Unit 2
What is one of the causes of acidosis?
kidney failure
Which fruit will the nurse remove from the dietary tray of a patient with high potassium levels?
kiwi
Which organs play major roles in maintaining pH balance in the body?
lungs and kidneys
A patient has been having acute diarrhea for more than 24 hours from a viral infection. Which acid-base imbalance is most likely to manifest?
metabolic acidosis
Which arterial blood gas laboratory values would be seen in metabolic alkalosis?
pH 7.49, HCO 3 - 32
A patient with severe hypokalemia is prescribed parenteral administration of potassium. How does the nurse administer potassium to the patient?
1 mEq of potassium to 10 mL intravenous solution
A patient with hyperkalemia is being treated with drugs to improve the condition. Which potassium level indicates that therapy is effective?
4.6 mEq/L
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.
The lab values for a patient admitted for an exacerbation of chronic obstructive pulmonary disease (COPD) reveal a pH of 7.29 with a decreased PaO 2 and an elevated PaCO 2. Which initial treatment does the nurse expect the provider to most likely order?
Bronchodilator therapy
The nurse manager of a medical-surgical unit is completing assignments for the day shift staff. The patient with which electrolyte laboratory value is assigned to the LPN/LVN?
Calcium level of 9.5 mg/dL
The nurse is assessing the laboratory reports of a patient with impaired kidney function. What changes most indicate the patient has metabolic acidosis?
Decrease in serum bicarbonate level
When caring for a patient with metabolic acidosis, what must the nurse keep in mind regarding acid-base chemistry?
Fluids with lower pH have higher acidity.
The nurse is reviewing assessment data for a patient who was admitted for emergency treatment of an acute asthmatic episode. Which assessment data suggest the patient is in an uncompensated acid-base imbalance?
HCO 3- of 24 mEq/L
The nurse instructs an older adult patient to increase intake of dietary potassium when the patient is prescribed which classification of drugs?
High-ceiling (loop) diuretics
The nurse is caring for a patient who is receiving intravenous (IV) magnesium sulfate. Which assessment parameter is critical?
Hourly deep tendon reflexes (DTRs)
A patient is admitted to the hospital with a heart rate of 166 beats/min, increased thirst, restlessness, and agitation. Which electrolyte imbalance does the nurse suspect?
Hypernatremia
A patient has a low serum potassium level and is ordered a dose of parenteral potassium chloride (KCl). How does a nurse safely administer KCl to the patient?
Infuses 10 mEq over a 1-hour period
Which laboratory value requires a priority response by the nurse to notify the primary health care provider?
Magnesium 4.2 mEq/L
The nurse is reviewing lab values for a patient recently admitted to the medical-surgical unit. Which lab result is severely abnormal?
Magnesium, 6.2 mEq/L
To decrease the risk of acid-base imbalance, what goal must the patient with diabetes mellitus strive for?
Maintaining blood glucose level within normal limits.
When evaluating the laboratory results of a patient with diabetic ketoacidosis, which lab value indicates the body has fully compensated from this acid-base imbalance?
Normal pH on arterial blood gases
The nurse is assessing the laboratory profiles of patients with acid-base imbalances. Which patient diagnosis correctly correlates to the appropriate lab values?
Patient D has respiratory depression.
A diabetic patient shows symptoms of diabetic ketoacidosis. What mechanism causes acidosis in this patient?
Overproduction of hydrogen ions
The nurse has just received a report on a patient being admitted from the emergency department (ED). Which items from the report would contribute to the development of metabolic acidosis? Select all that apply.
Reported heavy alcohol consumption Chronic cirrhosis of the liver with liver failure Seizure in the ambulance en route to the hospita
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
A patient with diabetes mellitus is brought to the emergency department after vomiting for several days. The patient has rapid, deep respirations and a urine dipstick reveals ketonuria. Which process does the nurse suspect is occurring with this patient?
Respiratory compensation for metabolic acidosis
Which are common symptoms of hypokalemia? Select all that apply.
Shallow respirations Weak, thready pulse Musculoskeletal weakness
A 90-year-old patient with hypermagnesemia is seen in the emergency department (ED). The ED nurse prepares the patient for admission to which inpatient unit?
Telemetry/cardiac stepdown
The nurse is planning care for a patient with hypocalcemia. Which nursing action is appropriate to delegate to unlicensed assistive personnel (UAP)?
Transferring the patient from the bed to a stretcher using a lift sheet
Which hormone regulates fluid and electrolyte balance by preventing water and sodium loss?
aldosterone
What is one of the causes of respiratory alkalosis?
anxiety
How does the body compensate for a low pH?
increase respiratory rates
Hyponatremia most affects the cells of which body systems? Select all that apply.
cerebral, cardiovascular, and neuromuscular
A patient has been poisoned by botulinum toxins. What assessment findings suggest the patient has acidosis? Select all that apply.
confusion warm, flushed, dry skin
Which conditions can cause metabolic acidosis? Select all that apply.
diarrhea, liver failure, kidney failure
When treating a patient for hyponatremia, which type of drug must be altered to decrease sodium loss?
diuretics
A patient is admitted with severe diabetic ketoacidosis. Arterial blood gas results reveal a pH of 7.21. What is this patient's acidosis most likely in response to?
excessive breakdown of fatty acids
Positive Trousseau's and Chvostek's signs are consistent with which electrolyte imbalance?
hypocalcemia
When assessing the laboratory results of a patient who has hypomagnesemia, for which additional electrolyte imbalance should the nurse monitor?
hypocalcemia
Which electrolyte imbalance should be anticipated and monitored in a patient with hyperphosphatemia?
hypocalcemia
A patient admitted with diabetic ketoacidosis was treated for metabolic acidosis with intravenous (IV) fluids and insulin. Which electrolyte imbalance does the nurse monitor for as the acid-base imbalance resolves?
hypokalemia
An electrocardiogram (ECG) is ordered for a patient who was placed on intravenous (IV) fluids containing potassium. Which ECG finding is consistent with hyperkalemia?
prolonged PR intervals
When caring for a patient with kidney failure who has metabolic acidosis, which symptom does the nurse expect as evidence of the body's compensatory effort?
rapid and deep respirations
A lab report for a 47-year-old patient shows the following results: pH 7.32; bicarbonate 24; PaO 2 77; PaCO 2 48. These findings are consistent with which acid-base imbalance?
respiratory acidosis
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
What is the major cause of death in patients diagnosed with hypokalemia?
respiratory insufficiency
Which electrolyte deficiency results in decreased depolarization in the excitable cells and increased cellular swelling?
sodium
Which electrolyte excess results in irritability and severe cellular dehydration?
sodium