Critical Care Hard ass PrepU

the nurse is reviewing the initial laboratory test results of a client diagnosed with DKA. Which of the following would the nurse expect to find?

-> With DKA, blood glucose levels are elevated to 300 to 1000 mg/dL or more. -> Urine contains glucose and ketones. -> The blood pH ranges from 6.8 to 7.3. -> The serum bicarbonate level is decreased to levels from 0 to 15 mEq/L. ->The compensatory breathing pattern can lower the partial pressure of carbon dioxide in arterial blood (PaCO2) to levels of 10 to 30 mm Hg.

Famotidine (Pepcid) mechanism of action

Blocks histamine H2 receptors on parietal cells of the stomach to decrease production of gastric acid Famotidine is useful for treating and preventing ulcers and managing gastroesophageal reflux disease. It functions by inhibiting the action of histamine at the H-2 receptor site located in the gastric parietal cells, thus inhibiting gastric acid secretion.

The nurse, caring for a patient with emphysema, understands that airflow limitations are not reversible. The end result of deterioration is:

Respiratory acidosis Decreased carbon dioxide elimination results in increased carbon dioxide tension (hypercapnia), which leads to respiratory acidosis and chronic respiratory failure.

What information will the nurse need to know in order to calculate a client's anion gap (AG)?

The anion gap is a diagnostic concept that describes the difference between the plasma concentration of the major measured cation sodium (Na+) and the sum of the measured anions chloride and bicarbonate (Cl- and HCO3-). The difference represents the concentration of unmeasured anions such as phosphates, sulfates, organic acid, and proteins.

Diabetic ketoacidosis (DKA) is a condition that mostly occurs in type 1 diabetics. What are the definitive diagnostic criteria for DKA?

definitive diagnosis of DKA consists of -> hyperglycemia (blood glucose levels >250 mg/dL), -> low bicarbonate (<15 mEq/L), and low pH (<7.3), with -> ketonemia (positive at 1:2 dilution) and moderate ketonuria.

client is admitted to the hospital with Cushing's syndrome. Which nursing interventions are appropriate for this client?

• Weigh the client daily. • Assess for peripheral edema. • Measure intake and output. Because weight gain and edema are common symptoms of Cushing's syndrome, appropriate interventions include assessing for peripheral edema, measuring intake and output, and weighing the client daily. A low-calorie, low-carbohydrate, high-protein diet is ordered for a client with this disorder. Fluid restriction is often prescribed as well. Treatment of Cushing's syndrome includes the administration of potassium replacements; therefore, restricting foods high in potassium would not be appropriate.

nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone?

Ketoralac (Toradol) Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ketorolac (Toradol) are effective in treating renal stone pain because they provide specific pain relief. They also inhibit the synthesis of prostaglandin E, reducing swelling and facilitating passage of the stone.

For which acid-base imbalance will the nurse monitor for a client taking large doses of loop diuretics?

Metabolic alkalosis Loop and thiazide diuretics commonly cause metabolic alkalosis as a result of hydrogen and potassium ion excretion in the urine. This leads to increased reabsorption of bicarbonate leading to metabolic alkalosis.

The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction Which acid-base imbalance is most likely to occur?

Metabolic alkalosis Metabolic alkalosis results in increased plasma pH because of an accumulated base bicarbonate or decreased hydrogen ion concentration. Factors that increase base bicarbonate include excessive oral or parenteral use of bicarbonate-containing drugs, a rapid decrease in extracellular fluid volume and loss of hydrogen and chloride ions as with gastric suctioning. Acidotic states are from excess carbonic acid and hydrogen ions in the system. Respiratory alkalosis results from a carbonic acid deficit that occurs when rapid breathing releases more CO2 than necessary.

history of Chronic cystitis comes to an outpatient clinic with signs and symptoms of this disorder. To prevent cystitis from recurring, the nurse recommends maintaining an acid-ash diet to acidify the urine, thereby decreasing the rate of bacterial multiplication. On an acid-ash diet, the client must restrict which beverage?

milk client on an acid-ash diet must avoid milk and milk products because these make the urine more alkaline, encouraging bacterial growth. Other foods to avoid on this diet include all vegetables except corn and lentils; all fruits except cranberries, plums, and prunes; and any food containing large amounts of potassium, sodium, calcium, or magnesium. Cranberry and prune juice are encouraged because they acidify the urine. Coffee and tea are considered neutral because they don't alter the urine pH.