Patho Ch. 8 Disorders of fluid & electrolyte & acid base balance

As other mechanisms prepare to respond to a pH imbalance, immediate buffering is a result of increased: intracellular albumin. sodium/phosphate anion absorption. bicarbonate/carbonic acid regulation. hydrogen/potassium binding.

bicarbonate/carbonic acid

Of the following clients, who would be at highest risk for developing hyperkalemia? A male admitted for acute renal failure following a drug overdose An older adult client experiencing severe vomiting and diarrhea as a result of influenza A client diagnosed with an ischemic stroke with multiple sensory and motor deficits A postsurgical client whose thyroidectomy resulted in the loss of some of the parathyroid glands

A male admitted for acute renal failure following a drug overdose

A client with ethylene glycol toxicity is restless, and stating he has flank pain. What intervention should the nurse perform to minimize complications? Reduce dietary calcium Encourage ambulation Increase IV fluids Give aspirin for pain

Increase IV fluids

Lymph fluid arises directly from which space? Intravascular Plasma Interstitial Intercellular

Interstitial

The nurse is reviewing the following lab results of a client diagnosed with renal failure:pH: 7.24PCO2: 38 mm Hg (5.05 kPa)HCO3:18 mEq/L (18 mmol/L)The nurse would interpret this as: Metabolic acidosis Respiratory alkalosis Metabolic alkalosis Respiratory acidosis

Metabolic acidosis

The effective circulating volume is the major regulator of water balance in the body. What else does it regulate? Magnesium Potassium Sodium Calcium

Sodium

Which assessment should be prioritized in the care of a client who is being treated for a serum potassium level of 2.7 mEq/L (2.7 mmol/L)? Detailed fluid balance and monitoring for pitting edema Monitoring of hemoglobin levels and oxygen saturation Cardiac monitoring looking for prolonged PR interval and flattening of the T wave Arterial blood gases checking for respiratory alkalosis

Cardiac monitoring looking for prolonged PR interval and flattening of the T wave

A client is admitted after losing 44 lb (20 kg) over the past 3 months, largely due to frequent vomiting. What intervention should the nurse anticipate in the treatment of the client's resulting acid-base imbalance? Fluid replacement with an intravenous solution containing electrolytes as prescribed Administration of intravenous sodium bicarbonate as prescribed Supplementary oxygen using a non-rebreather mask Mechanical ventilation and administration of supplementary oxygen

Fluid replacement with an intravenous solution containing electrolytes as prescribed

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

HCO3-

Hypothalamic sensory neurons that promote thirst when stimulated are called: Baroreceptors Osmoreceptors Thermoreceptors Chemoreceptors

Osmoreceptors

Water movement from the side of the membrane having a lesser number of particles and greater concentration of water to the side having a greater number of particles and lesser concentration of water is termed: Filtration Osmosis Active transport Diffusion

Osmosis

The renal control mechanism of restoring the acid-base balance is accomplished through which process? Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms. Regulation of the production of carbonic acid Reabsorption of hydrogen and excretion of carbonic acid Stimulation of the chemoreceptors in the brain stem

Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms.

The nurse is caring for a client who complains of headache and blurred vision. The nurse recognizes that these symptoms, accompanied by increased plasma partial pressure carbon dioxide (PCO2) level and decreased pH level, are consistent with which diagnosis? Metabolic alkalosis Respiratory acidosis Metabolic acidosis Respiratory alkalosis

Respiratory acidosis

When caring for clients with disorders of sodium balance, the nurse know that which finding is consistent with hypernatremia? Sodium 135 mEq/L (135 mmol/L) and serum osmolality of 275 mOsm/kg (275 mmol/kg) Sodium 148 mEq/L (148 mmol/L) and serum osmolality of 280 mOsm/kg (280 mmol/kg) Sodium 158 mEq/L (158 mmol/L) and serum osmolality of 320 mOsm/kg (320 mmol/kg) Sodium 145 mEq/L (145 mmol/L) and serum osmolality of 295 mOsm/kg (295 mmol/kg)

Sodium 158 mEq/L (158 mmol/L) and serum osmolality of 320 mOsm/kg (320 mmol/kg)

The nurse caring for a client with metabolic alkalosis should anticipate which laboratory results to confirm the diagnosis? pH of 7.30 and HCO3 of 20 mEq/L (20 mmol/L) pH of 7.35 and HCO3 of 22 mEq/L (22 mmol/L) pH of 7.45 and HCO3 of 24 mEq/L (24 mmol/L) pH of 7.25 and HCO3 of 18 mEq/L (18 mmol/L)

pH of 7.45 and HCO3 of 24 mEq/L (24 mmol/L)

