acid Base Imbalances + ABGs

metabolic alkalosis causes and compensation

- Vomiting -NGT suction - hypokalemia -compensation= slow and shallow respirations

metabolic acidosis causes and compensation

-Diarrhea;due to loss of bicarbonate - Renal Failure - Diabetic ketoacidosis - Compensation= Rapid, deep respirations (Kussmauls resp.)

Full compensation= Partial compensation=

-Full compensation= Fully Normal pH 7.35-7.45 -Partial compensation= pH is not normal

respiratory acidosis causes

-hypoventilation -Drugs= CNS depressants (EX: opioid overdose, alcohol intoxication) -COPD or asthma attack

The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer? 0.45% sodium chloride 0.9% sodium chloride 5% glucose in water 5% glucose in normal saline solution

0.45% sodium chloride

The weight of a client with congestive heart failure is monitored daily and entered into the medical record. In a 24-hour period, the client's weight increased by 2 lb. How much fluid is this client retaining? 1 L 500 ml 1500 ml 1250 ml

1 L

Normal urine pH

4.5-8

A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? Neutral Alkaline Acidic Basic

Acidic

What foods can the nurse recommend for the patient with hyperkalemia? Apples and berries Green, leafy vegetables Milk and yogurt Melons

Apples and berries

A 54-year-old male patient is admitted to the hospital with a case of severe dehydration. The nurse reviews the patient's laboratory results. Which of the following results are consistent with the diagnosis? Select all that apply. Blood urea nitrogen (BUN) of 23 mg/dL Serum osmolality of 310 mOsm/kg Serum sodium of 148 mEq/L Serum glucose of 90 mg/dL Urine specific gravity of 1.03 Hematocrit level of 48%

Blood urea nitrogen (BUN) of 23 mg/dL Serum osmolality of 310 mOsm/kg Serum sodium of 148 mEq/L Urine specific gravity of 1.03

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? Hyperkalemia Hypocalcemia Hypokalemia Hypercalcemia

Hypercalcemia

respiratory acidosis compensation

Kidneys conserve HCO3- and secrete H+ into urine

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? Headache or blurry vision Abdominal pain or diarrhea Hallucinations or tinnitus Light-headedness or paresthesia

Light-headedness or paresthesia

A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance? Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Metabolic acidosis

Metabolic alkalosis

respiratory alkalosis compensation

RESPIRATORY ALKALOSIS Compensation: Metabolic kidneys excrete bicarb and conserve H; cellular buffering Shallow RapidBreaths

Mnemonic for acid-base imbalances

ROME Respiratory opposite (pH + Co2 move in opposite direction) -Metabolic Equal (pH + Bicarb/ HCO3 move in equal/ same directions

PaCO2 48 is?

acidic; opposite ROME

A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. sodium 137 mEq/L (137 mmol/L)potassium 4.6 mEq/L (4.6 mmol/L)chloride 94 mEq/L (94 mmol/L)calcium 12.9 mg/dL (3.2 mmol/L) What laboratory value is of highest concern to the nurse? sodium 137 mEq/L (137 mmol/L) potassium 4.6 mEq/L (4.6 mmol/L) chloride 94 mEq/L (94 mmol/L) calcium 12.9 mg/dL (3.2 mmol/L)

calcium 12.9 mg/dL (3.2 mmol/L)

A client with severe hypervolemia is prescribed a loop diuretic and the nurse is concerned with the client experiencing significant sodium and potassium losses. What drug was most likely prescribed? furosemide hydrochlorothiazide metolazone spironolactone

furosemide

metabolic acidosis S&S

headache, confusion, drowsiness, increased RR

metabolic alkalosis

high pH, high HCO3 (22-26)

respiratory alkalosis ranges

high pH, low pCO2 (35-45)

respiratory alkalosis causes

hyperventilation

respiratory alkalosis S&S

lightheadedness and inability to concentrate due to cerebral artery vasoconstriction

Respiratory acidosis ranges

low pH, high pCO2 (35-45)

metabolic acidosis

low pH, low HCO3 (22-26)

normal pH PaCO2 HCO3

pH: acidic7.35-7.45alkaltic PaCO2: alkaltic35-45 acidic HCO3: 22-26