Foundations Acid Base

The nurse is monitoring a group of clients for acid-base imbalances. Which clients are at highest risk for metabolic acidosis? Select all that apply. 1.Client with asthma 2.Client with pancreatitis 3.Malnourished client 4.Client with diabetes mellitus 5.Client with status epilepticus 6.Client with severe prolonged diarrhea

2, 3, 4, 5, & 6

Which arterial blood gas (ABG) result should the nurse anticipate in the client who develops metabolic alkalosis after profuse vomiting for 2 days? 1.pH 7.32; Pco2 35; HCO3- 20 2.pH 7.30; Pco2 50; HCO3- 24 3.pH 7.49; Pco2 45; HCO3- 30 4.pH 7.52; Pco2 30; HCO3- 20

3

A client's arterial blood gases reveal a pH of 7.51 and a bicarbonate level of 31 mEq/L. The nurse prepares for the administration of which medication that should be prescribed to treat this acid-base disorder? 1.Furosemide 2.Acetazolamide 3.Spironolactone 4.Sodium bicarbonate

Acetazolamide

A 3-year-old child is hospitalized because of persistent vomiting. Which conditions should the nurse expect this child to be high risk for? Select all that apply. 1.Diarrhea 2.Dehydration 3.Metabolic acidosis 4.Metabolic alkalosis 5.Hyperactive bowel sounds

Dehydration & Metabolic alkalosis

A client is determined to be in respiratory alkalosis by blood gas analysis. The nurse should monitor this client for signs of which electrolyte disorder that could accompany the acid-base imbalance? 1.Hypokalemia 2.Hypercalcemia 3.Hypernatremia 4.Hypochloremia

Hypokalemia

The nurse is caring for an adult client with respiratory distress syndrome. A review of the arterial blood gas results indicates that the client is experiencing respiratory alkalosis. The nurse should then examine the results of serum electrolytes to see whether which electrolyte imbalance is present? 1.Hypokalemia 2.Hyponatremia 3.Hyperkalemia 4.Hypercalcemia

Hypokalemia

The nurse observes that a client with diabetic ketoacidosis is experiencing abnormally deep, regular, rapid respirations. How should the nurse correctly document this observation in the medical record? 1.Apnea 2.Bradypnea 3.Cheyne stokes 4.Kussmaul's respirations

Kussmaul's respirations

The nurse is assisting in the care of a client who had an ileostomy created a few days ago. The client has high output of drainage from the ileostomy. Based on this the nurse monitors the client for which acid-base imbalance? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic acidosis

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client closely for which acid-base disorder that is most likely to occur in this situation? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic alkalosis

An anxious client is experiencing respiratory alkalosis from hyperventilation as a result of anxiety. The nurse should do which action to help the client experiencing this acid-base disorder? 1.Put the client in a supine position. 2.Provide emotional support and reassurance. 3.Withhold all sedative or antianxiety medications. 4.Tell the client to breathe very deeply but more slowly.

Provide emotional support and reassurance

The nurse is assisting to admit a client with a diagnosis of acute Guillain-Barré syndrome. The nurse knows that if the disease progresses to a severe level, the client will be at risk for which acid-base imbalance? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Respiratory acidosis

The nurse is caring for a client with respiratory insufficiency. The arterial blood gas (ABG) results indicate a pH of 7.50 and a Pco2 of 30 mm Hg (30 mm Hg), and the nurse is told that the client is experiencing respiratory alkalosis. Which additional laboratory value should the nurse expect to note? 1.A sodium level of 145 mEq/L (145 mmol/L) 2.A potassium level of 3.0 mEq/L (3.0 mmol/L) 3.A magnesium level of 1.3 mEq/L (0.65 mmol/L) 4.A phosphorus level of 3.0 mg/dL (0.97 mmol/L)

a potassium level of 3.0 mEq/L (3.0 mmol/L)

The nurse determines that which clients are at high risk for metabolic acidosis? Select all that apply. 1.Clients with asthma 2.Clients with diabetes 3.Clients with pneumonia 4.Clients with kidney failure 5.Clients with severe anxiety 6.Clients with malnourishment

