Acid/Base Balance practice

A nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul's respirations. Based on this documentation, which of the following did the nurse observe? A. Respirations that are abnormally deep, regular, and increased in rate B. Respirations that are regular but abnormally slow C. Respirations that are labored and increased in depth and rate D. Respirations that cease for several seconds

A Kussmaul's respirations are abnormally deep, regular, and increased in rate. In bradypnea, respirations are regular but abnormally slow. In hyperpnea, respirations are labored and increased in depth and rate. Apnea is described as respirations that cease for several seconds.

A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that the client is most likely to experience what type of acid-base imbalance? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

A Respiratory acidosis is most often due to hypoventilation. Chronic respiratory acidosis is most commonly caused by chronic obstructive pulmonary disease. In end-stage disease, pathological changes lead to airway collapse, air trapping, and disturbance of ventilation-perfusion relationships.

A client is scheduled for blood to be drawn from the radial artery for an arterial blood gas determination. Before the blood is drawn, an Allen's test is performed to determine the adequacy of the A. popliteal circulation. B. ulnar circulation. C. femoral circulation. D. carotid circulation.

B Before radial puncture for obtaining an arterial specimen for arterial blood gases, you should perform an Allen's test to determine adequate ulnar circulation. Failure to determine the presence of adequate collateral circulation could result in severe ischemic injury to the hand if damage to the radial artery occurs with arterial puncture.

A nurse is caring for a client with renal failure. Blood gas results indicate a pH of 7.30, a PCO2 of 32 mmHg, and a bicarbonate concentration of 20 mEq/L. The nurse has determined that the client is experiencing metabolic acidosis. Which of the following laboratory values would the nurse expect to note? A. Sodium level of 145 mEq/L B. Magnesium level of 2.0 mg/dL C. Potassium level of 5.2 mEq/L D. Phosphorus level of 4.0 mg/dL

C Clinical manifestations of metabolic acidosis include hyperpnea with Kussmaul's respirations; headache; nausea, vomiting, and diarrhea; fruity-smelling breath resulting from improper fat metabolism; central nervous system depression, including mental dullness, drowsiness, stupor, and coma; twitching; and convulsions. Hyperkalemia will occur.

A nurse is caring for a client with an ileostomy understands that the client is at most risk for developing which acid-base disorder? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

C Intestinal secretions are high in bicarbonate and may be lost through enteric drainage tubes or an ileostomy or with diarrhea. These conditions result in metabolic acidosis.

A nurse understands that the excessive use of oral antacids containing bicarbonate can result in which acid-base disturbance? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

D Increases in base components occur as a result of oral or parenteral intake of bicarbonates, carbonates, acetates,citrates, or lactates. Excessive use of oral antacids containing bicarbonate can cause a metabolic alkalosis.

A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

D Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis as a result of the loss of hydrochloric acid.

A nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a PCO2 of 30 mmHg. The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition? A. Sodium level of 145 mEq/L B. Potassium level of f3.0 mEq/L C. Magnesium level of 2.0 mg/dL D. Phosphorus level of 4.0 mg/dL

B Clinical manifestations of respiratory alkalosis include headache, tachypnea, paresthesias, tetany, vertigo, convulsions, hypokalemia, and hypocalcemia. Options A, C, and D identify normal laboratory values.

A nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, PCO2 of 30 mmHg, and bicarbonate concentration of 22 mEq/L. The nurse analyzes these results as indicating A. metabolic acidosis, compensated. B. metabolic alkalosis, uncompensated. C. respiratory alkalosis, compensated. D. respiratory acidosis, uncompensated.

C The normal pH is 7.35 to 7.45. In a respiratory condition, an opposite effect will be seen between the pH and the PCO2. In this situation, the pH is at the high end of the normal value and the PCO2 is low. In an alkalotic condition, the pH is up. Therefore, the values identified in the question indicate a respiratory alkalosis. Compensation occurs when the pH returns to a normal value. Because the pH is in the normal range at the high end, compensation has occurred.

A nurse reviews the blood gas results of a client with Guillain-Barre syndrome. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which of the following validates the nurse's findings? A. pH 7.50, PCO2 52 mmHg B. pH 7.35, PCO2 44 mmHg C. pH 7.25, PCO2 50 mmHg D. pH 7.50, PCO2 30 mmHg

C The normal pH is 7.35 to 7.45. The normal PCO2 is 35 to 45 mmHg. In respiratory acidosis the pH is down and the PCO2 is up. Option A identifies an alkalotic condition. Option B identifies normal values. Option D identifies respiratory alkalosis.