acid-base balance prepU

The nurse tests the pH of fluid found on the vaginal exam and determines that the woman's membranes have ruptured based on which result? 5.0 5.5 6.0 6.5

6.5

A pregnant client reports an increase in a thick, whitish vaginal discharge. Which response by the nurse would be most appropriate? "You should refrain from any sexual activity." "You need to be assessed for a fungal infection." "This discharge is normal during pregnancy." "Use a local antifungal agents regularly."

"This discharge is normal during pregnancy."

To calculate the H2CO3 content of the blood, the nurse needs to measure the PCO2 (partial pressure of CO2) by its solubility coefficient. What is the solubility coefficient of CO2? 0.03 0.3 0.04 0.4

0.03

In which client would the nurse be most likely to assess the signs and symptoms of an acid-base imbalance? A client with chronic obstructive pulmonary disease (COPD) whose most recent arterial blood gases reveal a PCO2 of 51 mm Hg A client who has been admitted with a traumatic head injury and whose intracranial pressure is 18 mm Hg A laboring client who is receiving an oxytocin infusion and who has been in the second stage of labor for 7 hours A client with a fluid volume deficit who has been receiving intravenous 0.45% NaCl for over 48 hours

A client with chronic obstructive pulmonary disease (COPD) whose most recent arterial blood gases reveal a PCO2 of 51 mm Hg

A client's most recent laboratory results suggest the presence of metabolic alkalosis. What action by the nurse best addresses a potential cause of this acid-base imbalance? Administering an antiemetic to treat the client's frequent vomiting Repositioning the client frequently to reduce pressure on dependent skin surfaces Assessing the client's bowel sounds and administering scheduled stool softeners Assessing the client's level of consciousness using the Glasgow Coma Scale

Administering an antiemetic to treat the client's frequent vomiting

The gastric mucosal barrier works to prevent acids secreted by the stomach from actually damaging the wall of the stomach. What are factors that make up the gastric mucosal barrier? Select all that apply. An impermeable epithelial cell surface covering Mechanisms for selective transport of bicarbonate and potassium ions Characteristics of gastric mucus Cell coverings that act as antacids Mechanisms for selective transport of hydrogen and bicarbonate ions

An impermeable epithelial cell surface covering Characteristics of gastric mucus Mechanisms for selective transport of hydrogen and bicarbonate ions

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis? Assess the client's ability to take a deep breath Assess the client's ability to move all extremities Assess the client's breath odor Assess for excessive sweating

Assess the client's breath odor

A client with a history of diabetes presents to the emergency department following several days of polyuria and polydipsia with nausea/vomiting. On admission, the client labs show a blood glucose level of 480 mg/dL (26.64 mmol/L) and bicarbonate level of 7.8 mEq/L (7.8 mmol/L). The nurse suspects the client has diabetic ketoacidosis (DKA). The priority intervention should include: Limit fluid intake to only 250 mL/4 hours. Begin a loading dose of IV regular insulin followed by a continuous insulin infusion. Give at least 50 units of regular insulin IV stat and recheck blood glucose in 2 hours. Push a stat dose of bicarbonate followed by a double-dose (loading) of metformin.

Begin a loading dose of IV regular insulin followed by a continuous insulin infusion.

A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA? Give prescribed antiemetics. Begin fluid replacements. Administer prescribed dose of insulin. Administer bicarbonate to correct acidosis.

Begin fluid replacements.

The physician has prescribed 0.9% sodium chloride IV for a hospitalized client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply. Compare ABG findings with previous results. Maintain intake and output records. Document presenting signs and symptoms. Administer IV bicarbonate. Suction the client's airway.

Compare ABG findings with previous results. Maintain intake and output records. Document presenting signs and symptoms.

