NUR336 Evolve: Chapter 12 - Assessment and Care of Patients with Acid-Base Imbalances
A patient admitted to the emergency department is having an acute episode of asthmatic bronchitis. The nurse notes the pH on the most recent arterial blood gas is 7.31. What is the most likely explanation for this finding?
Acidosis in response to the excessive retention of carbon dioxide.
A patient is admitted with chronic anemia. What physiologic imbalance does the nurse suspect the patient is at risk of developing?
Acidosis.
The nurse is caring for a patient with hypoxemia and metabolic acidosis. Which task can be delegated to the nursing assistant who is helping with the patient's care?
Apply the pulse oximeter for continuous readings.
After successful resuscitation of cardiopulmonary arrest, the nurse views these arterial blood gases: pH 7.28; CO 2 52; HCO 3 - 16. What is the interpretation of these values?
Combined respiratory and metabolic acidosis.
The nurse is assessing the laboratory reports of a patient with impaired kidney function. What changes indicate the patient has metabolic acidosis?
Decrease in serum bicarbonate level.
A new nurse graduate is caring for a postoperative patient with the following arterial blood gases (ABGs): pH 7.30; Paco 2 60 mm Hg; Pao 2 80 mm Hg; bicarbonate 24 mEq/L; and O 2 saturation 96%. Which of these actions by the new graduate is indicated?
Encourage the patient to use the incentive spirometer and cough.
A patient is admitted from the emergency department for intravenous (IV) fluids to treat dehydration caused by several days of vomiting and diarrhea. The patient's admission venous blood work reveals a pH of 7.27 and bicarbonate of 26 mEq/L; potassium and chloride levels are within normal ranges. The provider has ordered adding bicarbonate to the IV fluids. Which action by the nurse is correct?
Hold the bicarbonate and report the laboratory values to the provider.
Which electrolyte abnormality does the nurse anticipate when reviewing laboratory data for a patient admitted with metabolic acidosis?
Hyperkalemia.
Which electrolyte imbalance is the patient with metabolic acidosis at risk to develop?
Hyperkalemia.
What is one of the causes of acidosis?
Kidney failure.
The nurse is caring for a critically ill patient with septic shock. The serum lactate level is 6.2. For which acid-base disturbance should the nurse assess?
Metabolic acidosis.
A patient is recovering from an acute episode of chronic obstructive pulmonary disease (COPD). Which nursing action is the greatest priority in the plan of care?
Monitor the respiratory rate and effort hourly.
When caring for a group of patients at risk for respiratory acidosis, the nurse identifies which person as at highest risk?
Patient who smokes cigarettes.
After a motor vehicle crash, the nurse is consoling a patient in the emergency department who is hysterical and hyperventilating after being notified of the death of a family member. What acid-base imbalance is this patient likely to develop?
Respiratory alkalosis.
Lab results for a 62-year-old patient show the following results: pH 7.48; bicarbonate 26; Pao 2 90; Paco 2 32. These findings are consistent with which acid-base imbalance?
Respiratory alkalosis.
The trauma nurse is caring for a patient who sustained thoracic trauma with multiple rib fractures and flail chest. Which intervention may be considered to promote gas exchange and prevent respiratory acidosis in this patient?
Ventilatory assistance.
Which arterial blood gas reading does the nurse anticipate in a patient diagnosed with chronic obstructive pulmonary disease (COPD)?
pH 7.36, PaO2 63 mm Hg, PaCO2 52 mm Hg, HCO3- 32 mEq/L.
