ABG practice quiz

The nurse is told to draw an arterial blood gas sample with the client on ambient air. The nurse documents in the record that the client was receiving how much oxygen for this procedure? 16% 21% 30% 40%

21% Ambient air is the same thing as room air, which contains 21% oxygen. It is not possible to give a client 16% oxygen because it is less than room air. The remaining options of 30% and 40% contain oxygen amounts that are commonly used to supplement oxygen for clients having respiratory difficulty.

A client is diagnosed with respiratory alkalosis induced by gram-negative sepsis. The nurse would plan to carry out which prescribed measure as the most effective means to treat the problem? Administer prescribed antibiotics. Have the client breathe into a paper bag. Administer antipyretics as needed (on prn basis). Request a prescription for a partial rebreather oxygen mask.

Administer prescribed antibiotics. The most effective way to treat an acid-base disorder is to treat the underlying cause of the disorder. In this case, the problem is sepsis, which is most effectively treated with antibiotic therapy. Antipyretics will control fever secondary to sepsis but do nothing to treat the acid-base balance. The paper bag and partial rebreather mask will assist the client in rebreathing exhaled carbon dioxide, but again, these do not treat the primary cause of the imbalance.

A client with a 3-day history of nausea and vomiting and suspected gastroenteritis presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths per minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats per minute. Arterial blood gases are drawn, and the nurse reviews the results, expecting to note which finding? A decreased pH and an increased Paco2 An increased pH and a decreased Paco2 A decreased pH and a decreased HCO3- An increased pH and an increased HCO3-

An increased pH and an increased HCO3- Clients experiencing nausea and vomiting would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH and HCO3- to increase. Symptoms experienced by the client would include a decrease in the respiratory rate and depth, and tachycardia. Option 1 reflects a respiratory acidotic condition. Option 2 reflects a respiratory alkalotic condition, and option 3 reflects a metabolic acidotic condition.

The nurse is reviewing the arterial blood gas values of a client and notes that the pH is 7.31, Paco2 is 50 mm Hg, and the bicarbonate (HCO3) level is 26 mEq/L. The nurse concludes that which acid-base disturbance is present in this client? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis In respiratory acidosis, the pH is decreased and the Paco2 level is increased. Options 1, 2, and 4 are incorrect. In respiratory alkalosis, the pH is elevated with a decrease in Paco2. In metabolic acidosis, both the pH and the HCO3 are decreased. In metabolic alkalosis, the pH and HCO3 are increased.

The nurse caring for a client with chronic obstructive pulmonary disease (COPD) anticipates which arterial blood gas (ABG) findings? pH, 7.40; PaO2, 90 mm Hg; CO2, 39 mEq/L; HCO3, 23 mEq/L pH, 7.32; PaO2, 85 mm Hg; CO2, 57 mEq/L; HCO3, 26 mEq/L pH, 7.47; PaO2, 82 mm Hg; CO2, 30 mEq/L; HCO3, 31 mEq/L pH, 7.31; PaO2, 95 mm Hg; CO2, 22 mEq/L; HCO3, 19 mEq/L

pH, 7.31; PaO2, 95 mm Hg; CO2, 22 mEq/L; HCO3, 19 mEq/L A client with COPD will exist in a state of respiratory acidosis. Options 2 and 4 reflect an acidotic pH. However, option 2 demonstrates increased CO2; a decreased pH and an increased CO2 indicate respiratory acidosis. Increased CO2 acts as an acid in the body, and CO2 is elevated in the client with COPD because of an inability to exhale well and eliminate CO2. Therefore, with a rise in CO2, there is a corresponding fall in pH. The other options are incorrect.

The client with a history of chronic lung disease is at risk for developing respiratory acidosis. The nurse asks this client about which symptoms that are characteristic of this disorder? "Do you have shallow breathing?" "Do you feel as if you have a lot of energy?" "Do you have a headache or become confused?" "Do you feel dizzy or have tingling sensations?"

