Patho M9: Acid-Base Imbalances
A nurse cares for a client with chronic respiratory acidosis who is placed on mechanical ventilation for an acute exacerbation of emphysema. Which acid-base abnormality will the nurse expect if the client's PaCO2 is corrected too quickly? A. pH 7.52 B. HCO3 18 mmoL/L C. HCO3 24 mmoL/L D. pH 7.35
A
The nurse cares for a client with metabolic acidosis and hyperphosphatemia. What pathophysiological process does the nurse recognize is the reason for the client's phosphate abnormality? A. Depression of glycolysis B. Ionized calcium is decreased C. Hydrogen ions move out of the cells D. Positive and negative ions enter the cells
A
The nurse reviews arterial blood gas results and notes the client has a metabolic acidosis. Which organ does the nurse expect will compensate for the client's acid-base imbalance? A. Lungs B. Brain C. Liver D. Kidneys
A
A client with renal impairment presents with an acid-base imbalance. Which mechanisms does the nurse recognize may be impaired? Select all that apply. A. Excretion of hydrogen buffered by ammonia. B. Secretion of bicarbonate into the urine. C. Resorption of hydrogen from the nephron into the blood. D. Secretion of hydrogen into the urine. E. Resorption of bicarbonate from the renal tubule into the blood.
A, D, & E
The nurse is caring for a client with uncompensated respiratory acidosis. Which acid-base findings will the nurse anticipate? Select all that apply. A. pH 7.29 B. pH 7.48 C. HCO3 18 mmoL/L D. HCO3 23 mmoL/L E. PaCO2 50 mmHg
A, D, & E
The nurse cares for a pediatric client who has accidentally taken an overdose of antacids. Which acid-base abnormality does the nurse anticipate the client will manifest? A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis
C
The nurse cares for four clients with acid-base imbalances. Which client is most likely experiencing metabolic alkalosis? A. Child with severe diarrhea. B. Older adult with a diagnosis of salicylate poisoning. C. Adult who has had lactated Ringer's solution infusing for 72 hours. D. Adolescent with a diagnosis of diabetic ketoacidosis.
C
The nurse is caring for a client with acute respiratory acidosis and notes the client's rate and depth of breathing are increased. What is the nurse's understanding of the cause of this finding? A. As the pH increases, the respiratory rate increases. B. As the carbon dioxide level decreases, the respiratory rate increases. C. Respiratory muscles increase the force of contraction with excess hydrogen levels in the blood. D. The diaphragm weakens with excess hydrogen levels in the blood.
C
A client with congestive heart failure is voiding large amounts of urine via indwelling urinary catheter. Which acid-base balance does the nurse recognize the client is at greatest risk for developing? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory alkalosis D. Respiratory acidosis
B
A client with liver failure is diagnosed with metabolic acidosis. What pathophysiological mechanism does the nurse recognize is the cause of the client's acid-base imbalance? A. Poor tissue perfusion and anaerobic metabolism. B. Impaired clearance of lactate. C. Volume deficit and loss of gastric acid. D. Impaired clearance of hydrogen ions.
B
A nurse cares for a client with hyperpyrexia due to pyelonephritis. Which acid-base imbalance is most likely with this client? A. Metabolic acidosis B. Respiratory alkalosis C. Respiratory acidosis D. Metabolic alkalosis
B
An older adult client presents to the emergency room with a severe acid-base imbalance after taking "cold medicine" for a week. The client has a history of arthritis and reports daily use of aspirin. Which late effect acid-base imbalance does the nurse suspect the client is experiencing? A. Respiratory alkalosis B. Metabolic acidosis C. Respiratory acidosis D. Metabolic alkalosis
B
The nurse cares for a critically ill client with a severe acid-base imbalance. When reviewing the client's anion gap, which additional laboratory value does the nurse recognize may skew the anion gap results? A. Hemoglobin B. Albumin C. PaCO2 D. PaO2
B
The nurse is caring for a client with respiratory acidosis. Which compensatory mechanism does the nurse understand will act to normalize the client's acid-base balance? A. Kidneys excrete bicarbonate. B. Kidneys reabsorb bicarbonate. C. Hypoventilation retains carbon dioxide. D. Hyperventilation releases carbon dioxide.
B
The nurse is caring for a client with an acid-base imbalance. The nurse recognizes that the client has an alteration in protein function due to the imbalance. Proteins are components of which pathophysiological concept or process? Select all that apply. A. Metabolic reaction catalysts B. Receptors C. Production of cellular energy D. Ion channels E. Ion pumps
B, D, & E
The nurse cares for a client with acute respiratory acidosis. Which central nervous system (CNS) manifestation will the nurse likely find? A. Parasthesias B. Anxiety C. Papilledema D. Dizziness
C
The nurse is caring for a client with metabolic alkalosis. The health care provider prescribes acetazolamide for the treatment of the client's condition. What is the nurse's understanding of the purpose of this treatment? A. It decreases carbonic acid levels in the blood. B. It increases renal resorption of bicarbonate. C. It increases renal excretion of bicarbonate. D. It decreases urinary output and hydrogen loss.
C
The nurse cares for a client experiencing prolonged vomiting resulting in metabolic alkalosis. Which physiologic effect of alkalosis does the nurse recognize? A. Decreased cardiac contractility. B. Movement of potassium out of the cells in exchange for hydrogen into the cells. C. Increased level of free calcium blocking sodium channels. D. Increased glycolysis and utilization of phosphate.
D
The nurse cares for a client with an acid-base imbalance. Which electrolyte imbalance will most likely cause respiratory acidosis? A. Hyponatremia B. Hypernatremia C. Hyperkalemia D. Hypokalemia
D
The nurse is reviewing the arterial blood gas results of a client. When comparing various components of the ABG, which statement does the nurse recognize is true? A. The lower the PaCO2, the lower the pH. B. The higher the HCO3, the lower the pH. C. The higher the pH, the higher the H+ concentration. D. The lower the pH, the higher the H+ concentration.
D