Acid-Base Imbalance
Place the steps the nurse uses to analyze ABG in correct order. 1. Eval whether or not compensation is occurring 2. Eval the PaO2 and O2sat 3. Eval PaCO2 and HCO3 to determine if it is resp or meta. 4. Evaluate pH to
1. Eval PaO2 and O2sat 2. Eval pH 3. Eval PaCO2 and HCO3- 4. Eval whether compensation is occurring
Order the nursing diagnoses for Mr. Abdul's plan of care from highest priority to lowest priority. 1. Acute confusion 2. Self-care deficit 3. Risk for injury 4. Impaired gas exchange
1. Impaired gas exchange 2. Risk for injury 3. Acute confusion 4. Self-care deficit
Death can occur with the pH is below ____ or rises higher than 7.8
6.9
Which nursing diagnoses should the nurse include in the plan of care for a patient who is experiencing acid-base imbalance, hypoxemia, hypotension, restlessness, anxiety, and decreased oxygen saturation? (select all that apply) 1. Acute confusion 2. Decreased cardiac output 3. Impaired gas exchange 4. Fatigue 5. Electrolyte imbalance
Acute confusion Decreased cardiac output Impaired gas exchange
Which collaborative nursing intervention is appropriate for a pt who is experiencing respiratory alkalosis? 1. Encouraging the pt to increase the depth and rate of respirations 2. Asking the pt to breathe slowly into a paper bag 3. Increasing the pt's oral fluid intake 4. Administering sodium bicarbonate to the pt, per order
Asking the pt to breathe slowly into a paper bag
Which assessment finding would require priority nursing interventions in a patient with metabolic or respiratory acidosis? 1. Dry skin 2. Rapid respiratory rate 3. Lethargy and confusion 4. Bradycardia and widened QRS complex
Bradycardia with widened QRS complex Cardiovascular manifestations that require priority nursing interventions are related to delayed electrical conduction, specifically bradycardia that may progress to heart block, tall T waves, widened QRS complex, and prolonged PR interval
Match the system with the accurate clinical manifestation for respiratory acidosis. Categories: Cardiovascular, neurological, respiratory Manifestations: tachycardia, headache, dyspnea
Cardiovascular: Tachycardia Neurological: Headache Respiratory: Dyspnea
Which NOC outcome is appropriate for Mr. Abdul's nursing diagnosis of acute confusion? (select all that apply) 1. Cognition 2. Distorted thoughts 3. Information processing 4. Memory 5. Adherence behavior
Cognition Distorted thought self-control Information processing Memory
The nurse is planning care for a pt who is experiencing metabolic alkalosis and formulates the nursing diagnosis acute confusion. Which NOC outcomes are appropriate for the nurse to include in the plan of care? (select all the apply) 1. Cognition 2. Tissue Perfusion: vital signs 3. Information processing 4. Fluid balance 5. Memory
Cognition Information processing Memory
Which neurological clinical manifestations are associated with metabolic acidosis? (select all that apply) 1. Nausea 2. Confusion 3. Lethargy 4. Vomiting 5. Anorexia
Confusion Lethargy Decreased level of consciousness is associated with metabolic acidosis
Lab values for a pt recently admitted include: pH 7.31, PaO2 59.2 mmHg, PaCO2 38.6 mmHg, HCO3- 17.5 mEq/L and O2sat 88%. The pt is awake, but lethargic, and is taking rapid, deep breaths. Which data in the medical history could be the cause for the current findings? 1. Asthma 2. Antacid use 3. Diabetes mellitus 4. Diuretic use
Diabetes mellitus
Which cause is associated with the development of metabolic acidosis because of an overproduction of hydrogen ions? (select all that apply) 1. Hyperaldosteronism 2. Diabetic ketoacidosis 3. Salicylate intoxication 4. Nasogastric suctioning 5. Excessive fasting for 30 days
Diabetic ketoacidosis Salicylate intoxication Excessive fasting for 30 days
Which nursing actions would the nurse perform when analyzing ABG during the assessment process for a pt who is suspected of having an acid-base imbalance? (select all that apply) 1. Examining oxygen status 2. Eval pH 3. Assessing PaCo2 & HCO3- 4. Monitoring potassium 5. Determining compensation
Examine oxygen status Eval pH Assess PaCO2 & HCO3 Determining compensation
