Pre-Assessment for Acid-Base Balance

The nurse is providing client teaching to a client with metabolic acidosis. What statement should the nurse include with teaching? "With metabolic acidosis, the heart and lungs compensate." "Metabolic acidosis can be due to excess bicarbonate." "Metabolic acidosis can be due to a loss of acid." "Metabolic acidosis is any acidosis not due to a respiratory issue."

"Metabolic acidosis is any acidosis not due to a respiratory issue."

A registered nurse is teaching about chemical buffers. Which statement about bicarbonate buffers indicates a need for further teaching? Select all that apply.

- "They are found in the intracellular fluids as bicarbonates." -"They proved especially effective in the renal tubules." -"They work by binding with acids and bases to neutralize them."

Which is true regarding uncompensated arterial blood gas (ABG)? Select all that apply. In uncompensated ABG, PaCO2 or HCO3- is abnormal. In uncompensated ABG, there is no indication that the renal or respiratory system has tried to correct the imbalance. In uncompensated ABG, pH is normal. In uncompensated ABG, pH is abnormal. In uncompensated ABG, both PaCO2 and HCO3- are abnormal.

- In uncompensated ABG, PaCO2 or HCO3- is abnormal. - In uncompensated ABG, there is no indication that the renal or respiratory -In uncompensated ABG, pH is abnormal.

Which is true regarding uncompensated arterial blood gas (ABG)? Select all that apply.

- In uncompensated ABG, PaCO2 or HCO3- is abnormal. - In uncompensated ABG, there is no indication that the renal or respiratory system has tried to correct the imbalance. -In uncompensated ABG, pH is abnormal.

The nurse is caring for a patient with a low PaO2 level. Which is correct regarding oxygenation and PaO2? Select all that apply

- PaO2 value indicates the partial pressure of oxygen in arterial blood and is the most important factor in determining how oxygen binds to hemoglobin - PaO2 values, when high, indicate more oxygen is able to bind with hemoglobin. - PaO2 values, when low, indicate less oxygen is able to bind with hemoglobin

The nurse is caring for a patient with a low PaO2 level. Which is correct regarding oxygenation and PaO2? Select all that apply. PaO2 value indicates the partial pressure of oxygen in arterial blood and is the most important factor in determining how oxygen binds to hemoglobin. PaO2 values, when high, indicate more oxygen is able to bind with hemoglobin. PaO2 values, when low, indicate less oxygen is able to bind with hemoglobin. PaO2 values lower than normal are associated with high levels of supplemental oxygen administration. PaO2 values higher than normal indicate hypoxemia.

- PaO2 value indicates the partial pressure of oxygen in arterial blood and is the most important factor in determining how oxygen binds to hemoglobin. - PaO2 values, when high, indicate more oxygen is able to bind with hemoglobin. - PaO2 values, when low, indicate less oxygen is able to bind with hemoglobin.

A nurse is providing a nonpulmonary treatment to a patient who has developed respiratory acidosis postsurgery. Which treatment is an example of nonpulmonary treatment? Performing chest tube insertion to increase lung expansion or remove drainage Providing heart failure treatment like diuretics for decreasing fluid in the lungs Removing a foreign body from the airway, if required Inserting an artificial airway for performing mechanical ventilation

- Providing heart failure treatment like diuretics for decreasing fluid in the lungs

A nurse checks the arterial blood gas (ABG) results of an older adult and finds that the patient's pH is 7.34, PaCO2 is 46 mm Hg and, if compensated, then the HCO3-is 27 mEq/L. What is the nurse's interpretation of the patient's condition by looking at these values? - Metabolic alkalosis - Respiratory alkalosis - Metabolic acidosis - Respiratory acidosis

- Respiratory acidosis

This patient has smoked for over 40 years and has advanced lung disease. What acid-base imbalance would the nurse anticipate seeing with the arterial blood gases? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

- Respiratory acidosis

Which clinical symptoms are observed in a patient who has developed preoperative metabolic acidosis? Select all that apply.

- Warm, flushed skin - Peripheral vasodilation - Kussmaul respiration

Which is true regarding metabolic acidosis? Select all that apply.

- metabolic acidosis occurs due to bicarbonate deficit -the lungs eliminate more carbon dioxide in response to metabolic acidosis - Rate and depth of respirations increase in response to metabolic acidosis

A nurse is performing an Allen's test on a postsurgical care patient. Arrange the order in which the nurse should perform the task.

- rest the patient's arm on the mattress or bedside stand - support wrist of the patient with a rolled towel. - instruct the patient to clench his/her fist. - Press on radial and ulnar arteries and hold this position for a few seconds. - w/o removing the fingers from the patient's arteries, advise the patient to unclench his/her fist and hold it in a relaxed position. - release pressure on the patient's ulnar artery -if the hand. becomes flushed, safely proceed with radial artery puncture. - if the hand does not become flushed, select another site for puncture.

