PrepU: Ch. 8 Fluid and Electrolyte Imbalance

Which clients are at risk for developing metabolic alkalosis? Select all that apply.

A client with chronic kidney disease taking calcium carbonate A client with gastric suction for a bowel obstruction A client with heart failure receiving furosemide

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

Of the following clients, who would be at highest risk for developing hyperkalemia?

A male admitted for acute renal failure following a drug overdose

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

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

Chemical buffer systems of the body fluids The kidneys The lungs

A client has been diagnosed with metabolic acidosis. What assessment finding does the nurse expect?

Decreased pH below 7.35

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?

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?

Intermittent muscle spasms and reports of numbness around her mouth

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?

Metabolic acidosis

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

Metabolic acidosis

A client tells the nurse that the client has been taking Alka-Seltzer (bicarbonate—antacid) four times a day for the past 2 weeks for an upset stomach. Upon assessment of the client, the nurse notes hyperactive reflexes, tetany, and mental confusion. Arterial blood gases reveal pH 7.55; serum HCO3− 37 mEq/L (37 mmol/L). The nurse suspects the client may be experiencing:

Metabolic alkalosis

Which clinical manifestation would lead the nurse to suspect a client has developed fluid volume excess?

weight gain

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.

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?

Respiratory acidosis

The nurse has just received the lab results of a client's calcium level. The nurse identifies a normal calcium level as:

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

The nurse is caring for the following group of clients. Select the client most likely to be diagnosed with respiratory alkalosis.

A 26-year-old female with anxiety who has been hyperventilating

The nurse is caring for a client who has developed hypoxemia and tissue hypoxia. Which of these interventions does the nurse set as a priority intervention?

Administration of supplemental oxygen

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

CO2

The nurse is caring for a client who receives hemodialysis. The nurse knows that hemodialysis involves movement of charged or uncharged particles along a concentration gradient. Which function best describes this process?

Diffusion

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:

Osmosis

A nurse is caring for a client with a low sodium level and increased water retention. Hematocrit and blood urea nitrogen levels are decreased, urine osmolality is high, and serum osmolality is low. A chest x-ray shows a possible lung mass. Based on these findings, which problem could the client be diagnosed with?

Syndrome of inappropriate antidiuretic hormone (SIADH)