Acid-Base

How can the nurse prevent vomiting in a client who reports feeling nauseated after cataract surgery? 1) administer the prescribed antiemetic medication 2) provide some dry crackers for the client to eat 3) explain that this is expected after surgery 4) teach how to breathe deeply until the nausea subsides

An antiemetic will prevent vomiting; vomiting increases intraocular pressure and should be avoided. Providing some dry crackers for the client to eat, explaining that this is expected after surgery, and teaching how to breathe deeply until the nausea subsides are unsafe; vomiting increases intraocular pressure, and aggressive intervention is required.

Which medication would the nurse identify as being used both for cervical ripening during labor and for the prevention of gastric ulcers? 1) Raloxifene 2) Clomiphene 3) Misoprostol 4) Dinoprostone

Misoprostol -can be used for cervical ripening and to prevent gastric ulcers. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used for ovulation. Dinoprostone can be used for cervical ripening, but this medication does not act as a stomach protectant.

A high school student arrives at the local blood drive center to donate blood for the first time and as the site is being prepared for needle insertion, the student becomes agitated and starts to hyperventilate. Which instruction would the nurse provide the student? 1) Breathe into cupped hands 2) Pant using rapid, shallow breaths 3) Use a rapid deep-breathing pattern 4) Hold the breath for as long as possible

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.

Which condition is a cardiovascular manifestation of alkalosis? SATP 1) Increased heart rate 2) Decreased heart rate 3) Widened QRS complex 4) Increased digitalis toxicity 5) Prolonged PR interval

Increased HR Increased digitalis toxicity -increased heart rate and digitalis toxicity are cardiovascular manifestations of alkalosis. Delayed electrical conduction is a cardiovascular manifestation of acidosis, which could result in decreased heart rate, widened QRS complexes, and prolonged PR intervals.

Which ion is the regulator of extracellular osmolarity? 1) Sodium 2) Potassium 3) Chloride 4) Calcium

Sodium: -sodium is the most abundant extracellular fluid cation and regulates serum (extracellular) osmolarity, as well as nerve impulse transmission and acid-base balance. Potassium is the major intracellular osmolarity regulator, and it also regulates metabolic activities, transmission and conduction of nerve impulses, cardiac conduction, and smooth and skeletal muscle contraction. Chloride is a major extracellular fluid anion and follows sodium. Calcium is an extracellular cation necessary for bone and teeth formation, blood clotting, hormone secretion, cardiac conduction, transmission of nerve impulses, and muscle contraction.

Which food item would the nurse instruct a client whose pathology reports states a urinary calculus is composed of uric acid to avoid? 1) Milk 2) Liver 3) Cheese 4) Vegetables

Liver -a low-purine diet controls the development of uric acid stones. Clients with uric acid stones should avoid foods high in purine, such as organ meats and extracts. The client should avoid milk if he or she had calcium stones, not uric acid stones. The client should avoid cheese or animal protein if he or she had cysteine stones, not uric acid stones. The client does not need to avoid vegetables when on a low--purine diet.

Which independent nursing action would be included in the plan of care for a client after an episode of ketoacidosis? 1) Monitoring for signs of hypoglycemia resulting from treatment 2) Withholding glucose in any form until the situation is corrected 3) Giving fruit juices, broth, and milk as soon as the client is able to take fluids orally 4) Regulating insulin dosage according to the client's urinary ketone levels

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. The regulation of insulin depends on the prescription for coverage; the prescription usually depends on the client's blood glucose level rather than ketones in the urine.

The nurse providing postoperative 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? 1) Acidic pH 2) Glucose negative 3) Bacteria negative 4) Presence of large proteins

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. The urine can be acidic; normal pH is 4.0 to 8.0. Glucose and bacteria should be negative and are normal findings.

A client with chronic obstructive pulmonary disease (COPD) has blood pH of 7.25 and Pco2 of 60mm Hg. These blood gas results require nursing attention because they indicate which condition? 1) Metabolic acidosis 2) Metabolic alkalosis 3) Respiratory acidosis 4) Respiratory alkalosis

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 35-45 mm Hg; therefore, 60 mm Hg is elevated, resulting in respiratory acidosis. HCO3 is the parameter for metabolic functions. A pH of 7.25 is acidic, indicating acidosis and not alkalosis.