Which steps followed by a nurse while caring for a patient with respiratory acidosis are examples of respiratory treatment? Select all that apply.

- use bronchodilators to open constricted airways - provide chest physiotherapy (PT) to remove secretions from the lungs - Administer antibiotics to treat infection

What is the normal HCO3- level in blood? 22 to 26 mEq/L 35 to 45 mm Hg 7.35 to 7.45 < 22 mEq/L

22 to 26 mEq/L

What is the normal PaCO2 level in blood? 7.35 to 7.45 22 to 26 mEq/L 35 to 45 mm Hg < 35 mm Hg

35 to 45 mm Hg

What is normal blood pH?

7.35

A nurse is caring for a patient who has developed postsurgical metabolic alkalosis. What should the nurse expect the primary health-care provider to prescribe to increase renal excretion of bicarbonate?

Acetazolamide

Metabolic acidosis is indicated by which arterial blood gas result? Within range pH and increased carbon dioxide levels Decreased serum pH and bicarbonate levels Increases in serum pH and bicarbonate levels Decrease in serum pH and increases in both carbon dioxide and bicarbonate levels

Decreased serum pH and bicarbonate levels

A nurse is caring for a patient who has been admitted in the intensive care unit due to excess use of bicarbonate. Which type of acid-base imbalance is most likely to result from excess use of bicarbonate?

Metabolic alkalosis

A registered nurse is teaching about partial pressure of CO2 in arterial blood (PaCO2). Which statement indicates a need for further teaching?

PaCO2 level when higher than 45 mm Hg indicates alkalosis

A nurse is providing a nonpulmonary treatment to a patient who has developed respiratory acidosis postsurgery. Which treatment is an example of nonpulmonary treatment?

Providing heart failure treatment like diuretics for decreasing fluid in the lungs.

A nurse checks the arterial blood gas (ABG) results of an older adult and finds that the client's pH is 7.46, PaCO2 is 34 mm Hg and, if compensated, then the HCO3 is 21 mEq/L. What should be the nurse's interpretation of the patient's condition by looking at these values?

Respiratory alkalosis

A nurse is caring for a patient experiencing hepatic failure. Which acid-base imbalance should the nurse expect to occur in the patient?

Respiratory alkalosis

What are the component parts of an arterial blood gas? Select all that apply. Serum pH levels Pulse oximetry Bicarbonate level Carbon dioxide level Oxygen

Serum pH levels Bicarbonate level Carbon dioxide level Oxygen

Which statement is incorrect regarding the characteristics of a renal buffer?

The renal buffer is the least effective, yet fastest acting, buffering system

Which statement is incorrect regarding the characteristics of a renal buffer? The renal buffer acts by regulating bicarbonate levels. The renal buffer in the kidneys excretes HCO3- in a state of alkalosis. The renal buffer is the least effective, yet fastest acting, buffering system. The renal buffer in the kidneys excretes H+ in a state of acidosis.

The renal buffer is the least effective, yet fastest acting, buffering system.

A nurse is caring for a patient who has developed postoperative respiratory acidosis. What is the most likely cause of respiratory acidosis?

bronchial obstruction

The nurse is caring for a patient with an acid-base imbalance. Which respiratory condition can cause respiratory alkalosis

hyperventilation

The nurse is caring for a patient with an acid-base imbalance. Which respiratory condition can cause respiratory alkalosis?

hyperventilation

A client's diagnostic test results indicate an increased anion gap. Based on this finding, what would the nurse anticipate that the client's labs reveal? Respiratory acidosis Metabolic acidosis Respiratory alkalosis Metabolic alkalosis

metabolic acidosis

A nurse is caring for a patient who developed an intestinal fistula after abdominal surgery. Which acid-base imbalance may occur in the patient because of intestinal fistula?

metabolic acidosis

Which finding in a client's arterial blood gas result indicates a normal blood pH level? pH value of 7.30 pH value of 7.25 pH value of 7.42 pH value of 7.55

pH value of 7.42

A nurse is checking the arterial blood gas (ABG) results of an older adult who has developed postsurgical acid-base imbalance. Which ABG result confirms that the patient has developed metabolic acidosis?

ph < 7.35 and HCO3- <22 mEq/L; if compensated, then the PCO2 < 35 mm Hg

A nurse is checking the arterial blood gas (ABG) results of an older adult who has developed postsurgical respiratory alkalosis. Which ABG result confirms that the patient has developed respiratory alkalosis?

ph > 7.45 and PaCO2 <35 mm Hg; if compensated, then the HCO3- < 22mEq/L

Hydrogen ion excess in the blood can lead to the disorders of which organ systems? Select all that apply.

respiratory neuromuscular cardiac