2, 4 & 6

A client has been diagnosed with metabolic alkalosis. Which laboratory values are most important for the nurse to monitor for this client? Select all that apply. 1.Red blood cells 2.Serum bilirubin 3.Serum electrolytes 4.Arterial blood gases (ABGs) 5.Complete blood count (CBC)

3 & 4

Which clients would the nurse determine is at risk for development of metabolic alkalosis? Select all that apply. 1.Client with emphysema 2.Client who is hyperventilating 3.Client with chronic kidney disease 4.Client who has been vomiting for 2 days 5.Client receiving oral furosemide 40 mg daily 6.Client admitted with acetylsalicylic acid overdose

4 & 5

The nurse is collecting data from a client with a suspected diagnosis of gastric ulcer. The client tells the nurse that oral antacids are taken frequently throughout the day. The nurse continues to collect data from the client, understanding that the client is at risk for which acid-base disturbance? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis:

metabolic alkalosis

The registered nurse (RN) reviews the results of the arterial blood gas (ABG) values with the licensed practical nurse (LPN) and tells the LPN that the client is experiencing respiratory acidosis. The LPN should expect to note which on the laboratory result report? 1.pH 7.50, Pco2 52 mm Hg 2.pH 7.35, Pco2 40 mm Hg 3.pH 7.25, Pco2 50 mm Hg 4.pH 7.50, Pco2 30 mm Hg

pH 7.25, Pco2 50mm Hg

A client has the following laboratory values: pH of 7.55, HCO3- of 22 mm Hg, and a Pco2 of 30 mm Hg. Which action should the nurse take? 1.Prepare the client for dialysis. 2.Administer insulin as prescribed. 3.Suction the client to improve respiratory status. 4.Encourage the client to slow down his breathing.

Encourage the client to slow down his breathing

A client with diabetes mellitus has a blood glucose level of 596 mg/dL on admission. The nurse anticipates that this client is at risk for which type of acid-base imbalance? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic acidosis

The nurse has assisted with obtaining a blood specimen for arterial blood gas (ABG) analysis. The nurse avoids doing which to properly obtain and send the specimen? 1.Place the specimen on ice. 2.Record the client's temperature on the requisition. 3.Record the percent of oxygen on the requisition. 4.Obtain a 3-mL syringe that is used for parenteral medication.

Obtain a 3-mL syringe that is used for parenteral medication

The nurse reviews the arterial blood gas results of a client and notes that the results indicate a pH of 7.30, Pco2 of 52 mm Hg, and HCO3- of 22 mEq/L. Which interpretation should the nurse correctly make about these results? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Respiratory acidosis

Arterial blood gases (ABGs) are obtained on a client with pneumonia. The ABG results are pH, 7.50; Pco2, 30 mm Hg; HCO3-, 20 mEq/L; and Po2, 75 mm Hg. The nurse interprets these results and determines that which acid-base condition exists? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

respiratory alkalosis

A client who has received sodium bicarbonate in large amounts is at risk for developing metabolic alkalosis. The nurse checks this client for which signs and symptoms characteristic of this disorder? 1.Disorientation and dyspnea 2.Drowsiness, headache, and tachypnea 3.Tachypnea, dizziness, and paresthesias 4.Decreased respiratory depth and rate and dysrhythmias

Decreased respiratory depth and rate and dysrhythmias

A client has the following laboratory values: a pH of 7.55, an HCO3- level of 22 mEq/L (22 mmol/L), and a Pco2 of 30 mm Hg (30 mm Hg). Which action should the nurse plan to take? 1.Perform Allen's test. 2.Prepare the client for dialysis. 3.Administer insulin as prescribed. 4.Encourage the client to slow down breathing.

Encourage the client to slow down breathing.

