Acid Base Balance and Imbalance
Which electrolyte imbalance is the patient with metabolic acidosis at risk to develop?
Hyperkalemia
To decrease the risk of acid-base imbalance, what goal must the patient with diabetes mellitus strive for?
Maintaining blood glucose level within normal limits.
A patient has been having acute diarrhea for more than 24 hours from a viral infection. Which acid-base imbalance is most likely to manifest?
Metabolic acidosis
When evaluating the laboratory results of a patient with diabetic ketoacidosis, which lab value indicates the body has fully compensated from this acid-base imbalance?
Normal pH on arterial blood gases
A 60-year-old patient is admitted to the hospital with symptoms of a disturbance in acid-base balance. Which pH value would be consistent with an excessive amount of acids in the body?
7.26
A patient is admitted with chronic anemia. What physiologic imbalance does the nurse suspect the patient is at risk of developing?
Acidosis
A patient admitted to the emergency department is having an acute episode of asthmatic bronchitis. The nurse notes the pH on the most recent arterial blood gas is 7.31. What is the most likely explanation for this finding?
Acidosis in response to the excessive retention of carbon dioxide
What is one of the causes of respiratory alkalosis?
Anxiety
When caring for a patient with a pulse oximetry level of 89%, which action does the nurse take first?
Apply oxygen as prescribed
The nurse is caring for a patient with hypoxemia and metabolic acidosis. Which task can be delegated to the nursing assistant who is helping with the patient's care?
Apply the pulse oximeter for continuous readings.
The nurse is caring for a group of patients with acidosis. The nurse recognizes that Kussmaul respirations are consistent with which situation?
Aspirin overdose
The nurse is assessing the laboratory reports of a patient with impaired kidney function. What changes indicate the patient has metabolic acidosis?
Decrease in serum bicarbonate level
Which action does the nurse take first for the patient who is admitted to the emergency department (ED) with a panic attack and whose blood gases indicate respiratory alkalosis?
Encourage the patient to take slow breaths
A new nurse graduate is caring for a postoperative patient with the following arterial blood gases (ABGs): pH 7.30; Paco2 60 mm Hg; Pao2 80 mm Hg; bicarbonate 24 mEq/L; and O2 saturation 96%. Which of these actions by the new graduate is indicated?
Encourage the patient to use the incentive spirometer and cough
A patient is admitted with severe diabetic ketoacidosis. Arterial blood gas results reveal a pH of 7.21. What is this patient's acidosis most likely in response to?
Excessive breakdown of fatty acids
When caring for a patient with metabolic acidosis, what must the nurse keep in mind regarding acid-base chemistry?
Fluids with lower pH have higher acidity.
The nurse is caring for a patient who has taken a large quantity of furosemide to promote weight loss. The nurse anticipates the finding of which acid-base imbalance?
HCO3- of 34 mEq/L
A patient is admitted from the emergency department for intravenous (IV) fluids to treat dehydration caused by several days of vomiting and diarrhea. The patient's admission venous blood work reveals a pH of 7.27 and bicarbonate of 26 mEq/L; potassium and chloride levels are within normal ranges. The provider has ordered adding bicarbonate to the IV fluids. Which action by the nurse is correct?
Hold the bicarbonate and report the laboratory values to the provider.
Which nursing intervention takes priority for a patient admitted with severe metabolic acidosis?
Initiate cardiac monitoring.
A morbidly obese patient has chosen gastric bypass surgery to promote weight loss. The nurse plans to teach the patient about the need to perform monitoring to detect what disturbance consistent with rapid weight loss associated with this procedure?
Ketosis
What is one of the causes of acidosis?
Kidney failure
The nurse obtains lab results for a 50-year-old patient with the following results: pH 7.24; bicarbonate 20; Pao2 82; Paco2 35. These findings are consistent with which acid-base imbalance?
Metabolic acidosis
A diabetic patient shows symptoms of diabetic ketoacidosis. What mechanism causes acidosis in this patient?
Overproduction of hydrogen ions
When caring for a patient with kidney failure who has metabolic acidosis, which symptom does the nurse expect as evidence of the body's compensatory effort?
Rapid and deep respirations
A lab report for a 47-year-old patient shows the following results: pH 7.32; bicarbonate 24; Pao2 77; Paco2 48. These findings are consistent with which acid-base imbalance?
Respiratory acidosis
A patient with diabetes mellitus is brought to the emergency department after vomiting for several days. The patient has rapid, deep respirations and a urine dipstick reveals ketonuria. Which process does the nurse suspect is occurring with this patient?
Respiratory compensation for metabolic acidosis
Which arterial blood gas reading does the nurse anticipate in a patient diagnosed with chronic obstructive pulmonary disease (COPD)?
pH 7.36, Pao2 63 mm Hg, Paco2 52 mm Hg, HCO3- 32 mEq/L