"Do you have a headache or become confused?" When a client is experiencing respiratory acidosis, the respiratory rate and depth increase in an attempt to compensate. The client also experiences headache, restlessness, and mental status changes such as drowsiness and confusion, visual disturbances, diaphoresis, and cyanosis as the hypoxia becomes more acute, along with hyperkalemia, a rapid irregular pulse, and dysrhythmias.

A client is about to have arterial blood gases drawn, and the nurse explains what an Allen's test is. What comment shows that the client understands the nurse's explanation? "I know I have to lie down while blood is drawn." "This test is done to make sure my circulation is good." "Blood is drawn from a special artery inside my elbow area." "The nurse will place pressure over the site for 20 minutes after blood is drawn."

"This test is done to make sure my circulation is good." The Allen's test is important because it ensures collateral circulation to the hand if thrombosis of the radial artery occurs after the puncture. Failure to determine the presence of adequate collateral circulation could result in severe ischemic injury to the hand if damage to the radial artery occurs with arterial puncture. Options 1, 3, and 4 are incorrect.

A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats/minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding? A decreased pH and an increased Paco2 An increased pH and a decreased Paco2 A decreased pH and a decreased HCO3- An increased pH and an increased HCO3-

A decreased pH and a decreased HCO3- Clients experiencing nausea and vomiting would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH and HCO3- to increase. Symptoms experienced by the client would include hypoventilation and tachycardia. Option 1 reflects a respiratory acidotic condition. Option 2 reflects a respiratory alkalotic condition, and option 3 reflects a metabolic acidotic condition.

The nurse is planning to obtain blood for arterial blood gas analysis from a client with chronic obstructive pulmonary disease. The nurse would plan time for which activity after the arterial blood specimen is drawn? Holding a warm compress over the puncture site for 5 minutes Encouraging the client to open and close the hand rapidly for 2 minutes Applying pressure to the puncture site by applying a 2 × 2 gauze for 5 minutes Having the client keep the radial pulse puncture site in a dependent position for 5 minutes

Applying pressure to the puncture site by applying a 2 × 2 gauze for 5 minutes Applying pressure over the puncture site reduces the risk of hematoma formation and damage to the artery. A cold (not warm) compress would aid in limiting blood flow. Keeping the extremity still and out of a dependent position will aid in the formation of a clot at the puncture site.

The nurse is reviewing the laboratory test results for an infant suspected of having hypertrophic pyloric stenosis. The nurse would expect to note which value as the most likely laboratory finding in this infant? Blood pH of 7.50 Blood pH of 7.35 Blood bicarbonate of 22 mEq/L (22 mmol/L) Blood bicarbonate of 27 mEq/L (27 mmol/L)

Blood pH of 7.50 Laboratory findings in an infant with hypertrophic pyloric stenosis include metabolic alkalosis due to vomiting. These include increased blood pH and bicarbonate level, decreased serum potassium and sodium levels, and a decreased chloride level. The normal pH is 7.35 to 7.45. The normal bicarbonate is 21 to 28 mEq/L (21 to 28 mmol/L).

The nurse is caring for a client with diabetic ketoacidosis whose respirations are abnormally deep, regular, and increased in rate. The nurse monitors the client, expecting that which occurs with this type of respiration? Select all that apply. Correction of bradypnea Blowing off carbon dioxide Correction of metabolic acidosis Correction of an acid-base imbalance Respiratory compensation Stimulation of Cheyne-Stokes respirations

Blowing off carbon dioxide Correction of metabolic acidosis Correction of an acid-base imbalance Respiratory compensation Abnormally deep, regular respirations that are increased in rate enable respiratory compensation to help correct metabolic acidosis. These respirations are called Kussmaul's respirations, and they occur by exhaling excess carbon dioxide. Bradypnea is abnormally slow but regular respirations. Cheyne-Stokes respirations have rhythmic crescendo and decrescendo of rate and depth, including brief periods of apnea. Kussmaul's respirations do not stimulate Cheyne-Stokes respirations.

