PCU Exam 2024
Questions and Answers
What are normal ABG values? - ph: acidic 7.35-7.45 basic
CO2: basic 35-45 acidic
HCO3-: acidic 22-26
... [Show More] basic
Normal pao2 - 80-100 mmhg
What ph levels are lethal? - outside 6.8-7.8
Where are abgs drawn from? What test is done to ensure adequate blood flow? - peripheral artery; allen's test for radial artery
How do the kidneys help maintain acid-base balance? - retain/excrete basic HCO3 and retain/excrete acidic H+
Treatments for respiratory acidosis - -oxygen
-intubation
-bronchodilators
-drug reversal agents
-incentive spirometer
-suction
Treatments for respiratory alkalosis - -breathing into paper bag
-anxiolytics
-analgesics
-reduce fever
-reduce ventilation
-return to normal altitude
Treatments for metabolic acidosis - -IV sodium bicarbonate
-manage blood sugar
-antibiotics
-reversal for OD
-anti-diarrheal agents
-dialysis
-encourage respirations/ventilate
Treatments for metabolic alkalosis - -antiemetics
-stop suctioning
-d/c drugs causing acid loss (diuretics, antacids)
-hydrochloric acid (rare)
What is systolic vs diastolic heart failure? - systolic: type of L sided HF with reduced EF of < 40%; impaired contraction
Diastolic: type of L sided HF with preserved EF > 50%; impaired relaxation
What 3 things occur in systolic HF? - 1. SNS activation (increased HR, contractility, peripheral vasoconstriction)
2. RAAS activation (sodium + water retention, peripheral vasoconstriction)
3. LV dilation
What are symptoms of right sided heart failure? - swelling: swelling, weight gain, edema, large neck vein (JVD), lethargy, irregular HR, nocturia, girth, hepatic tenderness, anorexia, ascitis
What are treatments for right sided heart failure? - -sodium and fluid restriction to manage preload
-moderate doses of diuretics
-ACE, arbs, beta blockers if due to L ventricular failure
What are symptoms of left sided heart failure? - drowning: dyspnea, rales/crackles, orthopnea, weakness, nocturnal dyspnea, increased HR, nagging cough, gaining weight, hypotension
What are symptoms of systolic heart failure? - s3, edema, weight gain, crackles, dyspnea, chest tightness, oliguria, JVD, weak pulses, cool pale skin, altered mental status
Diagnostic tests for heart failure - -ECG
-xray
-ECHO
-BNP (normal < 100 75 & under, < 450 75+)
-cardiac biomarkers
What are treatments for systolic HF? - -arnis, ACE-Is, arbs
-beta blockers
-aldosterone antagonists
-diuretics
-vasodilators
-anticoagulation
-physical activity
-inotropic agents (w/ caution - can cause dysrhythmia)
Which medication for HF interrupts SNS to normalize HR, decrease afterload and contractility? - beta blockers
Which medications for HF interrupts RAAS activation to block vasoconstriction and ADH? - ace inhibitors (ACE-I), angiotension receptor blockers (arbs), ARNI
What 3 things occur in diastolic HF? - 1. Pulmonary congestion
2. Pulmonary edema
3. Decreased O2 sats
What are treatments for diastolic HF & why? - -beta blockers to slow HR
-ACE-I & arbs to manage preload + afterload
-diuretics (use less than systolic HF, need to maintain adequate preload for filling)
Stages of kidney failure - 1. Creatinine 1.5-1.9, UO < 0.5ml/kg/hr or 6-12 hrs
2. Creatinine 2.0-2.9, UO < 0.5ml/kg/hr for 12+ hrs
3. Creatinine 4.0 OR 3x baseline, UO < 0.3ml/kg/hr 24+ hours [Show Less]