Acid-Base balance

Which type of acid-base imbalance would the nurse expect in a child admitted with a severe asthma exacerbation? A.) Metabolic acidosis caused by the kidneys'' inability to compensate for increased carbonic acid formation. B.) Metabolic alkalosis caused by excessive production of acid metabolites. C.) Respiratory alkalosis caused by accelerated respirations and loss of carbon dioxide. D.) Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid.

D.) Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid. The restricted ventilation accompanying an asthma attack limits the body's ability to blow off carbon dioxide. As carbon dioxide accumulates in the body fluids, it reacts with water to produce carbonic acid; the result is respiratory acidosis. Respiratory alkalosis is caused by the exhalation of large amounts of carbon dioxide; asthma attacks cause carbon dioxide retention.

An increase in which blood component is responsible for the acidosis related to untreated diabetes mellitus? A.) Lactic acid B.) Ketones C.) Glucose D.) Glutamic acid

B.) Ketones The ketones produced excessively in diabetes are a byproduct of the breakdown of body fats and proteins for energy. This occurs when insulin is not secreted or is unable to be used to transport glucose across the cell membranes into cells.

Which blood gas result would the nurse expect an adolescent with diabetic ketoacidosis to exhibit? A.) pH 7.30, CO2 40 mmHg, HCO3- 20 mEq/L B.) pH 7.35, CO2 47 mmHg, HCO3- 24 C.) pH 7.46, CO2 30 mmHg, HCO3- 24 mEq/L D.) pH 7.50, CO2 50mmHg, HCO3- 22 mEq/L

A.) pH 7.30, CO2 40 mmHg, HCO3- 20 mEq/L

The nurse is preparing a client for a needle insertion. The client becomes agitated and starts to hyperventilate. Which instruction would the nurse provide to the client? A.) Pant using rapid, shallow breaths. B.) Breathe into cupped hands C.) Use a rapid-deep breathing pattern. D.) Hold the breath for as long as possible

B.) Breathe into cupped hands. Breathing into cupped hands allows carbon dioxide to reenter the lungs, which will increase the serum bicarbonate level, relieving the respiratory alkalosis that is occurring as a result of hyperventilation. A rapid breathing pattern will exacerbate the respiratory alkalosis because excess carbon dioxide will continue to be expelled with rapid breathing. A fast deep-breathing pattern will exacerbate the respiratory alkalosis because excess carbon dioxide would be continued to expel.

Which effect of sodium bicarbonate is the nurse trying to prevent when teaching a client about the dangers of using sodium bicarbonate regularly? A.) Respiratory alkalosis B.) Metabolic alkalosis C.) Cardiac dysrhythmias D.) Gastric distention

B.) Metabolic alkalosis

Which factor is the likely cause of the laboratory result when arterial blood gases done on a client who is being resuscitated after cardiac arrest show a low pH? A.) Ketoacidosis B.) Irregular heartbeat C.) Lactic acid production D.) Sodium bicarbonate administration

C.) Lactic acid production Cardiac arrest causes decreased tissue perfusion, which results in anerobic metabolism and lactic acid production. Fat-forming ketoacidosis occur in diabetes. An irregular heartbeat does not cause acidosis. Sodium bicarbonate causes alkalosis, not acidosis.

Which independent nursing action would be included in the plan of care for a client after an episode of ketoacidosis? A.) Giving fruit juices, broth, and milk as soon as the client is able to take fluids orally. B.) Withholding glucose in any form until the situation is corrected. C.) Monitoring for signs of hypoglycemia resulting from treatment D.) Regulating insulin dosage according to the client's urinary ketone levels.

C.) Monitoring for signs of hypoglycemia resulting from treatment During treatment for ketoacidosis, hypoglycemia may develop; careful observation for this complication will be made by the nurse. Withholding all glucose may cause insulin coma. Whole milk and fruit juices are high in carbohydrates, which are contraindicated immediately following ketoacidosis.

A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and Pco2 of 60mmHg. These blood gas results require nursing attention because they indicate which condition? A.) Metabolic alkalosis B.) Metabolic acidosis C.) Respiratory alkalosis D.) Respiratory acidosis

D.) Respiratory Acidosis The normal blood pH range is 7.35 to 7.45; therefore, a blood pH of 7.25 indicates acidosis. The parameter for respiratory function is CO2, and the acceptable range of arterial PCO2 is 35-45mmHg; therefore, 60 mmHg is elevated, resulting in respiratory acidosis.