The nurse is caring for a pt admitted to the hospital with a temp of 104.2 degrees F. The pt is alone, scared, in pain, and hyperventilating. The nurse knows that this pt is at risk for respiratory alkalosis because of which factor? 1. Losing excessive potassium 2. Exhaling too much CO2 3. Inhaling too much oxygen 4. Requiring a bicarbonate injection
Exhaling too much CO2 Exhaling too much CO2 leads to carbonic acid deficit
Which concept is accurate regarding acid-base chemistry in acidosis? 1. Acids bind free hydrogen ions in solution 2. Acetic acid (CH3COOH) is a strong acid 3. Normally, blood is slightly acidic in nature 4. Fluids with lover pH have higher acidity
Fluids with lower pH have higher acidity Fluids with lower pH have a higher level of free hydrogen ions and therefore have higher acidity
The nurse is caring for a patient with pulmonary edema. The nurse knows this patient is at risk for respiratory acidosis as a result of which factor? 1. Hyperventilation 2. Impaired gas exchange 3. Hypocapnia 4. Hypoxia
Impaired gas exchange Excessive fluid in the alveoli interferes with gas exchange in the lungs
A pt is admitted with dehydration and lethargy. Which data should the nurse identify as supporting diagnosis of metabolic alkalosis? (select all that apply) 1. Increased pH 2. Decreased pH 3. Increased bicarbonate 4. Decreased bicarbonate 5. Renal failure
Increased pH Increased bicarbonate
A pt, who is postop for abdominal surgery, presents to the medsurg unit from the PACU. The nurse's admission assessment reveals the following: shallow and irregular respirations with a rate of 12 breaths per min. Lung sounds clear but decreased bilaterally. ABG result post-extubation: pH 7.29, PCO2 46 mmHg, O2stat 88%. Which nursing diagnosis is a priority for this patient? 1. Impaired gas exchange 2. Ineffective airway clearance 3. Ineffective breathing pattern 4. Acute pain
Ineffective breathing pattern
The nurse is teaching a pt about the general purpose of bicarbonate in the blood. Which pt response evaluated by the nurse indicates correct understanding? 1. It is a strong acid that plays a crucial role in acid-base balance 2. It causes the production of lactic acid, leading to acidosis 3. It is a weak base that plays a crucial role in acid-base balance 4. It causes the production of strong bases, leading to alkalinity
It is a weak base that plays a crucial role in acid-base balance
Which statement should the nurse student include in presentation regarding the mechanism which rids the body of excess hydrogen ions? 1. Chemical buffers rid the body of hydrogen ions 2. Respiratory change of air rid the body of hydrogen ions 3. Kidneys excrete hydrogen ions in the urine 4. An exchange of intracellular and extracellular fluids rids the body of hydrogen ions
Kidneys excrete hydrogen ions in the urine
The nurse is caring for a pt with an admitting diagnosis of metabolic acidosis. Which change in the pt's respiratory pattern indicates to the nurse that compensation is occurring? 1. Bradypnea 2. Tachypnea 3. Kussmaul Respirations 4. Cheyne-Stokes respirations
Kussmaul respirations
Which assessment finding causes the nurse to suspect that a pt is experiencing metabolic acidosis? 1. Dyspnea 2. Kussmaul respirations 3. Polyuria 4. Muscle twitching
Kussmaul respirations
A laboratory report for a patient shows the following results: pH 7.32; bicarbonate 23 mEq/L; partial pressure of arterial oxygen (PaO2) 77 mm Hg; and partial pressure of arterial carbon dioxide (PaCO2) 48 mm Hg. These findings are consistent with which acid-base imbalance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis
Respiratory acidosis In respiratory acidosis, there is a decrease in pH, a normal bicarbonate, a decrease in PaO2, and an increase in PaCO2
The nurse is proving care to a pt, following a motor vehicle accident. The steering wheel hit the pt's chest and trapped the pt in the car until the rescue works arrived. The pt is now complaining of dyspnea. For which acid-base imbalance does the nurse identify the pt to be at risk? 1. Respiratory acidosis 2. Respiratory alkalosis 3. Chronic acidosis 4. Compensatory alkalosis
