HESI MED SURG STUDY GUIDE

Chemical buffers - Act quickly to prevent major changes in body fluid pH by removing or releasing
hydrogen ions

Bicarbonate-carbonic acid - Main chemical buffer; 20:1 ratio; when the ratio is altered, the pH changes

Kidneys - Regulate bicarbonate levels by retaining and reabsorbing bicarbonate as needed; very slow
compensatory mechanisms; cannot help with compensation when metabolic acidosis is created by renal
failure

pH - Measures H+ concentrations

PCO2 - Partial pressure of CO2 in arteries; respiratory component of acid-base regulation

Hypercapnia - Respiratory acidosis

Hyperventilation - Respiratory alkalosis

HCO3 - Measures serum bicarbonate; reflect primary metabolism disorder or compensatory mechanism
to respiratory acidosis

Respiratory acidosis - Hypoventilation; caused by COPD, primary disease, drugs, obesity, mechanical
asphyxia, sleep apnea

Respiratory alkalosis - Hyperventilation; caused by overventilation on a ventilator, response to acidosis,

bacteremia, thyrotoxicosis, fever, hepatic failure, response to hypoxia, hysteria

Metabolic acidosis - Addition of large amounts of fixed acids to body fluids; caused by lactic acidosis
(circulatory failure), ketoacidosis (diabetes, starvation), phosphates and sulfates (renal disease), acid
ingestions, secondary to respiratory alkalosis, adrenal insufficiency

Metabolic alkalosis - Retention of base or removal of acid from body fluids; caused by excessive gastric
drainage, vomiting, potassium depletion, burns, excessive NaHCO3 administration

Holter monitor - Portable continuous monitor that can be placed o the client to provide a magnetic tape
recording of the heart; keep a diary concerning activity, medications, chest pains

30 large squares - How many large squares on an ECG strip equals 6-seconds

Count the number of R-R intervals in the 30 lg. squares and multiply by 10 - How to Determine the heart
rate for one minute

P wave - Atrial systole; represents depolarization of the artial muscle

QRS complex - Ventricular systole; represents depolarization of the ventricular muscle; normally follows
a P wave; normal length is <0.11 seconds

T wave - Ventricular diastole; represents repolarization of the ventricular muscle; critical time in
heartbeat; resting and regrouping stage so that the next beat can occur

T wave - If defibrillation occurs during this phase, the heart can be thrust into a life-threatening
dysrhythmia