PATHOPHYSIOLOGY Chapter 8 - PrepU

The nurse who is providing care for several clients recognizes which client is at the highest risk for developing an acid-base imbalance?

A client who is being treated for acute kidney injury and who requires dialysis

In which client would the nurse be most likely to assess the signs and symptoms of an acid-base imbalance?

A client with chronic obstructive pulmonary disease (COPD) whose most recent arterial blood gases reveal a PCO2 of 51 mm Hg

A client tells the nurse that the client has been taking Alka-Seltzer (bicarbonate—antacid) four times a day for the past 2 weeks for an upset stomach. Upon assessment of the client, the nurse notes hyperactive reflexes, tetany, and mental confusion. Arterial blood gases reveal pH 7.55; serum HCO3− 37 mEq/L (37 mmol/L). The nurse suspects the client may be experiencing:

Metabolic alkalosis

The nurse is administering a unit of packed red blood cells to a client and piggybacks the unit of blood through a solution of 0.9% NaCl. Blood cells placed in a solution of 0.9% saline will do which of the following?

Neither shrink nor swell

The nurse is caring for a client with a serum sodium level of 128 mEq/L (128 mmol/L). Which physiologic event is an expected result of this blood value?

Swelling of cells

A nurse is caring for a client with a low sodium level and increased water retention. Hematocrit and blood urea nitrogen levels are decreased, urine osmolality is high, and serum osmolality is low. A chest x-ray shows a possible lung mass. Based on these findings, which problem could the client be diagnosed with?

Syndrome of inappropriate antidiuretic hormone

A client with a blood glucose reading of 673 mg/dl (37.4 mmol/l) is diagnosed with diabetic ketoacidosis (DKA). Blood gas results are as follows: serum pH 7.29; HCO3−level 19 mEq/dl (19 mmol/l); PCO2 level 32 mm Hg. The nurse should prepare for which initial treatment orders?

initiation of an insulin IV infusion along with fluid replacement

Which unit of measure best describes the concentration of solute in a particular volume of fluid based on electrolyte equivalency?

mEq/L

When caring for the client with hyperkalemia, the nurse recognizes the body should respond in which of these ways?

secrete potassium in the distal tubules for excretion

A client is admitted to the emergency department with possible internal bleeding after being involved in an automobile accident. What type of isotonic intravenous (IV) solution does the nurse prepare to infuse?

0.9% NaCl

Body weight consists of which percentage of body water?

60%

The nurse has just received the laboratory results of a client's calcium level. The nurse identifies a normal calcium level as:

8.5 to 10.5 mg/dl (2.25 mmol/l to 2.6 mmol/l)

The nurse is caring for a client with an acid-base imbalance. Which of these does the nurse recognize is correct regarding compensation?

A pH moves toward the normal range.

A client's most recent laboratory results suggest the presence of metabolic alkalosis. What action by the nurse best addresses a potential cause of this acid-base imbalance?

Administering an antiemetic to treat the client's frequent vomiting

The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of:

Bicarbonate

A client is admitted after losing 44 lb (20 kg) over the past 3 months, largely due to frequent vomiting. What intervention should the nurse anticipate in the treatment of the client's resulting acid-base imbalance?

Fluid replacement with an intravenous solution containing electrolytes as prescribed

When caring for a client with hypomagnesemia, the nurse prioritizes assessment of which body system?

Cardiac

The nurse is caring for a client who receives hemodialysis. The nurse knows that hemodialysis involves movement of charged or uncharged particles along a concentration gradient. Which function best describes this process?

Diffusion

A client with ethylene glycol toxicity is restless, and stating he has flank pain. What intervention should the nurse perform to minimize complications?

Increase IV fluids

Which intervention is a priority for the nurse when caring for a client with hypokalemia?

Initiating cardiac monitoring

A female client with a history of chronic renal failure has a total serum calcium level of 7.9 mg/dL (1.98 mmol/L). While performing an assessment, the nurse should focus on which clinical manifestation associated with this calcium level?

Intermittent muscle spasms and reports of numbness around her mouth

A client has been ill for several days and has not had anything to eat, consuming only about 6 oz of water per day. The client has been vomiting and having diarrhea. Which condition is the nurse most concerned about the client developing?

Ketoacidosis

There are two types of diabetes insipidus (DI): neurogenic and nephrogenic. In nephrogenic DI, there is an inability of the kidney to concentrate urine and to conserve free water. Nephrogenic DI can be either genetic or acquired. What are the causes of nephrogenic DI?

Lithium and hypokalemia

The nurse is caring for a client who has excessive diarrhea. Which acid-base disturbance does the nurse anticipate will result from having excessive diarrhea?

Metabolic acidosis

A client with schizophrenia is admitted to the behavioral health department and is observed drinking copious amounts of water and voiding large amounts of dilute urine. The nurse recognizes this behavior is consistent with which problem?

Psychogenic polydipsia

What is the nurse's expectation about a client's ability to compensate for a metabolic blood gas disorder?

The client will compensate with the respiratory system.