PP Acid/Base
The client is severely hypoxic.
A client has the following arterial blood gas values: pH, 7.52; PaO2, 50 mm Hg (6.7 kPa); PaCO2, 28 mm Hg (3.72 kPa); HCO3- 24 mEq/L (24 mmol/L). Based upon the client's PaO2, which nursing clinical judgment should the nurse make?
monitor the client's vital signs, serum electrolyte levels, and acid-base balance.
A client is admitted to the psychiatric clinic for treatment of anorexia nervosa. At the beginning of the client's hospitalization, the most important nursing action is to:
irregular heart rate
A client is in a metabolic acidosis from severe diarrhea. What assessment finding would be most concerning?
5% Dextrose in 0.45% normal saline with KCl 40 mEq/L at 125 mL/h
A client receiving chemotherapy for metastatic colon cancer is admitted to the hospital because of prolonged vomiting. Irregular pulse of 120 bpm, blood pressure 88/48, respiratory rate of 14 breaths/min, serum potassium of 2.9 and ABG—pH 7.46, PCO2 45 mm Hg (6.0 kPA), PO2 95 mm Hg (12.6 kPa), bicarbonate level 29 mEq/L (29 mmol/L). The nurse should implement which prescription first?
Returning bicarbonate to the body's circulation
A client with a diagnosis of respiratory acidosis is experiencing renal compensation. What function does the kidney perform to assist in restoring acid-base balance?
respiratory alkalosis
A client with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause of:
The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance.
A medical nurse educator is reviewing a client's recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?
80. First calculate the pulse pressure (subtract the DBP from the SBP) and divide that by 3, then add the DBP: 120-60=60. 60/3=20. 20+60=80
A nurse is assessing a client with increasing intracranial pressure. What is a client's mean arterial pressure (MAP) in mm Hg when blood pressure (BP) is 120/60 mm Hg? Record your answer using a whole number.
Obtaining a patent intravenous site
A nurse is caring for a 12-month-old infant with dehydration with resulting metabolic acidosis. The infant exhibits lethargy and poor skin turgor. Which of the following actions by the nurse takes priority?
Tachypnea
A nurse reviews the arterial blood gas (ABG) values of a client with complaints of difficulty breathing: pH, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm Hg; and HCO3--, 24 mEq/L. What assessment finding would the nurse anticipate based on these blood gases?
Notify the HCP that the membranes are ruptured.
A primigravid client at 38 weeks' gestation comes to the labor room because "my water broke." The health care provider (HCP) asks the nurse to verify spontaneous rupture of membranes using nitrazine paper. The nurse observes that the nitrazine paper turns bright blue. What action should the nurse take next?
metabolic acidosis
The nurse should assess the client with severe diarrhea for which acid-base imbalance?
Thoracic skeletal changes
What factor has the potential to lead to chronic respiratory acidosis in older adults?
Carbon Dioxide (CO2)
When a client's ventilation is impaired, the body retains which substance?
pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28
Which of the following arterial blood gas (ABG) results would the nurse anticipate for a client with a 3-day history of vomiting?
Hypoventilation due to inability to take deep breaths because of pain
Which of the following findings would be expected in a client with chest trauma, rib fractures, and respiratory acidosis?
Increased Intracranial Pressure (ICP)
Which of the following may occur with respiratory acidosis?
respiratory alkalosis
The nurse observes a client with an onset of heart failure having rapid, shallow breathing at a rate of 32 breaths/minute. What blood gas analysis does the nurse anticipate finding initially?
pH 7.24
Arterial blood gas analysis would reveal which of the following related to acute respiratory failure?
Slow, irregular respirations
Which respiratory pattern indicates increasing intracranial pressure in the brain stem?
restlessness
Which sign is an early indicator of hypoxia in the unconscious client?
"My stomach feels better."
Which statement made by a client who is taking misoprostol, indicates a therapeutic outcome of therapy?
Albuterol Nebulizer
A client experiencing a severe asthma attack has the following arterial blood gas results: pH 7.33; Pco2 48 mm Hg (6.4 kPa); Po2 58 mm Hg (7.7 kPa); HCO3 26 mEq/L (26 mmol/L). Which prescription should the nurse implement first?
pH 7.32 Potassium 5.8 mEq/L
A nurse is caring for an older adult client who is admitted with an electrolyte imbalance. Which laboratory values should be a priority concern for the nurse? Select all that apply.
respiratory acidosis
As status asthmaticus worsens, the nurse would expect the client to experience which acid-base imbalance?
compensated respiratory alkalosis
Upon shift report, the nurse learns the following laboratory values: pH, 7.44; PCO2, 30mmHg; and HCO3,21 mEq/L for a client with noted acid-base disturbances. Which acid-base imbalance is the client most likely experiencing?
IV fluids to increase urine output and allopurinol to inhibit uric acid.
The client with leukemia received induction chemotherapy 2 days ago and is now reporting severe diarrhea, decreased urination, cardiac dysrhythmias, and parasthesias with tetany. Laboratory reports reveal hyperkalemia, hyperuricemia, and hypocalcemia. Which of the following actions would the nurse anticipate?
metabolic alkalosis
The nurse is caring for a client admitted with pyloric stenosis. A nasogastric tube placed upon admission is on low intermittent suction. Upon review of the morning's blood work, the nurse observes that the patient's potassium is below reference range. The nurse should recognize that the patient may be at risk for what imbalance?
Partial pressure of arterial oxygen (PaO2) of 69 mm Hg
The nurse is caring for a client with acute respiratory distress syndrome. What portion of arterial blood gas results does the nurse find most concerning, requiring intervention?
pH 7.20, PaCO2 36, HCO3 14-
The nurse is caring for a client with end-stage kidney disease. What arterial blood gas results are most closely associated with this disorder?
"I took my metformin this morning."
The nurse is preparing a client for a cardiac catheterization. Which of the following client statements would the nurse need to report to the healthcare provider immediately?
metabolic acidosis
The nurse is caring for a client with severe diarrhea. The nurse recognizes that the client is at risk for developing which of the following acid-base imbalances?
• Compare ABG findings with previous results. • Maintain intake and output records. • Document presenting signs and symptoms.
The physician has prescribed sodium chloride for a hospitalized 51-year-old client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply.
Maintain intake and output records. Document presenting signs and symptoms. Compare ABG findings with previous results.
The physician has prescribed sodium chloride for a hospitalized 51-year-old client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply.
