Acid Base Balance Review
After initiating continuous mechanical ventilation, how often do ABGs need to be drawn?
20 minutes
HCO3
22-26 mEq/L
PaCO2
35-45 mEq/L
pH
7.35-7.45
PaO2
80-100
What are common S & Sx of hypercalcemia?
Bones: abnormal bone remodeling and risk for Fx Stones: increase risk for kidney stones Groans: abd cramping, N, constipation Psychiatric Overtones: lethargy, depressed mood, psychosis, and cognitive dysfunction.
What are some common S & Sx of hypocalcemia?
CATS Convulsions Arrythmias Tetany Stridor and Spasms
Which of the following clients is at highest risk for peptic ulcer disease?
Client with blood type O Clients with blood type O are more susceptible to peptic ulcers than those with blood types A, B, and AB.
Pt is a 15 yo male who ingested drain cleaner. As a school nurse what interventions would you perform?
Contact PCP immediately dilute with milk or water
What are common S & Sx of hypokalemia?
Dysrrythmias Muscle cramps and twitching paralysis kidney porblems
The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of:
HCO3−
A client is receiving a diuretic as the first-line treatment of mild hypertension. The nurse monitors the client for signs and symptoms of hypokalemia with which agent?
Hydrochlorothiazide
Which intervention is most appropriate for a client with an ABG of pH 7.5, PaCO2 of 26 mm Hg O2 saturation of 96%, HCO3- of 24 mEq/L PaO2 of 94 mm Hg
Instruct the client to breathe into a paper bag The ABG results reveal respiratory alkalosis. The best intervention to raise the PaCO2 level would be to have the client breathe into a paper bag. Administering a decongestant, offering fluids frequently, and administering supplemental oxygen wouldn't raise the lowered PaCO2 level.
What are common S & Sx of hyperkalemia?
LOW BP LOW Urine Output muscle spasms muscle weakness/numbness
Pt is a 58 yo male who presents with co swelling and pain in right big toe. Pt reports eating meals that consist of mostly red meat and has 4 glasses of beer 2-3x a week. What labs would the nurse assume the provider to order and what diet is recommended?
Labs: Uric acid in blood Diet: Low purine diet (fruits and veg, whole grains, low fat dairy, legumes, and nuts.)
Pt is a T1D who presents with N/V and fatigue. What disease process that manifests as low pH and low bicarb should the nurse be concerned for?
Metabolic Acidosis
ROME
Respiratory Opposite Metabolic Equal
Pt presents with acute anxiety, ABGs are drawn and the lab values are as follows; pH: 7.55 PaO2: 90 mmHg PaCO2: 27 mmHg HCO3: 24 mEq/L What does the nurse suspect?
Respiratory Alkalosis
A client in the emergency department reports that they have been vomiting excessively for the past 2 days. The client's arterial blood gas analysis shows pH of 7.50 PaCO2 of 43 mm Hg PaO2 of 75 mm Hg HCO3- of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?
metabolic alkalosis
A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder?
pH 7.28, PaO2 50 mm Hg
The nurse is caring for a client with metabolic alkalosis. What would the nurse assume the ABG result to be?
pH 7.50 HCO3 45 mEq/L
The nurse is caring for a client with metabolic alkalosis whose breathing rate is 8 breaths/min. Which arterial blood gas data does the nurse anticipate finding?
pH: 7.60 PaCO2: 64 mm Hg HCO3: 42 mEq/l
Pt is a T1D and presents to ER with co N/V/D, muscle cramps, and confusion. A STAT ABG is drawn and the lab values are as follows: pH: 7.53 PaCO2: 36 HCO3: 28 What does the nurse suspect?
uncompensated metabolic acidosis