Respiratory acidosis Trauma to the chest decreases ventilation and impacts gas exchange
The nurse is caring for a school-age pt who fell at school and is receiving treatment for a fractured arm. The pt is crying and complaining of pain. The nurse reviews the pt's lab results, which indicated an elevated pH and decreased PaCO2. Which condition is the pt experiencing based on the current data? 1. Respiratory alkalosis 2. Respiratory acidosis 3. Renal compensation 4. Hypoxia
Respiratory alkalosis
Which acid-base imbalance manifests with tachypnea and light headedness? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis
Respiratory alkalosis
Which intervention is appropriate for a pt who is experiencing metabolic acidosis? 1. Oxygen 2. Potassium 3. Seizure precaution 4. Sodium bicarbonate
Sodium bicarbonate
While the nurse is assessing a patient with metabolic acidosis, which finding supports that the patient has lactic acidosis? 1. Symptoms of hypoxia 2. Low blood glucose levels 3. History of excessive oral antacid use 4. Inability of kidney tubules to secrete hydrogen ions into the urine
Symptoms of hypoxia Lactic acidosis occurs when the body has too little oxygen to meet metabolic oxygen demands, such as during heavy exercise, seizure activity, fever, and reduced oxygen intake
The nurse is assessing a pt who is diagnosis with respiratory acidosis. Which cardiovascular finding does the nurse anticipate when assessing the cardiovascular system? (select all that apply) 1. Tachycardia 2. Dysrhythmias 3. Hypotension 4. Dyspnea 5. Confusion
Tachycardia Dysrhythmia
Which clinical manifestation does the nurse anticipate when assess a pt who is experiencing respiratory alkalosis? 1.Dyspnea 2. Tachypnea 3. Hypertension 4. Hypotension
Tachypnea
Which patient condition may have caused a pH of 7.48? (select all that apply) 1. Vomiting (emesis) 2. Anxiety 3. Hypokalemia 4. Loop diuretic therapy 5. Chest trauma
Vomiting (emesis) Hypokalemia Loop diuretic
Which arterial blood gas laboratory values would be seen in metabolic alkalosis? 1. pH 7.49, HCO3- 32 2. pH 7.28, CO2 54 3. pH 7.53, CO2 28 4. pH 7.31, HCO3- 18
pH 7.49, HCO3- 32 In metabolic alkalosis pH is greater than 7.45 and HCO2- greater than 28
What are normal ABG levels
pH: 7.35-7.45 PaCO2: 35-45mmHg HCO3-: 22-26 mEq/L PaO2: 80-100mmHg
Which is the primary chemical buffer to correct an acid-base imbalance within a pt's urine? 1. Carbonic acid-bicarbonate 2. Phosphates 3. Plasma proteins 4. Hemoglobin
Phosphates
Which PaO2 value indicates moderate hypoxemia? 1. 20-40 mmHg 2. 40-60 mm Hg 3. 60-80 mm Hg 4. 80-100 mm Hg
40-60 mm Hg
Which should the nurse assess for in all pt's who are experiencing an acid-base imbalance? (select all that apply) 1. Urine output 2. ABG analysis 3. Vital signs 4. Bowel sounds 5. Skin turgor
ABG analysis Vital signs
After reviewing assessment data for a patient who was admitted for emergency treatment of an acute episode of emphysema, the nurse understands that which data suggests the patient is in an uncompensated acid-base imbalance? 1. Anxious 2. Partial pressure of arterial carbon dioxide (PaCO2) of 30mm Hg 3. Bicarbonate (HCO3-) of 24 mEq/L 4. Temperature of 101.5 Degrees F
Bicarbonate (HCO3-) of 24 mEq/L Kidney compensation for the respiratory acid-base imbalance from the (PaCO2 30mm Hg) from the acute emphysema episode is not yet evident in the arterial blood gas analysis (HCO2- 24 mEq/L), resulting in an uncompensated acid-base imbalance state
a pt is admitted with an acid-base imbalance. The pt's current assessment data includes hypotension and dysrhythmia. Which is the priority nursing diagnosis that the nurse should include in the plan of care? 1. Decreased cardiac output 2. Acute confusion 3. Impaired gas exchange 4. Fatigue
Decreased cardiac output
Which patient conditions has the greatest risk for respiratory acidosis? (select all that apply) 1. A fractured femur 2. Fractured ribs 3. A continuous opioid infusion 4. Pain 5. Anxiety
Fractured ribs A continuous opioid infusion Fractured ribs decrease chest expansion and impair gas exchange and opioid infusions cause respiratory depression and impaired gas exchange. Both lead to respiratory acidosis