A client has an increase in respiratory rate. What assessment findings does the nurse expect? Decreased pH Decreased red blood cells Increased PCO2 Decreased PCO2

Decreased PCO2

When caring for the client with hyperkalemia, the nurse recognizes the body should respond in which of these ways? store sodium and potassium for future use Actively reabsorb calcium retain bicarbonate and potassium secrete potassium in the distal tubules for excretion

secrete potassium in the distal tubules for excretion

The nurse has just received the lab results of a client's calcium level. The nurse identifies a normal calcium level as: 13.5 to 14.5 mg/dL (3.38 to 3.63 mmol/L) 12.0 to 15.0 mg/dL (3.0 to 3.75 mmol/L) 9.0 to 10.5 mg/dL (2.25 mmol/L to 2.63 mmol/L)) 3.5 to 5.3 mg/dL (0.88 to 1.32 mmol/L)

9.0 to 10.5 mg/dL (2.25 mmol/L to 2.63 mmol/L))

The nurse is caring for a client with an acid-base imbalance. Which of these does the nurse recognize is correct regarding compensation? An increased pH is demonstrated. A decreased pH is demonstrated. A pH moves toward the normal range. There is no alteration in the blood gas values.

A pH moves toward the normal range.

When caring for a client with hypomagnesemia, the nurse prioritizes assessment of which body system? Endocrine Hepatic Cardiac Pulmonary

Cardiac

Which diagnostic signs might be seen in a client whose serum calcium level is 7.1 mg/dL? Select all that apply. Chevostek Trousseau Homan Chadwick Chandelier

Chevostek Trousseau

A heart failure client has become confused and took too many of his "water pills" (diuretics). On admission, his serum potassium level was 2.6 mEq/L (2.6 mmol/L). Which assessments correlate to this hypokalemia finding? Select all that apply. Constipation Paresthesia with numbness of the lips/mouth Polyuria Bradycardia ECG showing short runs of ventricular fibrillation

Constipation Polyuria Bradycardia

Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma PCO2 levels. What is a common cause of respiratory alkalosis? Cluster breathing Kussmaul breathing Hypoventilation Hyperventilation

Hyperventilation

A community health nurse who is attending a marathon recognizes that which types of hypotonic hyponatremia is likely when a client reports muscle weakness, cramping, and general fatigue in spite of adequate water hydration during the run? Hypervolemic Hypovolemic Normovolemic Euvolemic

Hypovolemic

A female client with a history of chronic renal failure has a total serum calcium level of 7.9 mg/dL (1.98 mmol/L). While performing an assessment, the nurse should focus on which clinical manifestation associated with this calcium level? Heart rate of 120 beats/min associated with diaphoresis (sweaty) Intermittent muscle spasms and reports of numbness around her mouth Difficulty arousing the client and noticing she is disoriented to time and place Reports of shortness of breath on exertion with decreased oxygen saturation levels

Intermittent muscle spasms and reports of numbness around her mouth

The nurse is evaluating a client's blood gases. The client has a pH of 7.35. How does the nurse interpret this value? It indicates acidosis. It indicates alkalosis. It is within a normal range. It indicates a respiratory problem.

It is within a normal range.

A client has these arterial blood gas values: anion gap 20 mEq/L (20 mmol/L), pH 7.29, PCO2 37 mm Hg (4.92 mmol/L), HCO3- 11 mEq/L (11 mmol/L), base excess -6 mEq/L (-6 mmol/L). With what condition do these values correspond? Hyperkalemia Lactic acidosis lithium toxicity Multiple myeloma

Lactic acidosis

The nurse is caring for a client with worsening respiratory acidosis. Which of these interventions does the nurse anticipate if the client's condition continues to deteriorate? Introduction of large muscle exercise Resolution of the underlying emotional cause Mechanical ventilation Reducing the amount of supplemental oxygen

Mechanical ventilation

Following several days in an acidotic state, a hospitalized client has returned to a desired pH level. Which process could have contributed to the resolution of the client's health problem? Exchange of Na+ and H+ ions. Excretion of HCO3- by the kidneys. Selective renal secretion and reabsorption of CO2. Phosphate and ammonia buffer systems in the renal tubules.

Phosphate and ammonia buffer systems in the renal tubules.

What is the nurse's expectation about a client's ability to compensate for a metabolic blood gas disorder? The client will compensate with the same system. The client's breathing will slow down. The client will compensate with the respiratory system. The client will not be able to compensate.

The client will compensate with the respiratory system.