A client has been diagnosed with metabolic alkalosis as a result of excessive antacid use. The nurse monitoring this client would expect to note which signs/symptoms? Disorientation and dyspnea Decreased respiratory rate and depth Drowsiness, headache, and tachypnea Tachypnea, dizziness, and paresthesias

Decreased respiratory rate and depth A client with metabolic alkalosis is likely to exhibit decreased respiratory rate and depth as a compensatory mechanism. A client with metabolic acidosis would display the symptoms noted in option 3. The client with respiratory acidosis and the client with respiratory alkalosis would display the symptoms noted in options 1 and 4, respectively.

The nurse is providing care to a client with the following arterial blood gas results: pH of 7.50, Pao2 of 90 mm Hg, Paco2 of 40 mm Hg, and bicarbonate of 35 mEq/L. When the nurse notifies the primary health care provider about these levels, the nurse would anticipate receiving from the PHCP which prescription for this client? Obtain a serum alcohol level. Obtain a serum salicylate level. Discontinue nasogastric suctioning. Discontinue the client's fentanyl patch.

Discontinue nasogastric suctioning. The arterial blood gas (ABG) results indicate metabolic alkalosis, as the pH and bicarbonate are elevated. Nasogastric suctioning may cause metabolic alkalosis by decreasing the acid components in the stomach. Excess alcohol ingestion and salicylate toxicity may cause metabolic acidosis. Fentanyl (an opioid) may cause respiratory acidosis.

The nurse is caring for a client who overdosed on acetylsalicylic acid (aspirin) 24 hours ago. The nurse would expect to note which findings associated with an anticipated acid-base disturbance? Disorientation and dyspnea Drowsiness, headache, and tachypnea Tachypnea, dizziness, and paresthesias Decreased respiratory rate and depth, cardiac irregularities

Drowsiness, headache, and tachypnea The client who ingests a large amount of acetylsalicylic acid (aspirin) is at risk for developing metabolic acidosis 24 hours later. If metabolic acidosis occurs, the client is likely to exhibit drowsiness, headache, and tachypnea. In the very early hours following aspirin overdose, the client may exhibit respiratory alkalosis as a compensatory mechanism. However, by 24 hours post overdose, the compensatory mechanism fails, and the client reverts to metabolic acidosis. The client with metabolic alkalosis (option 4) is likely to experience cardiac irregularities and a compensatory decreased respiratory rate and depth. Options 1 and 3 indicate respiratory acidosis and alkalosis, respectively.

A client with a chronic airflow limitation is experiencing respiratory acidosis as a complication. The nurse who is trying to enhance the client's respiratory status would avoid which action? Keeping the head of the bed elevated Monitoring the flow rate of supplemental oxygen Assisting the client to turn, cough, and breathe deeply Encouraging the client to breathe slowly and shallowly

Encouraging the client to breathe slowly and shallowly The client with respiratory acidosis is experiencing elevated carbon dioxide levels caused by insufficient ventilation. The nurse would encourage the client to breathe slowly and deeply to expand alveoli and to promote better gas exchange. The actions listed in options 1, 2, and 3 are helpful actions on the part of the nurse.

A client is admitted to the hospital 24 hours after an aspirin (acetylsalicylic acid) overdose. The nurse assesses the client for which signs or symptoms indicating an acid-base disturbance that could occur in the client? Bradypnea, dizziness, and paresthesias Headache, nausea, vomiting, and diarrhea Bradycardia, listlessness, and hyperactivity Restlessness, confusion, and a positive Trousseau's sign

Headache, nausea, vomiting, and diarrhea The client who ingests a large amount of aspirin (acetylsalicylic acid) is at risk for developing metabolic acidosis 24 hours after the poisoning. If metabolic acidosis occurs, the client may exhibit hyperpnea with Kussmaul's respirations, headache, nausea, vomiting, diarrhea, fruity-smelling breath because of improper fat metabolism, central nervous system depression, twitching, convulsions, and hyperkalemia. Shortly after aspirin overdose, the client may exhibit respiratory alkalosis as a compensatory mechanism. By 24 hours postoverdose, however, the compensatory mechanism fails, and the client reverts to metabolic acidosis.