Which lab value would indicate to the nurse that a pt is experiencing metabolic acidosis? 1. pH of 7.3 2. PaCO2 of 39 mmHg 3. PaO2 of 52 mmHg 4. HCO3- level of 17.6 mEq/L
HCO3- level of 17.6 mEq/L
The nurse evals the ABG of a pt who is suspected of having an acid-base imbalance. The ABG indicates decrease pH, an increased PaCO2, and normal HCO3-. Which conclusion by the nurse is accurate? 1. Respiratory alkalosis 2. Respiratory acidosis 3. Metabolic alkalosis 4. Metabolic acidosis
Respiratory acidosis
Which change associated with an acid-base imbalance does the nurse assess for in an older-adult patient admitted with pneumonia? (Select all that apply) 1. Generalized edema 2. Dry mucous membranes 3. Dark, concentrated urine 4. Clear, straw-colored urine 5. Thready peripheral pulse 6. New-onset mental status change
Dry mucous membrane Dark, concentrated urine Thready peripheral pulses New-onset mental status change Patients at increased risk for acidosis are older adults and those with impaired breathing. The nurse should assess for changes in mental status, change in pulse quality/rate, signs of dehydration
The nurse is caring for a pt with an admitting diagnosis of metabolic acidosis. Which diagnosis of metabolic acidosis. Which change in the pt's respiratory pattern indicated to the nurse that compensation is occurring? 1. Bradypnea 2. Tachypnea 3. Kussmaul respirations 4. Cheyenne-Stokes respirations
Kussmaul respirations Kussmaul respirations remove excess carbon dioxide from the system. This is an indication of compensation
The nurse formulates a nursing diagnosis of decreased cardiac output for a patient admitted with metabolic acidosis. The goal statement is: the patient's blood pressure will return to baseline or WNL w/in 24 hrs of admission. Which NOC outcome should the nurse include in the plan of care? 1. Hydration 2. Tissue Perfusion: vital signs 3. Fluid balance 4. Respiratory status: gas exchange
Tissue perfusion: vital signs
Which pts should the nurse identify as being at risk for respiratory acidosis secondary to impaired gas exchange? (select all that apply) 1. A pt experiencing an asthma attack 2. A pt diagnosed with scoliosis 3. A pt who is two hours postop for thoracic surgery 4. A pt with a fear of being hospitalized 5. A pt with a nicotine overdose
A pt experiencing an asthma attack A pt diagnosed with scoliosis A pt who is two hours postop for thoracic surgery
Which should the nurse assess for in all pts who are experiencing an acid-base imbalance? (select all that apply) 1. Urine output 2. ABG analysis 3. Vital signs 4. Bowel sounds 5. Skin turgor
ABG analysis Vital signs
Which physiologic imbalance is the patient at rusk for developing if they have chronically low hemoglobin? 1. Acidosis 2. Alkalosis 3. Hypokalemia 4. Ineffective ventilation
Acidosis When there is less hemoglobin to buffer hydrogen ions, the body has a reduced ability to prevent acidosis
The nurse is completing a pt's shift assessment and notes that the pt is lethargic, but restless and agitated. Which nursing diagnosis should the nurse include to the plan of care based on the data? 1. Actue confusion 2. Decreased cardiac output 3. Impaired gas exchange 4. Fatigue
Acute confusion
The nurse is providing care to a pt who exercises in excess, leading to acidosis. Which pt statement does the nurse evaluate as accurate related to the cause of acidosis? 1. Fat metabolism is causing ketones to form, leading to my acidosis 2. Breakdown of protein is causing phosphoric acid to form, leading to acidosis 3. Anaerobic respiration is causing last acid to form, leading to acidosis 4. Carbon dioxide dissolving in water is causing carbonic acid to form, leading to acidosis
Anaerobic respiration is causing lactic acid to form
Which increased blood arterial level causes a compensatory increase in respiratory rate? 1. pH 2. Lactate 3. Bicarbonate 4. Carbon Dioxide
Carbon Dioxide When the amount of carbon dioxide in arterial blood rises, the central nervous system compensates for the imbalance by increasing the rate and depth of breathing.
