Nursing Assignment | Nursing Essay Questions

b) Choose one and write out Ka expression for one of the conditions below and calculate the pH based on lab results below. Be sure to show every step of your work. (Using Table 11. 10 and PDF – Nursing Quick Reference for Health) : i) Respiratory Acidosis (HCO3′ Within Normal Limit (WNL), PCO2 Increase, pH decrease) (1) [H2CO3) = 55.8 mmole/L (2) (HCO3) = 24 mmole/L (WNL) ii) Metabolic Acidosis (HCO3 decrease, pCO2 WNL, pH decrease) (1) [H2CO3) = 2.4 mmole/L (WNL) (2) [HCO3) = 8 mmole/L iii) Respiratory Alkalosis – Hyperventilation (HCO3 WNL, pCO2 decrease, pH increase) (1) [H2CO3] = 1.4 mmole/L (2) [HCO3) = 24 mmole/L (WNL) iv) Metabolic Alkalosis. (HCO3 increase, pCO2 WNL, pH increase) (1) [H2CO3) = 2.4 mmole/L (WNL) (2) (HCO3) = 35 mmole/L ABG Quick Interpretation 22-26 Parameter Acidosis Normal Alkalosis Reflects PH <7.35 7.35-7.45 > 7.45 Acid Base Status of Body PCO2 > 45 35-45 <35
Respiratory Component HCO3 <22 > 26 Metabolic Component Facts: Body will not overcompensate when it comes to acid base balance so: . pH midpoint is 7.4 • If pH on report is < 74 = original problem was acidosis in nature • If pH on report is > 74-original problem was alkalosis in nature Examples: PCO2 is High and pH is 737 – compensated Respiratory Acidosis because in spite of high pCO2 which would indicate Acidosis the pH is within normal range indicating that the metabolic component has kicked in and caused pH to shift more towards the midpoint of 7.4 and therefore compensated for the respiratory acidosis. 2. pH is 7.44 and the HCO3 is 33 it is a Metabolic Alllosis with Respiratory Compensation bringing the pH back to WNL but not past midpoint pH PCO2 HCO3 Interpretation WNL Respiratory Alkalosis WNL Metabolic Alkalosis WNL Respiratory Acidosis WNL Metabolic Acidosis Compensated Resp. Acidosis Compensated Resp. Alkalosis Compensated Meta Acidosis > 7.4 Compensated Meta. Alkalosis Where compensation is not involved you can look at the arrows • Arrows are in same direction = metabolic conditions • Arrows in opposite direction=respiratory conditions Problems with readings of pulse oximeters Clinical Situation Result Carboxyhemoglobin Falsely High Saturation Bilirubin Falsely High Saturation Melanotic Skin Variable, Reduced Signal Poor Peripheral Perfusion Low Signal, Unreliable Results ABG Quick Interpretation 35-45 <35 Parameter Acidosis Normal Alkalosis Reflects pH <7.35 7.35-7.45 > 7.45 Acid Base Status of Body PCO2 > 45 Respiratory Component HCO3 <22 > 26 Metabolic Component Facts: Body will not overcompensate when it comes to acid base balance so: . pH midpoint is 7.4 • If pH on report is < 74 = original problem was acidosis in nature . If pH on report is > 7.4 = original problem was alkalosis in nature 22-26 Examples: PCO2 is High and pH is 7.37 – compensated Respiratory Acidosis because in spite of high pCO2 which would indicate Acidosis the pH is within normal range indicating that the metabolic component has kicked in and caused pH to shift more towards the midpoint of 7.4 and therefore compensated for the respiratory acidosis 2. pH is 7.44 and the HCO3 is 33 it is a Metabolic Alkalosis with Respiratory Compensation bringing the pH back to WNL but not past midpoint рн PCO2 HCO3 Interpretation WNL Respiratory Alkalosis WNL Metabolic Alkalosis WNL Respiratory Acidosis WNL Metabolic Acidosis Compensated Resp. Acidosis Compensated Resp. Alkalosis Compensated Meta Acidosis > 7.4 Compensated Meta. Alkalosis “Where compensation is not involved you can look at the arrows . Arrows are in same direction = metabolic conditions • Arrows in opposite direction=respiratory conditions Problems with readings of pulse oximeters Clinical Situation Result Carboxyhemoglobin Falsely High Saturation Bilirubin Falsely High Saturation Melanotic Skin Variable, Reduced Signal Poor Peripheral Perfusion Low Signal, Unreliable Results. Get  Nursing Assignments  Help Today
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