Acid Base Balance

Which assessment finding in a laboring client indicates respiratory alkalosis?

tingling in hands (indicates respiratory alkalosis due to a decrease in CO2)

A child w type 1 diabetes is admitted to the hospital w deep, rapid respirations; flushed, dry cheeks; abdominal pain w nausea; and increased thirst. Which lab findings will nurse see?

pH 7.25; glucose 460 mg/dL (The clinical manifestations indicate ketoacidosis, so these values are expected; pH of 7.25 indicates acidosis)

The nurse is caring for a client after abdominal surgery and encourages the client to turn from side to side and to engage in deep-breathing exercises. Which complication is the nurse trying to prevent?

Respiratory Acidosis (Shallow respirations, bronchial tree obstruction, and atelectasis compromise gas exchange in lungs; an increased CO2 level leads to respiratory acidosis)

A client appears anxious, exhibiting 40 shallow respirations per minute. Client reports dizziness, light-headedness, and tingling sensations of fingertips and around lips. The nurse concludes that the client's symptoms are most likely related to which condition?

Hyperventilation (The client is hyperventilating and blowing off excessive CO2, which leads to these adaptations; if uninterrupted, can result in respiratory alkalosis)

The nurse is caring for a child with severe dehydration and its associated acid-base imbalance. Which compensatory mechanism within the body is activated to counteract the effects of the child's acid-base imbalance?

Increased resp rate (The child has metabolic acidosis; the lungs compensate by blowing off excess carbonic acid in form of CO2. The child has metabolic acidosis; the lungs compensate by blowing off excess carbonic acid in the form of CO2)

The nurse assesses a client who is experiencing profound (late) hypovolemic shock. When monitoring client's arterial blood gas results, which response is expected?

Metabolic acidosis (Decreased oxygen promotes conversion of pyruvic acid to lactic acid, resulting in metabolic acidosis)

A critically ill 5-year-old child exhibits Kussmaul respirations. Which would the nurse suspect may be causing an increasing acid-base imbalance?

Metabolic acidosis caused by a concentration of cations in body fluids (Metabolic acidosis results from excess concentration of hydrogen. The kidneys cannot convert ammonium to ammonia, and there is inadequate base bicarb to maintain acid-base balance. With Kussmaul respirations there is excess of hydrogen ions, the opposite of excess of base bicarb)

The lab data for a client w prolonged vomiting reveal arterial blood gases of pH 7.51, Pco 2 of 45 mm Hg, HCO 3 of 58 mEq/L (59 mmol/L), and a serum potassium level of 3.8 mEq/L (3.8 mmol/L). What does the nurse conclude?

Metabolic alkalosis (Elevated plasma pH and elevated bicarbonate levels support metabolic alkalosis. The arterial CO2 level of 45 mm Hg is within expected value of 35 mm Hg to 45 mm Hg; no hypocapnia present)

Which type of acid-base imbalance would the nurse expect in a child admitted with a severe asthma exacerbation?

Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid (restricted ventilation accompanying an asthma attack limits body's ability to blow off CO2, as CO2 accumulates in body fluids, it reacts w water to make carbonic acid; the result is respiratory acidosis)

The arterial blood gases for client w acute respiratory distress are pH 7.30, PaO 2 80 mm Hg (10.64 kPa), PaCO 2 55 mm Hg (7.32 kPa), and HCO 3 23 mEq/L (23 mmol/L). How would the nurse interpret?

Uncompensated respiratory acidosis (The increased PaCO 2 indicates respiratory acidosis and low pH indicates that respiratory acidosis is uncompensated)

A 4-month-old infant is brought to the emergency department after 2 days of diarrhea. The infant is listless and has sunken eyeballs, a depressed anterior fontanel, and poor tissue turgor. Breathing is deep, rapid, and unlabored. Stools are liquid and there has been no obvious urine output. Which problem would the nurse be concerned about?

metabolic acidosis (Metabolic acidosis occurs w loss of alkaline fluid thru diarrhea and is manifested by lethargy and Kussmaul breathing; all assessments indicate dehydration)

The nurse determined a client's arterial blood gases reflected a compensated respiratory acidosis. The pH was 7.34; which additional laboratory value did the nurse consider?

bicarbonate (HCO 3) value is 50 mEq/L (50 mmol/L) (The HCO 3 value is elevated. The urinary system compensates by retaining hydrogen (H +) ions, which become part of the bicarb ions; the bicarb level becomes elevated and increases pH level to near expected range)

Which blood gas report most likely reflects the acid-base balance of an infant w severe dehydration?

pH of 7.20 and HCO 3 - of 20 mEq/L (Low blood pH and bicarbonate levels indicate metabolic acidosis, which occurs w severe dehydration because reduced urine output causes retention of hydrogen ions)