What happens when hydrogen ions are released into the blood due to metabolic process? 1. The blood becomes more acidic 2. The blood becomes more alkaline 3. The blood pH increases 4. The blood becomes more basic
The blood becomes more acidic
The nurse is providing care to a pt who states, "I rinse my mouth after meals with baking soda and take antacids before bed each night." The nurse knows this pt is at risk for which condition? 1. Elevated hydrogen ion level 2. Elevated HCO3- level 3. Decreased pH level 4. Decreased PaO2 level
Elevated HCO3- level Bicarbonate is absorbed by the GI tract, causing an elevation the HCO3 level
Which interventions should the nurse implement for a pt who is experiencing respiratory acidosis? (select all that apply) 1. Increase the rate of IV fluid administration 2. Encourage deep breathing exercises 3. Monitor breath sounds 4. Provide emotional support 5. Administer prescribed narcotic
Encourage deep breathing exercises Monitor breath sounds Provide emotional support
A postoperative patient has the following ABGs: pH 7.30; PaCO2 60 mm Hg; PaO2 80 mm Hg; HCO3- 24 mEq/L, O2 sat 96%. Which action would the nurse take? 1. Administer oxygen by nasal cannula 2. Inform the charge nurse that no changes in therapy are needed 3. Encourage the patient to do deep breathing, and assist with repositioning 4. Request a prescription for sodium bicarbonate from the health care provider
Encourage the patient to do deep breathing, and assist with repositioning
Which manifestation would the nurse anticipate finding when assess a patient with metabolic respiratory acidosis? (select all that apply) 1. Hypertension 2. Flaccid paralysis 3. Cold and moist skin 4. Kussmaul respiration 5. Delayed electrical conduction
Flaccid paralysis Kussmaul respiration Delayed electrical conduction Acidosis causes neuromuscular manifestations such as flaccid paralysis, which is associated with muscle tenderness and severe hypokalemia. Acidosis causes Kussmaul respiration, and slows down the electrical conduction by prolonging the atrioventricular node delay
Which electrolyte abnormality would the nurse anticipate when reviewing laboratory data for a patient admitted with metabolic acidosis? 1. Hyponatremia 2. Hypernatremia 3. Hypokalemia 4. Hyperkalemia
Hyperkalemia Hyperkalemia occurs during metabolic acidosis as the body attempts to maintain pH by moving potassium ions from the cell in exchange with hydrogen ions moving into the cell
Mr. Abdul states, "I can't catch my breath." The nurse observes that his breathing is labored, his respirations are slow and deep, and his oxygen saturation level is 90%. Based on these assessment findings, which nursing diagnosis does the nurse include in Mr. Abdul's plan of care? 1. Impaired gas exchange 2. Decreased cardiac 3. Acute confusion 4. Imbalanced nutrition
Impaired gas exchange
Which interventions should the nurse implement for a pt who is experiencing respiratory acidosis? (select all that supply) 1. Increase the rate of IV fluid administration 2. Encourage deep breathing exercising 3. Monitor breath sounds 4. Administer prescribed narcotic
Monitor breath sounds Encourage deep breathing exercises Provide emotional support
Which condition or symptom is likely responsible for this acid-base imbalance: pH 7.32; PaO2 82 mm Hg; PaCO2 33 mm Hg; HCO3- 18 mEq/L? (select all that apply) 1. Liver failure 2. Anxiety 3. Dehydration 4. Constipation 5. Prolonged vomiting 6. Respiratory rate of 8 breaths/min
Liver failure Dehydration Respiratory rate of 8 breaths/min
The nurse is proving care to a pt with the following ABG: pH 7.30, PaCO2 40 mmHg, HCO3- 20 mEq/L. Which should the nurse document in the medical record regarding ABG? 1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic alkalosis 4. Metabolic acidosis
Metabolic acidosis
Which acid-base imbalance would be expected in a patient who has been having acute diarrhea for more than 24 hours? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis
Metabolic acidosis Diarrhea results in excessive elimination of bicarbonate, creating an imbalance between hydrogen ions and bicarbonate, leading to metabolic acidosis
Deep and rapid breaths consistent with Kussmaul reparation are found in patients with which type of acid-base Imbalance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis
Metabolic acidosis In metabolic acidosis, the rate and depth of breaking increase as the hydrogen ion levels increase and breathing pattern becomes deep and rapid, not under voluntary control.
Which nursing action is the greatest priority in the plan of care for a patient recovering from an acute episode of COPD? 1. Assess nail beds every 2 hours for cyanosis 2. Assess orientation status every 4 hours 3. Monitor the respiratory rate and effort hourly 4. Monitor arterial blood gas (ABG) results as ordered
Monitor the respiratory rate and effort hourly It is most important to monitor respiratory status in the patient with respiratory acidosis.