The nurse caring for a client with respiratory acidosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's respiratory acidosis is improving? pH has decreased CO2 has decreased HCO3- has decreased O2 has decreased

CO2 has decreased

While discussing carbon dioxide transport within the body, the instructor asks, "What enzyme helps carbon dioxide with water to form bicarbonate?" Which student response is correct? Dihydrofolate reductase Orotidine 5'-phosphate decarboxylase Neuraminidase Carbonic anhydrase

Carbonic anhydrase

A client who is blind is admitted for treatment of a small bowel obstruction and has been vomiting for days. Which nursing diagnosis takes highest priority for this client? Deficient fluid volume Risk for injury Activity intolerance Impaired physical mobility

Deficient fluid volume

You are an ICU nurse who has just admitted a new client with an acid/base imbalance. What would you do to provide accurate baseline data for this client? Record intake and output Monitor lab values Document presenting signs and symptoms Implement medication ordered

Document presenting signs and symptoms

Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes mellitus. Which of the following explains the cause of this secondary diabetes? Dysfunction of the pancreatic islet cells Ingestion of foods high in sugar Inability for the liver to reabsorb serum glucose Renal failure

Dysfunction of the pancreatic islet cells

The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of: HCO3− H2CO3 HCl H+

HCO3−

The nurse is caring for a client with ketoacidosis who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet. The nurse understands which phenomenon is most likely occurring? High fat, low carbohydrate dietary intake is associated with respiratory acidosis. In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids. Metabolism of dietary fats without the buffer action of carbohydrates results in the catabolism of ketoacids. Decreased carbohydrate intake induces insulin deficiency and consequent ketoacidosis.

In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids.

A nurse is caring for a client with bulimia nervosa who has been admitted to the hospital with weakness, hypotension, and abdominal discomfort. Which type of acid-base imbalance should the nurse assess the client for? Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Metabolic acidosis

Metabolic acidosis

A client experiencing an acute panic attack develops respiratory alkalosis. The nurse measures a respiratory rate of 46 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 162/90 mm Hg, and a temperature of 98.6°F (37°C). Which action will the nurse implement first to help improve respiratory alkalosis? Apply oxygen via nasal cannula. Administer albuterol inhaler. Instruct the client to breathe into a paper bag. Administer sodium bicarbonate intravenously.

Instruct the client to breathe into a paper bag.

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? Administer an ordered decongestant. Instruct the client to breathe into a paper bag. Offer the client fluids frequently. Administer ordered supplemental oxygen.

Instruct the client to breathe into a paper bag.

A client has an increased serum lactic acid level. The physician understands this is indicative of which disease process? Ischemia Toxicity of lead exposure Free radical injury Apoptosis

Ischemia

A client has an increase in her anion gap (AG). What does the nurse determine is the significance of this finding? It indicates the client has metabolic alkalosis. It indicates the client has respiratory alkalosis. It indicates the client has metabolic acidosis. It indicates the client has respiratory acidosis.

It indicates the client has metabolic acidosis.

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? Low oxalate Low purine High protein High sodium

Low purine

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? Respiratory alkalosis Respiratory acidosis Metabolic alkalosis Metabolic acidosis

Metabolic acidosis

The nurse is caring for a client who has excessive diarrhea. Which acid-base disturbance does the nurse anticipate uncovering during evaluation of the arterial blood gas? No change in values from normal An increase in bicarbonate Metabolic acidosis Increased pH value

Metabolic acidosis

The nurse is caring for a client with renal failure experiencing shortness of breath and increased respiratory rate. The arterial blood gas reflects a pH of 7.10 and HCO3 level of 18 mEq/L (18 mmol/L). How does the nurse interpret these findings? Metabolic acidosis Respiratory acidosis Metabolic alkalosis Respiratory alkalosis

Metabolic acidosis

A client with a history of chronic cystitis comes to an outpatient clinic with signs and symptoms of this disorder. To prevent cystitis from recurring, the nurse recommends maintaining an acid-ash diet to acidify the urine, thereby decreasing the rate of bacterial multiplication. On an acid-ash diet, the client must restrict which beverage? Cranberry juice Coffee Prune juice Milk

Milk

Which medication classification represents a proton (gastric acid) pump inhibitor? Omeprazole Sucralfate Famotidine Metronidazole

Omeprazole

A nurse cares for an obese client taking phentermine/topiramate-ER. Which laboratory findings will the nurse recognize as most concerning and will report to the health care provider? Select all that apply. Potassium 3.3 mEq/L Bicarbonate 19 mEq/L Total cholesterol 220 Calcium 9 mg/dL Chloride 98 mEq/L

Potassium 3.3 mEq/L Bicarbonate 19 mEq/L

A client has meconium-stained amniotic fluid. Fetal scalp sampling indicates a blood pH of 7.12; fetal bradycardia is present. Based on these findings, the nurse should take which action? Administer amnioinfusion. Prepare for cesarean birth. Reposition the client. Start I.V. oxytocin infusion as ordered.