The nurse is reviewing the arterial blood gas results of the client. Blood gas results indicate a pH of 7.30 and a Pco2 of 50 mm Hg, and the nurse has determined that the client is experiencing respiratory acidosis. Which additional laboratory values should the nurse expect to note in this client? 1.Sodium of 145 mEq/L 2.Potassium 5.4 mEq/L 3.Magnesium 2 mEq/L 4.Phosphorus 2.3 mEq/L

Potassium 5.4 mEq/L

A client presents to the emergency department with lethargy; deep, regular respirations; and a fruity odor to the breath. The client's arterial blood gas (ABG) results are pH of 7.25, Pco2 of 34 mm Hg, Po2 of 86 mm Hg, and HCO3- of 14 mEq/L. The nurse interprets that the client has which acid-base disturbance? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic acidosis

A client who has fallen from a roof and fractured his ribs has arterial blood gas (ABG) results of: pH 7.48, Paco2 32 mm Hg, Pao2 89 mm Hg, and HCO3- 22 mEq/L. How should the nurse interpret the client's blood gas results? 1.Normal results 2.Respiratory acidosis 3.Metabolic acidosis 4.Respiratory alkalosis

Respiratory alkalosis

The nurse is caring for a client who is nervous and is hyperventilating. The nurse should monitor the client for signs of which acid-base imbalance? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Respiratory alkalosis

The nurse is caring for a client with a diagnosis of chronic obstructive pulmonary disease (COPD). The nurse should monitor the client for which acid-base imbalance? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

respiratory acidosis

The licensed practical nurse (LPN) is assisting in the care of a client who overdosed on acetylsalicylic acid 24 hours ago. The LPN should report to the registered nurse (RN) which findings associated with an anticipated acid-base disturbance? 1.Drowsiness, headache, and tachypnea 2.Tachypnea, dizziness, and paresthesias 3.Disorientation, hypotension, and dyspnea 4.Decreased respiratory rate and depth and cardiac irregularities

Drowsiness, headache, and tachypnea

A client underwent creation of an ileostomy 2 days ago. The nurse checks the client for signs of which acid-base disorder that a client with an ileostomy is at risk for developing? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic acidosis

The nurse is caring for a client with kidney failure. The nurse is told that the blood gas results indicate a pH of 7.30 and a HCO3- of 20 mm Hg, and that the client is experiencing metabolic acidosis. The nurse reviews the laboratory results and finds which value to be of concern? 1.Sodium level, 145 mEq/L 2.Potassium level, 5.6 mEq/L 3.Magnesium level, 2.6 mg/dL 4.Phosphorus level, 4.5 mg/dL

Potassium level, 5.6 mEq/L

The nurse is told that the arterial blood gas (ABG) results indicate a pH of 7.50 and a Pco2 of 32 mm Hg (32 mm Hg). The nurse determines that these results are indicative of which acid-base disturbance? 1. Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

respiratory alkalosis

A client has had a set of arterial blood gases drawn. The results are pH, 7.34; Paco2, 37 mm Hg; Pao2, 79 mm Hg; and HCO3,- 19 mEq/L. The nurse interprets that the client is experiencing which acid-base imbalance? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic acidosis

A client with a chronic airflow limitation is experiencing respiratory acidosis as a complication. The nurse trying to enhance the client's respiratory status should avoid performing which actions? Select all that apply. 1.Keeping the head of the bed elevated 2.Monitoring the client's oxygen saturation level 3.Increase the liter flow to 5 L per nasal cannula 4.Assisting the client to turn, cough, and deep breathe 5.Encouraging the client to breathe slowly and shallowly

3 & 5

The nurse is caring for a client with severe diarrhea. The nurse monitors the client closely, understanding that this client is at risk for developing which acid-base disorder? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic acidosis

A client is in respiratory alkalosis induced by gram-negative sepsis. The nurse assists in implementing which measure as the effective means to treat the problem? 1.Administer prescribed antibiotics. 2.Have the client breathe into a paper bag. 3.Administer prescribed as-needed (PRN) antipyretics. 4.Request a prescription for a partial rebreather oxygen mask.

administer prescribed antibiotics