Acid Base

a pathology report state's a client's urinary calculus is composed of uric acid. which food item would the nurse instruct the client to avoid?

liver -a low-purine diet controls the development of uric acid stones -client's with uric acid stones should avoid foods high in purine, such as organ meats and extracts

which clinical findings would the nurse expect when assessing a client with hyperthyroidism?

-diarrhea -weight loss

an infant returns to the pediatric unit with an IV infusion in progress after corrective surgery. which is the priority nursing action?

assessing the IV site for infiltration

which medication would the nurse identify as being used both for cervical ripening during labor and as a stomach protectant?

Misoprostol

which long-term effect is associated with untreated congenital hypothyroidism?

cognitive impairment

on admission to an ICU, a client is diagnosed with compensated metabolic acidosis. the nurse expects which assessment finding?

deep and rapid respirations -deep, rapid respirations are an adaptation to a decreased serum pH.

which ABG is associated with diabetic ketoacidosis?

pH: 7.28; PCO2: 28; HCO3: 18 -diabetic ketoacidosis would be associated with metabolic acidosis, which is reflexted by a low pH and bicarbonate

which result would the nurse expect to see on the ECG tracing monitor when a client has diabetic ketoacidosis and a potassium level of 5.4?

peaked T waves and widened QRS complexes

which assessment would the nurse perform while caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS)?

signs of dehydration -HPS causes partial and then complete obstruction -nonprojectile vomiting progresses to projectile vomiting, which rapidly leads to dehydration

the nurse assess a client who is experiencing profound (late) hypovolemic shock. when monitoring the client's ABG results, which response would the nurse expect?

metabolic acidosis

which initial change in acid-base balance will the nurse expect when a client is in the progressive stage of shock?

metabolic acidosis

which descriptors for maturity-onset diabetes of the young (MODY) would the nurse identify as accurate?

-autosomal dominant -characterized by young age of onset

which conditions are cardiovascular manifestations of alkalosis?

-increased HR -increased digitalis toxicity

which pH value of amniotic fluid is indicated by a Nitrazine test strip that turns deep blue?

7.5

a client undergoes surgical implantation of radon seeds for oral cancer. the nurse would observe the client for which side effects?

nausea or vomiting

a client is experiencing persistent vomiting, and serum electrolytes have been prescribed. the nurse would monitor which lab results?

sodium and chloride levels

which complication is most serious for a client with kidney failure?

hyperkalemia

which blood gas result would the nurse expect an adolescent with diabetic ketoacidosis to exhibit?

pH 7.30, CO2 40, HCO3 20

the nurse providing postop care for a client who had kidney surgery reviews the client's urinalysis report. which urinary finding indicates the need to notify the primary health care provider?

presence of large proteins -the glomeruli are not permeable to large proteins such as albumin or red blood cells, and finding them in the urine is abnormal; the nurse would report their presence to the primary health care provider to modify the client's treatment plan

what does the nurse consider to be the priority nursing intervention for a client on diuretic therapy who has developed metabolic alkalosis?

preventing falls - a client with alkalosis has hypotension and muscle weakness

when a client who has had a thoracotomy develops respiratory acidosis, which action would the nurse take?

encourage deep breathing -hypoventilation because of pain is the usual cause of resp. acidosis after chest surgery and the nurse would encourage deep breathing to eliminate excess carbon dioxide.

a client with esophageal varices experiences severe hematemesis, and a Sengstaken-Blakemore tube is inserted. which design and purpose does the tube have?

triple-lumen; for esophageal compression -one lumen inflates the esophageal balloon that compresses the esophagus -the second inflates the gastric balloon, and the third is attached to suction to decompress the stomach

which situation associated with the physiological finding of ketones in the blood and urine would be the nurse's focus when collecting additional data about a client?

starvation -in starvation there are inadequate carbs available for immediate energy, and stored fats are used in excessive amounts, producing ketones

which nutrient causes elevated ketones in diabetic acidosis by incomplete oxidation?

fats -incomplete oxidation of fat results in fatty acids that further break down to ketones

a client is receiving haloperidol for agitation, and the nurse is monitoring the client for side effects. which response identified by the nurse is unrelated to an extrapyramidal tract effect?

hypertensive crisis

a client appears anxious, exhibiting 40 shallow respirations per minute. the client reports dizziness, light-headedness, and tingling sensations of the fingertips and around the lips. the nurse concludes that the client's symptoms are most likely related to which condition?

hyperventilation

the clinic nurse is taking the sexual health history of an adolescent when the adolescent begins to perspire and hyperventilate. the client reports feeling dizzy and short of breath. which condition would the nurse identify?

hyperventilation syndrome -hyperventilation syndrome is resp. alkalosis that occurs with deep, rapid breathing; the clinical findings are related to an increased pH and lowered bicarbonate and oxygen levels

which insulin will the nurse prepare for the emergency treatment of ketoacidosis?

insulin aspart -a rapid-acting insulin (within 10-20 mins) and is used to meet a client's immediate insulin needs

which mechanism of action explains how propylthiouracil (PTU) manages hyperthyroidism?

it decreases production of thyroid hormones

an increase in which blood component is responsible for the acidosis related to untreated diabetes mellitus?

ketones -the ketones produced excessively in diabetes are a byproducrt 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 membrane into the cells. the major ketone, acetoacetic acid, is an alpha-ketoacid that lowers the blood pH, resulting in acidosis.

when arterial blood gases done on a client who is being resuscitated after cardiac arrest show a low pH, which factor is the likely cause of the lab result?

lactic acid production

which independent nursing action would be included in the plan of care for a client after an episode of ketoacidosis?

monitoring for signs of hypoglycemia resulting from treatment

which type of acid-base imbalance would the nurse expect in a child admitted with a severe asthma exacerbation?

respiratory acidosis caused by impaired respirations and increased formation of carbonic acid

which is the regulator of extracellular osmolarity?

sodium -most abundant extracellular fluid cation and regulates serum (extracellular) osmolarity, as well as nerve impulse transmission and acid-base balance

an arterial blood gas report indicates the client's pH is 7.25, PCO2 is 35, and HCO3 is 20. which disturbance would the nurse identify based on these results?

metabolic acidosis