A client with a history of lung disease is at risk for developing respiratory acidosis. The nurse would assess the client for which signs and symptoms characteristic of this disorder? Bradycardia and hyperactivity Decreased respiratory rate and depth Headache, restlessness, and confusion Bradypnea, dizziness, and paresthesias

Headache, restlessness, and confusion When a client is experiencing respiratory acidosis, the respiratory rate and depth increase in an attempt to compensate. The client also experiences headache; restlessness; mental status changes, such as drowsiness and confusion; visual disturbances; diaphoresis; cyanosis as the hypoxia becomes more acute; hyperkalemia; rapid, irregular pulse; and dysrhythmias. Options 1, 2, and 4 are not specifically associated with this disorder.

A child is hospitalized because of persistent vomiting. The nurse would monitor the child closely for which problem? Diarrhea Metabolic acidosis Metabolic alkalosis Hyperactive bowel sounds

Hyperactive bowel sounds Vomiting causes the loss of hydrochloric acid and subsequent metabolic alkalosis. Metabolic acidosis would occur in a child experiencing diarrhea because of the loss of bicarbonate. Diarrhea might or might not accompany vomiting. Hyperactive bowel sounds are not associated with vomiting.

A client is determined by blood gas analysis to be in respiratory alkalosis. Which electrolyte disorder would the nurse monitor for that could accompany the acid-base imbalance? Hypokalemia Hypercalcemia Hypochloremia Hypernatremia

Hypokalemia Clinical manifestations of respiratory alkalosis include tachypnea, hyperpnea, weakness, paresthesias, tetany, dizziness, convulsions, coma, hypokalemia, and hypocalcemia. The clinical picture does not include hypercalcemia, hypochloremia, or hypernatremia.

A client with chronic obstructive pulmonary disease who sustained a head injury has a high level of carbon dioxide (CO2) in the bloodstream, as measured by arterial blood gases. The nurse anticipates that which underlying pathophysiology can occur as a result of this elevated CO2? It will cause arteriovenous shunting. It will cause vasodilation of blood vessels in the brain. It will cause blood vessels in the circle of Willis to collapse. It will cause hyperresponsiveness of blood vessels in the brain.

It will cause vasodilation of blood vessels in the brain. CO2 is one of the metabolic end products that can alter the tone of the blood vessels in the brain. High CO2 levels cause vasodilation, which may cause headache, whereas low CO2 levels cause vasoconstriction, which may cause light-headedness. The statements included in the other options are incorrect effects.

A client's blood gas results reveal acidosis. What are some signs and symptoms the nurse would expect to see? Select all that apply. Seizures Lethargy Headache Weakness Confusion Hyperactivity

Lethargy Headache Weakness Confusion In both respiratory and metabolic acidosis, the central nervous system (CNS) is depressed. Headache, lethargy, weakness, and confusion develop, leading eventually to coma and death. Therefore, seizures and hyperactivity would not be noted.

A client reports ingesting large amounts of oral antacids on a daily basis because of a gastric ulcer. The nurse plans care, knowing that the excessive use of oral antacids containing bicarbonate can result in which acid-base disturbance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic alkalosis Increases in base components occur as a result of oral or parenteral intake of bicarbonates, carbonates, acetates, citrates, or lactates. Excessive use of oral antacids containing bicarbonate can cause a metabolic alkalosis. The remaining acid-base disturbances are incorrect.

