Respiratory Alkalosis​

Liam is a 19-year-old male preparing for a speech in his communications class. Liam appears sleepy and states he has a headache. His roommate has noticed increased anxiety over the last few days and encourages Liam to visit the student health clinic on campus. ​ What priority assessment data does the nurse obtain first? Select all that apply.

* Skin temperature *Arterial blood gas results *Heart rate *Glasgow Coma Scale *Respiratory rate *Blood pressure *Oxygen saturation *Temperature

Indicate which clients are at risk for respiratory alkalosis by selecting their picture. Select all that apply.

*Abbie *Liam

Which priority actions will the nurse perform to gather cues related to the change in Ms. Smyth's behavior? Click on the three actions the nurse will complete first.

*Assess level of consciousness *Assess level of pain *Assess neurovascular status of lower extremities

Which conditions contribute to the development of respiratory alkalosis? Select all that apply.

*Mechanical ventilation *Exercise *Hypoxia *Anxiety *Liver failure *Septicemia

The nurse received the results of Liam's arterial blood gas test. What condition does the nurse report to the health care provider?

*Partially compensated respiratory alkalosis

Select the assessment data that alerts the nurse that Ms. Smyth may be experiencing an acid-base imbalance.

*Tachycardic *Tachypneic *Pain *Muscle cramps *Tingling *Paresthesia

The nurse plans to include which items when providing discharge teaching to help Liam control his anxiety levels before they impact his health. Which items should the nurse included? Select all that apply.

*Take slow, controlled breaths. *Positive self-talk. *Exercise. *Imagine yourself succeeding at the task.

1._______________ related to 2._____________________________ as evidenced by 3._____________________, 4.___________________________ , and 5._____________________.

1. Anxiety 2. required public speaking event 3. rapid breathing 4. preoccupation with upcoming speech assignment 5. rapid pulse

1. Have client breath into a paper bag for 12 breaths, repeat x2, 5 minutes apart, if needed 2. Alprazolam 0.25 mg orally disintegrating tablet on tongue once 3. Psychiatry consultation 4. naloxone 0.04 mg IM now

1. Complete within 15 minutes 2. Complete within 15 minutes 3. Complete within 60 minutes 4. Check with the prescriber

1. Intravenous (IV) infusion 0.9% NS at 125 mL/h 2. sodium bicarbonate 1mEq/kg IV push one-time STAT 3. Breathe into a paper bag, no more than 10 breaths, repeat once, if needed, for continued hyperventilation 4. alprazolam 0.5 mg po one-time now 5. acetaminophen 500-1000 mg po now 6. Arterial blood gas STAT 7. Admit to mental health, diagnosis chronic anxiety

1. Non-Essential 2. Contraindicated 3. Indicated 4. Indicated 5. Indicated 6. Indicated 7. Contraindicated

The nurse caring for Ms. Smyth plans to complete prescribed actions in priority order. For the actions listed below, drag into order from the first to be completed to the last.

1. Obtain arterial blood gas (ABG) 2. Insert peripheral vascular access devices (VAD or IV) 3. Begin 0.9% saline 75 ml/h infusion 4. Administer morphine 5. Obtain complete blood cell count (CBC) with differential and comprehensive metabolic panel (CMP) 6. Left leg X-ray

1. Acidosis 2. Alkalosis 3. Normal

1. Respiratory: Damien Metabolic: Safia 2. Respiratory: Abbie, Liam 3. Harold

Based on the most recent data in Ms. Smyth's electronic health record (EHR) the nurse realizes that she is at risk for 1._________________ as evidenced by 2._________________. To promote Ms. Smyth's health, the emergency department nurse reinforces the need for 3.________________ with the nurse receiving report when Ms. Smyth is admitted for surgery.

1. fat embolus 2. X-ray results 3. Immobilization of the left leg

Based on the information provided, which nursing diagnosis should the nurse select for Liam?

Anxiety

1. Hyperventilation 2. Rapid pulse 3. Apprehension 4. Nasal flaring 5. Orthopnea 6. Preoccupation 7. Avoidance behaviors 8. Urinary frequency

Anxiety *1, 2, 3, 6, 8 Fear *1, 2, 3, 7, 8 Ineffective Breathing Pattern *1, 2, 3, 4, 5 Liam's Assessment Data *1, 2, 3, 6

Bedside testing results include blood glucose 98 and electrocardiogram (ECG) shows no changes.

Hyperventilation

Ms. Smyth is restless and anxious as she awaits surgery to repair her leg. Based on these assessment findings, which medication does the nurse anticipate being prescribed?

Sertraline

The nurse just received the results of Mr. Jones's arterial blood gas (ABG) test. What condition does the nurse report to the health care provider?​

Uncompensated respiratory alkalosis.