Chapter 8: Acid-Base Imbalances multiple choice

Normal Ranges pH Bicarbonate concentration (kidney; metabolic) PCO2 (lung; respiratory)

ph: 7.35-7.45 Bicarbonate (HCO3-): 22-35 mEq/L PCO2: 35-45mmHg

Question 3 of 5 In acidosis, ______________________. Select all that apply. potassium shifts into cells. ventilation is suppressed. ventilation is increased. potassium shifts out of cells. hydrogen shifts out of cells.

potassium shifts out of cells. ventilation is suppressed

Question 2 of 7 Read each clinical scenario and then drag and drop the suspected acid-base imbalance that is best exemplified by that scenario. Carl has type 1 diabetes and has arrived in the emergency room with tachycardia, Kussmaul respirations, and a fruity acetone smell to his breath. His blood pH measures in the acidic levels. Carl's symptoms, lab findings and history point to ______________________. compensated metabolic acidosis compensated metabolic alkalosis compensated respiratory acidosis compensated respiratory alkalosis uncompensated metabolic acidosis uncompensated respiratory acidosis uncompensated respiratory alkalosis uncompensated metabolic alkalosis

uncompensated metabolic acidosis Because the blood pH is acidic, the condition is an uncompensated state of acidosis. A fruity, acetone smell to the breath likely indicates the presence of ketones. People with type I diabetes may begin to form elevated levels of ketones in certain situations. Ketones are acidic, leading to Carl's state of uncompensated metabolic acidosis.

Question 5 of 7 Read each clinical scenario and then drag and drop the suspected acid-base imbalance that is best exemplified by that scenario. Lily is a four-year-old girl, who has been experiencing severe vomiting for the past 3 days. Vital signs reveal a slightly elevated heart rate with slow respirations. Her blood pH is elevated. Lily's symptoms, lab findings and history point to ______________________. compensated metabolic acidosis compensated metabolic alkalosis compensated respiratory acidosis compensated respiratory alkalosis uncompensated metabolic acidosis uncompensated metabolic alkalosis uncompensated respiratory acidosis uncompensated respiratory alkalosis

uncompensated metabolic alkalosis Elevated blood pH indicates uncompensated alkalosis is occurring. Severe vomiting can cause alkalosis through loss of hydrogen chloric acid with stomach contents. Electrolyte imbalances due to vomiting can also result in the kidneys reabsorbing fewer hydrogen ions. As these causes are not respiratory in nature, the patient has uncompensated metabolic acidosis.

Question 1 of 7 Read each clinical scenario and then drag and drop the suspected acid-base imbalance that is best exemplified by that scenario. Karen presents with rapid respirations, cyanosis, and tachycardia. She recently had an upper respiratory infection and was diagnosed with chronic obstructive pulmonary disorder (COPD) 5 years ago. Her blood pH is acidic. Karen's symptoms, lab findings and history point to ______________________. compensated metabolic acidosis compensated metabolic alkalosis compensated respiratory acidosis compensated respiratory alkalosis uncompensated metabolic acidosis uncompensated metabolic alkalosis uncompensated respiratory acidosis uncompensated respiratory alkalosis

uncompensated respiratory acidosis The acidic pH indicates that this is an uncompensated condition. Rapid respirations coupled with cyanosis and a previous diagnosis of COPD indicate uncompensated respiratory acidosis.

Question 4 of 7 Read each clinical scenario and then drag and drop the suspected acid-base imbalance that is best exemplified by that scenario. Meryl, a 72-year-old woman, presents with hyperventilation due to severe anxiety. Respirations are shallow and very rapid. Speaking is difficult for her due to an elevated respiratory rate. Her arterial blood gases reveal an elevated pH value. Meryl's symptoms, lab findings and history point to ______________________. compensated metabolic acidosis compensated metabolic alkalosis compensated respiratory acidosis compensated respiratory alkalosis uncompensated metabolic acidosis uncompensated metabolic alkalosis uncompensated respiratory acidosis uncompensated respiratory alkalosis

uncompensated respiratory alkalosis Because the blood gases reveal an elevated pH level, uncompensated alkalosis is present. The fact that Meryl is hyperventilating, which reduces carbon dioxide levels and elevates pH, indicates the acid-base disturbance is respiratory in nature.