The nurse notes that a client's arterial blood gas (ABG) results reveal a pH of 7.50 and a Paco2 of 30 mm Hg (30 mm Hg). The nurse monitors the client for which clinical manifestations associated with these ABG results? Select all that apply. Nausea Confusion Bradypnea Tachycardia Hyperkalemia Light-headedness

Nausea Confusion Tachycardia Light-headedness Respiratory alkalosis is defined as a deficit of carbonic acid or a decrease in hydrogen ion concentration that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions that cause overstimulation of the respiratory system. Clinical manifestations of respiratory alkalosis include lethargy, light-headedness, confusion, tachycardia, dysrhythmias related to hypokalemia, nausea, vomiting, epigastric pain, and numbness and tingling of the extremities. Hyperventilation (tachypnea) occurs. Bradypnea describes respirations that are regular but abnormally slow. Hyperkalemia is associated with acidosis.

A client's arterial blood gas results reveal a Pao2 of 55 mm Hg. The client's admitting diagnosis is acute respiratory failure secondary to community-acquired pneumonia. What is the nurse's best action? Repeat arterial blood gas testing. Maintain continuous pulse oximetry. Decrease the amount of oxygen administered. Notify the primary health care provider (PHCP).

Notify the primary health care provider (PHCP). Respiratory failure is defined as a Pao2 of 60 mm Hg or lower. The nurse needs to notify the PHCP for further prescriptions. Common causes of hypoxemic respiratory failure are pneumonia, pulmonary embolism, and shock. This client needs to be receiving oxygen. Repeating the arterial blood gases and maintaining continuous pulse oximetry do nothing to correct the problem.

A client with a fractured femur experiences sudden dyspnea, tachypnea, and tachycardia. A set of arterial blood gas tests reveals the following: pH, 7.35 (7.35); Paco2, 43 mm Hg (43 mm Hg); Pao2, 58 mm Hg (58 mm Hg); HCO3, 23 mEq/L (23 mmol/L). The nurse interprets that the client probably has experienced fat embolus because of the result of which parameter? pH Pao2 Hco3 Paco2

Pao2 A significant feature of fat embolism is a significant degree of hypoxemia, with a Pao2 often less than 60 mm Hg (60 mm Hg). The data in the question indicate that the items in the remaining options are normal blood gas results.

A client with no history of respiratory disease is admitted to the hospital with respiratory failure. Which results on the arterial blood gas report that are consistent with this disorder would the nurse expect to note? Pao2 58 mm Hg, Paco2 32 mm Hg Pao2 60 mm Hg, Paco2 45 mm Hg Pao2 49 mm Hg, Paco2 52 mm Hg Pao273 mm Hg, Paco262 mm Hg

Pao2 49 mm Hg, Paco2 52 mm Hg Respiratory failure is described as a Pao2 of 60 mm Hg or lower and a Paco2 of 50 mm Hg or higher in a client with no history of respiratory disease. In a client with a history of a respiratory disorder with hypercapnia, increases of 5 mm Hg or more (Paco2) from the client's baseline are considered diagnostic.

A client is being treated for metabolic acidosis with medication therapy and other measures. The nurse would plan to monitor the results of which electrolyte, which could dramatically decline with effective treatment of the acidosis? Sodium Potassium Magnesium Phosphorus

Potassium The serum potassium level tends to rise with metabolic acidosis. This is because potassium moves out of the cells and into the bloodstream. When acidosis is corrected with treatment, the potassium will shift back into the cellular compartment. This can cause a rapid drop in the serum potassium level. Because of the effects of potassium on the heart, this electrolyte needs to be monitored closely while the client is treated.

The nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a Paco2 of 30 mm Hg. The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition? Magnesium level of 1.8 (0.74 mmol/L) Sodium level of 145 mEq/L (145 mmol/L) Potassium level of 3.0 mEq/L (3.0 mmol/L) Phosphorus level of 3.0 mg/dL (0.97 mmol/L)

Potassium level of 3.0 mEq/L (3.0 mmol/L) Respiratory alkalosis is defined as a deficit of carbonic acid or a decrease in hydrogen ion concentration that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions that cause overstimulation of the respiratory system. Some clinical manifestations of respiratory alkalosis include light-headedness, confusion, tachycardia, dysrhythmias related to hypokalemia, nausea, vomiting, diarrhea, epigastric pain, and numbness and tingling of the extremities. All three incorrect options identify normal laboratory values. The correct option identifies the presence of hypokalemia.

The nurse is caring for a client with chronic kidney disease. Arterial blood gas results indicate a pH of 7.30 (7.30), a Paco2 of 32 mm Hg (32 mm Hg), and a bicarbonate concentration of 20 mEq/L (20 mmol/L). Which laboratory value would the nurse expect to note? Sodium level of 145 mEq/L (145 mmol/L) Potassium level of 5.2 mEq/L (5.2 mmol/L) Phosphorus level of 3.0 mg/dL (0.97 mmol/L) Magnesium level of 1.3 mg/dL (0.53 mmol/L)

Potassium level of 5.2 mEq/L (5.2 mmol/L) Interpretation of the arterial blood gas (ABG) indicates metabolic acidosis with partial compensation by the respiratory system. Clinical manifestations of metabolic acidosis include hyperpnea with Kussmaul's respirations; headache; nausea, vomiting, and diarrhea; fruity-smelling breath resulting from improper fat metabolism; central nervous system depression, including mental dullness, drowsiness, stupor, and coma; twitching; and convulsions. Hyperkalemia will occur.

An anxious client is experiencing respiratory alkalosis from hyperventilation caused by anxiety. The nurse would take which action to help the client experiencing this acid-base disorder? Put the client in a supine position. Provide emotional support and reassurance. Withhold all sedative or antianxiety medications. Tell the client to breathe deeply but more rapidly.

Provide emotional support and reassurance. An anxious client benefits from emotional support and reassurance, which in turn reduces anxiety and may lower the respiratory rate. The client may benefit from the administration of a sedative or antianxiety medication if it is prescribed. The client would try to breathe more slowly. Lying supine provides no benefit to the client and may cause problems with breathing.

The nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul's respirations. Which patterns did the nurse observe? Select all that apply. Respirations that are shallow Respirations that are increased in rate Respirations that are abnormally slow Respirations that are abnormally deep Respirations that cease for several seconds

Respirations that are increased in rate Respirations that are abnormally deep Kussmaul's respirations are abnormally deep and increased in rate. These occur as a result of the compensatory action by the lungs. In bradypnea, respirations are regular but abnormally slow. Apnea is described as respirations that cease for several seconds.

A client who is found unresponsive has arterial blood gases drawn and the results indicate the following: pH is 7.12, Paco2 is 90 mm Hg, and HCO3- is 22 mEq/L. The nurse interprets the results as indicating which condition? Metabolic acidosis with compensation Respiratory acidosis with compensation Metabolic acidosis without compensation Respiratory acidosis without compensation

Respiratory acidosis without compensation The acid-base disturbance is respiratory acidosis without compensation. The normal pH is 7.35 to 7.45. The normal Paco2is 35 to 45 mm. In respiratory acidosis, the pH is decreased and the Paco2 is elevated. The normal bicarbonate (HCO3-) level is 21 to 28 mEq/L. Because the bicarbonate is still within normal limits, the kidneys have not had time to adjust for this acid-base disturbance. In addition, the pH is not within normal limits. Therefore, the condition is without compensation. The remaining options are incorrect interpretations.