Prepare for cesarean birth.

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances? Respiratory acidosis Respiratory alkalosis Metabolic alkalosis Metabolic acidosis

Respiratory acidosis

The nurse is caring for a client with chronic obstructive pulmonary disease. The client reports that he is having difficulty breathing and is feeling fatigued. The nurse realizes that this client is at high risk for which condition? Respiratory alkalosis Respiratory acidosis Metabolic acidosis Metabolic alkalosis

Respiratory acidosis

The nurse enters a client's hospital room and finds the client breathing rapidly, stating, "I must be having a stroke, my fingers are tingling!" Which acid-base balance disorder is this client experiencing due to hyperventilation? Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis

Respiratory alkalosis

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? Serum bicarbonate of 28 mEq/L PaCO2 less than 35 mm Hg Serum bicarbonate of 21 mEq/L pH 7.26

Serum bicarbonate of 28 mEq/L

What information will the nurse need to know in order to calculate a client's anion gap (AG)? Select all that apply. Sodium Chloride Bicarbonate Proteins Sulfates

Sodium Chloride Bicarbonate

The nurse is assessing a client with abnormal blood gas values. Which of these interpretations does the nurse make regarding the client's physiologic status? The client has a decreased hemoglobin. The client has alterations in vital signs. The client has abnormalities in his buffer system. The client has abnormalities in his cardiovascular system.

The client has abnormalities in his buffer system.

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The client asks what is making the acidotic state. The nurse is most correct to identify which result of the disease process that causes the fall in pH? The lungs are unable to breathe in sufficient oxygen. The lungs are unable to exchange oxygen and carbon dioxide. The lungs have ineffective cilia from years of smoking. The lungs are not able to blow off carbon dioxide.

The lungs are not able to blow off carbon dioxide

Which medication may be responsible for a client developing increased uric acid levels by decreasing ECF volume? Vitamin C Thiazide diuretics Penicillin antibiotics Antacids

Thiazide diuretics

The physician is treating a client in lactic acidosis following cardiac arrest. Which treatment will be effective in correcting this acidosis? Treatments to improve tissue perfusion and oxygenation Administration of sodium bicarbonate Administration of potassium chloride Hypoventilation

Treatments to improve tissue perfusion and oxygenation

The nurse is assessing blood gas results for a client with diabetes and ketoacidosis and notes a pH level of 7.15. Which dysrhythmis should the nurse closely monitor while treating this client? Atrial fibrillation Ventricular tachycardia First-degree heart block Sinus tachycardia

Ventricular tachycardia

A nurse is providing client teaching about the body's plasma pH and the client asks the nurse what is the major chemical regulator of plasma pH. What is the best response by the nurse? renin-angiotensin-aldosterone system bicarbonate-carbonic acid buffer system sodium-potassium pump ADH-ANP buffer system

bicarbonate-carbonic acid buffer system

A client with emphysema is at a greater risk for developing which acid-base imbalance? chronic respiratory acidosis metabolic alkalosis metabolic acidosis respiratory alkalosis

chronic respiratory acidosis

The nurse is caring for a client who is suspected to have overdosed on opioids. Assessment findings include a heart rate of 60 beats/minute, respiratory rate of 6 breaths/minute, a blood pressure of 95/55 mmHg, and an oxygen saturation of 96% on room air. Based on the assessment findings, what is the nurse's priority concern? hypoxic respiratory failure hypercapnic respiratory failure total airway occlusion decreased organ perfusion