Question 3 of 7 Read each clinical scenario and then drag and drop the suspected acid-base imbalance that is best exemplified by that scenario. May was diagnosed with COPD 7 years ago. She presents with rapid respirations, cyanosis, and tachycardia. She recently had an upper respiratory infection. Her blood pH is acidic. Medical intervention, including respiratory stimulants and bronchodilators, helps stabilize May's breathing and arterial blood gases. Blood pH returns to the normal range. May's symptoms, lab findings and history point to ______________________. compensated metabolic acidosis compensated metabolic alkalosis compensated respiratory acidosis compensated respiratory alkalosis uncompensated metabolic acidosis uncompensated metabolic alkalosis uncompensated respiratory acidosis uncompensated respiratory alkalosis

Compensated respiratory acidosis In this case, as blood pH has returned to the normal range, the acid-base disorder would be considered as "compensated." Initial pH was listed as acidic and issues such as recent upper respiratory infection and prior COPD diagnosis point to a respiratory condition. Taking all of this into account, Michelle has compensated respiratory acidosis.

Question 6 of 7 Read each clinical scenario and then drag and drop the suspected acid-base imbalance that is best exemplified by that scenario. Patricia has mild bacterial pneumonia and is being treated with antibiotics. Labored breathing, with increased rate and depth, is noted. Cyanosis is present. Initial values for arterial blood gases reveal elevated pH and below normal carbon dioxide and oxygen levels. With treatment, pH has returned to a normal pH value. Patricia's symptoms, lab findings and history point to ______________________. compensated metabolic acidosis compensated metabolic alkalosis compensated respiratory acidosis compensated respiratory alkalosis uncompensated metabolic acidosis uncompensated metabolic alkalosis uncompensated respiratory acidosis uncompensated respiratory alkalosis

Compensated respiratory alkalosis Patricia's disorder involves the respiratory system. Arterial blood gas values initially show elevated pH accompanied by lower than normal carbon dioxide. As pH returns to normal, Patricia has compensated respiratory alkalosis.

Question 2 of 5 How do the lungs and kidneys, respectively, compensate for metabolic acidosis? Hyperventilation; excrete hydrogen ions Hypoventilation; excrete bicarbonate ions Hyperventilation; excrete bicarbonate ions Hypoventilation; reabsorb hydrogen ions Hyperventilation; reabsorb hydrogen ions

Hyperventilation; excrete hydrogen ions

Question 2 of 5 If a patient presents with metabolic acidosis, which of the following signs would you expect to observe? Increased respiratory rate Fever Pale appearance of the skin Decreased urination Hypoventilation

Increased respiratory rate

Question 4 of 5 Which state of acid-base imbalance develops due to hypercapnia (elevated CO2 in the blood because hypoventilation) Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis

Question 4 of 5 An elderly woman appears in the clinic struggling to catch her breath. She was diagnosed with chronic obstructive pulmonary disease two years prior. Arterial blood gases reveal lower than normal pH and elevated carbon dioxide. What acid-base imbalance is she suffering? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis

Question 3 of 5 This measurement assesses the difference between measured cations (sodium and potassium) and anions (chloride and bicarbonate) in the blood. pH anion gap serum osmolarity oncotic pressure C-reactive protein

anion gap

Question 1 of 5 In the bicarbonate buffering system in the body, bicarbonate acts as a(n) _____________ , while carbon dioxide is a(n) _____________. acid, base base, acid neutral substance, acid neutral substance, base acid, neutral substance

base, acid

Question 1 of 5 In the bicarbonate buffering system, carbon dioxide and water join to form ___________, which dissociates into hydrogen and ________________. bicarbonate, carbonic acid bicarbonate, oxygen bicarbonate, carbon dioxide carbonic acid, bicarbonate carbonic acid, carbon dioxide

carbonic acid, bicarbonate

Question 5 of 5 A client's gastrointestinal contents were aspirated during surgery. The arterial blood gas values show a pH of 7.55, partial pressure of carbon dioxide of 52 mmHg, and bicarbonate concentration of 40 milliequivalent per liter. What is the underlying disorder? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

metabolic alkadosis

Question 5 of 5 A significant loss of acidic gastric fluids via vomiting may cause _______________. metabolic acidosis metabolic alkalosis respiratory acidosis respiratory alkalosis

metabolic alkadosis