Arterial blood gas analysis yields the following results: pH 7.48 (7.48), Paco2 32 mm Hg (32 mm Hg), Pao2 94 mm Hg (94 mm Hg), HCO3 level 24 mEq/L (24 mmol/L) for a client seen in the health care clinic. The nurse interprets that the client has which acid-base disturbance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory alkalosis The normal pH is 7.35 to 7.45. The normal Paco2 is 35 to 45 mm Hg, and the normal HCO3 concentration is 21 to 28 mEq/L. The pH is elevated in alkalosis and low in acidosis. In a respiratory condition, an opposite effect will be seen between the pH and the Paco2. In a metabolic condition, the pH and the bicarbonate move in the same direction.

The nurse is caring for a client with respiratory failure related to Guillain-Barré syndrome. The nurse understands that what other extrapulmonary causes can lead to respiratory failure? Select all that apply. Stroke Pneumonia Sleep apnea Obstructive lung disease Opioid analgesics, sedatives, anesthetics

Stroke Sleep apnea Opioid analgesics, sedatives, anesthetics Extrapulmonary causes of respiratory failure include the following: stroke; sleep apnea; and opioid analgesics, sedatives, and anesthetics. Both obstructive lung disease and pneumonia are intrapulmonary causes of respiratory failure.

The nurse is caring for a client whose arterial blood gas results reveal alkalosis. What client reactions would the nurse expect to see? Select all that apply. Tetany Lethargy Tingling Confusion Numbness Restlessness

Tetany Tingling Numbness Restlessness A client's reaction to alkalosis causes tingling and numbness of the fingers, restlessness, and tetany caused by irritability of the central nervous system (CNS). If the severity of alkalosis increases, convulsions and coma may occur.

The nurse is caring for a client having respiratory distress related to an anxiety attack. Recent arterial blood gas (ABG) values are pH = 7.53, Pao2 = 72 mm Hg, Paco2 = 32 mm Hg, and HCO3- = 28 mEq/L (28 mmol/L). Which conclusion about the client would the nurse make? The client has acidotic blood. The client is probably overreacting. The client is fluid volume overloaded. The client is probably hyperventilating.

The client is probably hyperventilating. The ABG values are abnormal, which supports a physiological problem. The ABGs indicate respiratory alkalosis, not acidosis, as a result of hyperventilating. Concluding that the client is overreacting is an inaccurate analysis. No conclusion can be made about a client's fluid volume status from the information provided.

The nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which result validates the nurse's findings? pH 7.25, Paco2 50 mm Hg pH 7.35, Paco2 40 mm Hg pH 7.50, Paco2 52 mm Hg pH 7.52, Paco228 mm Hg

pH 7.25, Paco2 50 mm Hg Atelectasis is a condition characterized by the collapse of alveoli, preventing the respiratory exchange of oxygen and carbon dioxide in a part of the lungs. The normal pH is 7.35 to 7.45. The normal Paco2 is 35 to 45 mm Hg. In respiratory acidosis, the pH is decreased and the Paco2 is elevated. Option 2 identifies normal values. Option 3 identifies an alkalotic condition, and option 4 identifies respiratory alkalosis.

A client is examined in the hospital emergency department after taking an overdose of acetylsalicylic acid. The client has rapid breathing, nausea and vomiting, and lethargy. The primary health care provider prescribes arterial blood specimens for blood gas analysis to be drawn. Aspirin toxicity is suspected when the blood gas results are reported as which value? pH 7.50, Pco2 60 mm3 Hg, HCO3 30 mEq/L (30 mmol/L) pH 7.44, Pco2 30 mm3 Hg, HCO3 21 mEq/L (21 mmol/L) pH 7.29, Pco2 29 mm3 Hg, HCO3 19 mEq/L (19 mmol/L) pH 7.33, Pco252 mm3Hg, HCO328 mEq/L (28 mmol/L)

pH 7.29, Pco2 29 mm3 Hg, HCO3 19 mEq/L (19 mmol/L) The client who has aspirin toxicity will manifest metabolic acidosis with respiratory compensation as seen when the pH is lower than 7.35 mm Hg and the HCO3 is less than 22 mEq/L (22 mmol/L). In the correct option, the pH is acidotic and the HCO3 is decreased, indicating metabolic acidosis. The Pco2 is alkalotic, indicating partial compensation.

