tingling, and paraesthesia. Measurement of arterial blood gas reveals pH 7.6, PaO2 120 mm Hg, PaCO2 31 mm Hg, and HCO3 25 mmol/L. What does this mean? a) Respiratory Alkalosis, Uncompensated b) Respiratory Acidosis, Partially Compensated c) Metabolic Alkalosis, Uncompensated d) Metabolic Alkalosis, Partially Compensated Question 3 Explanation: The primary disorder is acute respiratory alkalosis (low CO2) due to the pain and anxiety causing her to hyperventilate. There has not been time for metabolic compensation. 4. Ricky’s grandmother is suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid-base disorder is shown? a) Respiratory Alkalosis, Uncompensated b) Respiratory Acidosis, Partially Compensated c) Metabolic Alkalosis, Uncompensated d) Metabolic Alkalosis, Partially Compensated Question 4 Explanation: The primary disorder is uncompensated metabolic alkalosis (high HCO3 -). As CO2 is the strongest driver of respiration, it generally will not allow hypoventilation as compensation for metabolic alkalosis. [Show More]

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