Prep U Chapter 9: Altered Acid-Base Balance

A client with a long history of alcohol abuse has been admitted to the emergency department after several of days of heavy drinking. The nurse can best promote the restoration of the client's acid-base balance by:

administering intravenous sodium bicarbonate as prescribed. (Pg. 222)

As other mechanisms prepare to respond to a pH imbalance, immediate buffering is a result of increased:

bicarbonate/carbonic acid regulation. (Pg. 222)

The nurse is examining a client's laboratory results and notes a decreased blood pH level. Which finding will the nurse apply as the best evidence that the client is experiencing metabolic acidosis?

decreased HCO3−

The nurse is caring for a client with metabolic alkalosis. Which of these arterial blood gas results supports this diagnosis?

pH of 7.50 and HCO3 of 45 mEq/L (45 mmol/L) (Pg. 224)

The nurse who is providing care for several clients recognizes which client is at the highest risk for developing an acid-base imbalance?

A client who is being treated for acute kidney injury and who requires dialysis (Pg. 223)

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 (Pg. 224)

The nurse is caring for a client with an acid-base imbalance. Which of these does the nurse recognize is correct regarding compensation?

A pH moves toward the normal range. (Pg. 224)

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?

In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids. (Pg. 224)

A client who has just had her first postoperative dinner out to celebrate her recovery from an intestinal bypass is brought to the emergency room by her spouse. He reports that his wife seems disoriented and is slurring her words. The client did not have any alcohol with her pasta dinner. What might be the cause of her symptoms?

Lactic acidosis (Pg. 225)

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?

Mechanical ventilation (Pg. 221)

The nurse is caring for a client who has excessive diarrhea. Which acid-base disturbance does the nurse anticipate will result from having excessive diarrhea?

Metabolic acidosis (Pg. 224)

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. (Pg. 223-224)

The nurse is caring for a client with dehydration who reports urine with a strong ammonia odor. How will the nurse explain this finding to the client?

Ammonia chloride is normally produced in the kidney's renal tubules to buffer acids. The odor is stronger because the urine is concentrated. (Pg. 223)

The nurse recognizes the role of the lungs in acid-base balance is regulation of which of the following?

CO2 (Pg. 223)

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 (Pg. 224-225)

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-

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?

Hyperventilation (Pg. 221)

The body regulates the pH of its fluids by what mechanism? Select all that apply.

-Chemical buffer systems of the body fluids -The lungs -The kidneys

The nurse is reviewing laboratory results for a client receiving total parenteral nutrition. Which finding(s) suggests metabolic acidosis secondary to TPN? Select all that apply.

-increased plasma chloride level -decreased CO2 level (Pg. 227-228)

A child accidentally consumes a container of wood alcohol. The ED physician knows that the child is at risk of developing which of the following?

Metabolic acidosis