Surgery Questions

3 (Kussmaul respirations are the regular, rapid, and deep respirations observed in clients who have metabolic acidosis. Therefore client 3 may have metabolic acidosis. Respiratory rate >20 breaths/min indicates tachypnea (client 1), which is a sign of fever, hypoxemia, and restrictive lung disease)

3 (Normally, calcium ions block the movement of sodium into cells. When calcium is low, this allows sodium to move freely into cells, creating increased excitability of the nervous system. Initial symptoms are paresthesias. This can lead to tetany if untreated)

3 (In respiratory alkalosis the pH level is elevated because of loss of hydrogen ions; the PCO2 level is low because carbon dioxide is lost through hyperventilation. An elevated pH, elevated PCO2 is partially compensated metabolic alkalosis. A decreased pH, elevated PCO2 is respiratory acidosis. A decreased pH, decreased PCO2 is metabolic acidosis with some compensation.)

2 (Carbohydrates provide 4 kcal/g; therefore 3 L × 50 g/L × 4 kcal/g = 600 kcal, only about a third of the basal energy needed. Four hundred kilocalories is less than the kilocalories provided by the prescribed (IV) fluid. Eight hundred kilocalories and 1000 kilocalories are more than the kilocalories provided by the prescribed IV fluid)

1 (Sodium, which helps regulate the extracellular fluid volume, is lost with vomiting. Chloride, which balances cations in the extracellular compartment, also is lost with vomiting. Because sodium and chloride are parallel electrolytes, hyponatremia will accompany hypochloremia. Bicarbonate and sulfate levels, magnesium and protein levels, and calcium and phosphate levels do not provide significant information in relation to the effects of vomiting.)

The spinal cord itself is injured with loss of sensation and voluntary motor function is called what?

We have to _______________ spine on board with head and neck in ____________ position to make sure incomplete injury doesn’t become complete

In spinal cord injuries, symptoms or effects of injury depend on what?

Mechanism of injury: The head goes back (MVAs, falls, sports injuries​)

The spinal cord is injured and can still relay messages to the brain but not all of signals reach their destination and is called what?

Occurs with both primary and secondary injuries, contributing to capillary compression and cord ischemia​

In hemorrhage, if MAP falls <70 with a brain injury, _______ damage will occur.

The main goal in hemorrhage is to ________ the bleeding and ___________ volume.

Mechanism of Injury: The head is suddenly accelerated, chin goes to chest very quickly, falls and contact injuries​

Whenever there is a suspected or spinal injury, what are some precautions that should be followed?- need backboard- neutral positioning-do not move until head is ________-no twisting of any body part-no sitting up

Systemic hemorrhage can result in ___________ and decreased _________________ to the spinal cord.

This is loss of motor function, pain, temperature perception: position, vibration, light touch in tact (disc herniation of hyperflexion injury) extreme sports/contact sports​

caused by lack of oxygen, can also be from skin breakdown with assistive devices (halo vest) used to stabilize spine

This has motor deficits and sensation in the arms, bladder complications, and function may be lost or preserved (common in hyperextension injuries aka MVA or contact sports injury)​

Hypovolemia can worsen outcomes for secondary injuries because It can cause _______________ which makes it difficult to maintain cerebral and spinal perfusion pressure - MAP >70; need fluids and __________