Acid Base Balance practice

For the child experiencing excessive vomiting secondary to pyloric stenosis, the nurse should assess the child for which of the following acid-base imbalances? 1. Respiratory alkalosis. 2. Respiratory acidosis. 3. Metabolic alkalosis. 4. Metabolic acidosis

3

preop med to reduce salivation increase hr for brady cardia to dilute pupils for eye exam *contraindicated in pts with narrow angled glaucoma

Atropine

used to treat symptoms of cardiac decompensation given as a drip must be diluted monitor serum k levels use short term if infiltrates tissue necrosis may occur

Dobutamine

increases cardiac output IV only improves bp *do not give to pts taking MAOIS*

Dopamine

allergic reactions

Epinephrine

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? A. albuterol nebulizer B. chest x-ray C. ipratropium inhaler D. sputum culture

a

A client with Guillian-Barre syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirm respiratory acidosis? A. pH 7.25; PaCO2 50 mm Hg B. pH 7.29; PaCO2 30 mm Hg C. pH 7.35;PaCO2 70 mm Hg D. pH 7.5; PaCO2 30 mm Hg

a

A 75-year old client who complains of a "sour stomach" has been taking baking soda (sodium bicarb) regularly as a self-treatment. This may place the client at risk for what acid-base imbalance? A. metabolic acidosis B. respiratory alkalosis C. respiratory acidosis D. metabolic alkalosis

d

Which mental status change may occur when a client with pneumonia is first experiencing hypoxia? A. coma B. irritability C. apathy D. depression

b

A nurse working in the emergency department receives arterial blood gas results on four clients. Which laboratory results require immediate nursing interventions? A. pH 7.28, PaCO2 60 mm Hg, and PaO2, 58 mm Hg B. pH 7.48, PaCO2 35 mm Hg, and PaO2, 65 mm Hg C. pH 7.34, PaCO2 33 mm Hg, and PaO2, 80 mm Hg D. pH 7.33, PaCO2 58 mm Hg, and Pa02 65 mm Hg

a

A client experiencing an acute panic attack develops respiratory alkalosis. The Nurse measures a respiratory rate of 46 breaths per minute a heart rate of 110 bpm a blood pressure of 162/90 mm Hg, and a temperature of 98.6 (37 C ) which action will the nurse implement first? A. administer albuterol inhaler B. instruct the client to breathe into a paper bag C. administer sodium bicarb IV D. Apply oxygen via nasal cannula

b

A client with a diagnosis or respiratory acidosis is experiencing renal compensation. What function does the kidney perform to assist in restoring acid-base balance? A. excreting bicarbonate in the urine B. returning bicarbonate to the body's circulation C. returning acid to the body's circulation D. sequestering free hydrogen ions in the nephrons

b

A nurse is reviewing arterial blood gas (ABG) results on four clients. Which results would the nurse report immediately to the healthcare provider? A. pH 7.36, PaO2 86 mm Hg, PaCO2 55 mm Hg, HCO3 30 mEq/L and 02 sat 90%. B. pH 7.31, Pa02 84 mm Hg PaCO2 50 mm Hg, HCO3 24 mEq/L and 02 90% C. ph 7.35, PaO2 82 mm Hg, PaCO2 44 mm Hg, HCO3 mEq/L and 02 95% D. ph 7.45, PA02 90 mm Hg, PaCO2 28 mm Hg, HCO3 32 mEq/L and 02 sat 98%.

b

The nurse has received lab reports from several clients undergoing care. Which set of arterial blood gas (ABG), results will the nurse investigate first? A. pH 7.34, PaCO2 36 mm Hg ,PaO2 95 mm Hg, HCO3 20 mEq/L B. PH 7.49, PaCO2 30 mm Hg, PaO2 75 mm Hg, HCO3 22 mEq/l C. pH 7.35, PaCo2 48 mm Hg, PaO2 91 mm Hg, HCO3 28 mEq/L D. pH 7.47, PaCO2 43 mm Hg, PaO2 99 mm Hg, HCO3 29 mEq/L

b

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? A. nausea or vomiting B. hallucinations or tinnitus C. light-headedness or paresthesia D. abdominal pain or diarrhea

c

A client with emphysema is at a greater risk for developing which acid-base imbalance? A. chronic metabolic acidosis B. respiratory alkalosis C. metabolic alkalosis D. chronic respiratory acidosis

d