A pt presents with muscle twitching and tetany. 10 minutes after hospital admission, the pt experiences a seizure. Which acid-base imbalance should the nurse suspect? 1. Metabolic alkalosis 2. Metabolic acidosis 3. Respiratory alkalosis 4. Respiratory acidosis
Metabolic alkalosis
Which nursing intervention would be included in the plan of care for a patient who is in metabolic alkalosis because of overuse of diuretics? (select all that apply)
Monitoring electrolyte levels Administering IV fluids Placing the patient on fall precautions For a patient with metabolic alkalosis because of diuretic therapy, the patient's diuretics should be stopped, the nurse should administer IV fluids and monitor electrolyte levels, and the patient should be placed on fall precautions because hypotension and muscle cramping are common with metabolic acidosis
Which nursing intervention is appropriate for all pt's who are experiencing an acid-base imbalance? 1. Encouraging deep breathing exercises 2. Monitoring the ABG analysis 3. Preparing for mechanical ventilation 4. Administering oxygen, per order
Monitoring the ABG analysis
Which factor contributes to the development of metabolic acidosis? (select all that apply) 1. Reported heavy alcohol consumption 2. Chronic cirrhosis of the liver with liver failure 3. Fractured wrist from an altercation at a local bar 4. Seizure in the ambulance on the way to hospital 5. Blood pressure of 148/92 mm Hg upon admission to ED
Reported heavy alcohol consumption Chronic cirrhosis of the liver with liver failure Seizure in the ambulance on the way to hospital
The nurse is planning a collaborative care conference for a pt diagnosed with an acid-base imbalance. Which members for the healthcare team should the nurse including during the acute phase of an acid-base imbalance? (select all that apply) 1. Unlicensed assistive personnel (UAP) 2. Physical therapist 3. Primary care provider 4. Respiratory therapist 5. Occupational therapist
Primary care provider Respiratory therapist
The pt's ABG analysis is as follows: pH 7.2, PaCO2 60 mmHg, PaO2 73 mmHg, HCO3- 25 mEq/L. The nurse identifies the nursing diagnostic statement of impaired gas exchange 2/t COPD AEB ABG results. Which goal statement should the nurse include in the plan of care? 1. Pt's pH value will return to a level between 7.35 and 7.45 within 12 hrs 2. Pt's oxygen sat will be > 97% within 12 hrs 3. Pt will be able to walk 100 ft down the hall with a RR less than 22 breaths per minute 4. The pt will require decreased supplemental oxygen
Pt pH value will return to a level between 7.35-7.45 within 12 hrs
An older adult pt reports fatigue, decreased energy, and difficulty breathing. The medical diagnosis is respiratory acidosis w/ metabolic compensation. The nurse formulates a nursing diagnosis of fatigue. Which goal statement should the nurse include in the plan of care? 1. Pt will verbalize feelings of increased energy w/in 24 hrs of admission 2. Pt will seek information about the plan of care at time of admission 3. Pt will find time to nap between treatment sessions 4. Pt will quit smoking w/in 3 months
Pt will verbalize feelings of increased energy w/in 24 hrs of admission
Which patient would be appropriate to assign to the new nurse working on the medsurg unit? 1. Pt with COPD with PaCO2 50 mmHg 2. Pt with reactive airway disease, wheezing, and PaCO2 62 mmHg 3. Pt with diabetic ketoacidosis and change in mental status who has pH 7.18 4. Pt with irregular HR and prolonged vomiting with a HCO3- 40 mEq/L
Pt with COPD with PaCO2 50 mmHg PaCO2 is abnormal but is anticipated for a pt with COPD and is stable for a new nurse
The nurse admits a pt who is unresponsive. Which conditions in the medical history should the nurse identify as placing the pt at risk for metabolic acidosis? (select all that apply) 1. Asthma 2. Hypertension 3. Type 1 diabetes 4. Sepsis 5. Vomiting
Sepsis Type 1 diabetes
Which can occur if the pH of the blood is outside of the normal range? (select all that apply) 1. Serious physiological problems 2. Malfunction of enzymes within the cell 3. Poor oxygen management by hemoglobin 4. Significant psychological problems 5. Cellular function is enhanced
Serious physiological problems Malfunction of enzymes within the cell Poor oxygen management by hemoglobin
Which NOC outcome is appropriate when planning care based on Mr. Abdul's nursing diagnosis fo decreased cardiac output? 1. Fluid balance 2. Tissue perfusion: vital signs 3. Hydration 4. Respiratory status: gas exchange
Tissue perfusion: vital signs
A pt's lab values are pH 7.48, PaCO2 32 mmHg. The nurse anticipates seeing what changes in the pt's lab values as a result of renal compensation for this change in acid-base balance? (select all that apply) 1. pH decreases to 7.42 2. Bicarbonate value decrease 3. pH decreases to 7.29 4. Bicarbonate value increases 5. PaCO2 increases
pH decreases to 7.42 Bicarbonate value decreases