hypercapnic respiratory failure

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? nausea or vomiting abdominal pain or diarrhea hallucinations or tinnitus light-headedness or paresthesia

light-headedness or paresthesia

A client presents to the emergency department, reporting that they have been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts this client at risk for which imbalances? metabolic acidosis and hyperkalemia metabolic acidosis and hypokalemia metabolic alkalosis and hyperkalemia metabolic alkalosis and hypokalemia

metabolic alkalosis and hypokalemia

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms? azithromycin valacyclovir penicillin metronidazole

metronidazole

A client with a history of chronic cystitis comes to an outpatient clinic with signs and symptoms of this disorder. To prevent cystitis from recurring, the nurse recommends maintaining an acid-ash diet to acidify the urine, thereby decreasing the rate of bacterial multiplication. On an acid-ash diet, the client must restrict which beverage? cranberry juice coffee prune juice milk

milk

A pregnant client has developed iron-deficiency anemia and has been prescribed 200 mg of elemental iron per day. The nurse should encourage the client to take this medication with which substance? orange juice milk water a full meal

orange juice

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder? pH 7.28, PaO2 50 mm Hg pH 7.46, PaO2 80 mm Hg pH 7.36, PaCO2 32 mm Hg pH 7.35, PaCO2 48 mm Hg

pH 7.28, PaO2 50 mm Hg

The nurse has received lab reports for several clients undergoing care. Which set of arterial blood gas (ABG) results will the nurse investigate first? pH 7.34, partial pressure of arterial carbon dioxide (PaCO2) 36 mmHg, partial pressure of arterial oxygen (PaO2) 95 mmHg, bicarbonate (HCO3-) 20 mEq/L pH 7.49, PaCO2 30 mmHg, PaO2 75 mmHg, and HCO3- 22 mEq/L pH 7.47, PaCO2 43 mmHg, PaO2 99 mmHg, and HCO3- 29 mEq/L pH 7.35, PaCO2 48 mmHg, PaO2 91 mmHg, and HCO3- 28 mEq/L

pH 7.49, PaCO2 30 mmHg, PaO2 75 mmHg, and HCO3- 22 mEq/L

The nurse is caring for a client with metabolic alkalosis whose breathing rate is 8 breaths/min. Which arterial blood gas data does the nurse anticipate finding? pH: 7.32; PaCO2: 28 mm Hg (3.72kPa); HCO3: 24 mEq/l (24 mmol/l) pH: 7.60; PaCO2: 64 mm Hg (8,51 kPa); HCO3: 42 mEq/l (42 mmol/l) pH: 7.28; PaCO2: 52 mm Hg (6.92 kPa); HCO3: 32 mEq/l (32 mmol/l) pH: 7.32; PaCO2: 26 mm Hg (3.46 kPa); HCO3: 18 mEq/l (18 mmol/l)

pH: 7.60; PaCO2: 64 mm Hg (8,51 kPa); HCO3: 42 mEq/l (42 mmol/l)

A client has these arterial blood gas values: pH, 7.30; PaO2, 89 mm Hg; PaCO2, 50 mm Hg; and HCO3-, 26 mEq/L. Based on these values, the nurse should suspect which condition? respiratory acidosis respiratory alkalosis metabolic acidosis metabolic alkalosis

respiratory acidosis

The nurse assesses an adolescent client with lethargy, retractions of the intercostal spaces, a persistent expiratory wheeze, diminished breath sounds, tachycardia, and tachypnea. Arterial blood gas results are pH 7.10; PCO2 80 mm Hg (10.64 kPa); PO2 35 mm Hg (4.66 kPa), HCO3 29 mEq/l (29 mmol/l). What is the priority condition the nurse must address? respiratory acidosis change in mental status increased heart rate breathing pattern

respiratory acidosis

A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects: metabolic acidosis. metabolic alkalosis. respiratory acidosis. respiratory alkalosis.

respiratory alkalosis.

Gout and the development of kidney stones are often attributed to high levels of what compound? Uric acid Urea Protein Albumin

uric acid

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? specific gravity of 1.03 urine pH of 3.0 absence of protein absence of glucose

urine pH of 3.0