The nurse is reviewing the arterial blood gas analysis results for a client in the respiratory care unit who is receiving nasal oxygen and notes a pH of 7.38, Paco2 of 38 mm Hg, Pao2 of 86 mm Hg, and HCO3 of 23 mEq/L. What action would the nurse take in response to these results? Discontinue the oxygen. Continue to monitor the client. Call 911 to have the client intubated immediately. Have another set drawn because these results are not possible.

Call 911 to have the client intubated immediately. The client's results fall in the normal range for pH (7.35 to 7.45), Paco2 (35 to 45 mm Hg), and bicarbonate level (21 to 28 mEq/L). With acidosis, the pH would be less than 7.35; with alkalosis, the pH would be greater than 7.45. Carbon dioxide levels would be high with respiratory acidosis, whereas bicarbonate levels would be low if metabolic acidosis were present.

The nurse is caring for a client with metabolic alkalosis. The nurse plans care, knowing that most problems of metabolic alkalosis are related to increased stimulation of what systems? Select all that apply. Buffer Cardiac Nervous Chemical Respiratory Neuromuscular

Cardiac Nervous Neuromuscular Most problems of alkalosis are related to increased stimulation of the cardiac, nervous, and neuromuscular systems. Chemical reactions are also called buffer systems and are not related to most problems of alkalosis. The respiratory system is related to respiratory alkalosis and not metabolic alkalosis.

A client experiencing metabolic acidosis is to be admitted to the nursing unit. The nurse plans care, knowing that what reaction is the most powerful regulator of acid-base balance? uffer Kidney Cations Respiratory

Kidney The renal reaction is the most powerful regulator of acid-base balance. Renal tubules secrete hydrogen ions and potassium effectively, and in lesser amounts they secrete ammonia and uric acid. They respond to large or chronic fluctuations in hydrogen ion production or elimination and also reabsorb carbon dioxide molecules. However, the kidney tubules have the slowest response (hours to days).

An anxious preoperative client is at risk for developing respiratory alkalosis. The nurse would assess the client for which signs and symptoms characteristic of this disorder? Headache and tachypnea Hyperactivity and dyspnea Muscle twitches and cyanosis Light-headedness and paresthesias

Light-headedness and paresthesias Clinical manifestations of respiratory alkalosis include a decrease in the respiratory rate and depth, headache, light-headedness, vertigo, mental status changes, paresthesias such as tingling of the fingers and toes, hypokalemia, hypocalcemia, tetany, and convulsions. The remaining three options are not clinical manifestations of respiratory alkalosis.

A client with diabetes mellitus is most likely to experience which type of acid-base imbalance as a complication of the disorder? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis Diabetes mellitus can lead to metabolic acidosis. When the body does not have sufficient circulating insulin, the blood glucose level rises while the cells of the body use all available glucose and then break down glycogen and fat for fuel. The by-products of fat metabolism are acidotic, leading to the complication called diabetic ketoacidosis. The acid-base disorders in the remaining options are unlikely to occur in diabetes mellitus unless there is another existing disorder.

A client with diabetes mellitus has a blood glucose level of 644 mg/dL (35.7 mmol/L). The nurse plans care, knowing that the client is at risk for the development of which type of acid-base imbalance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis Diabetes mellitus can lead to metabolic acidosis. When the body does not have sufficient circulating insulin, the blood glucose level rises. At the same time, the cells of the body use all available glucose. The body then breaks down glycogen and fat for fuel. The by-products of fat metabolism are acidotic, potentially leading to the condition known as diabetic ketoacidosis. The remaining options are incorrect.

The nurse is caring for a client with hyperglycemia and diabetic ketoacidosis (DKA) who now has developed Kussmaul's respirations. The nurse plans care, understanding that the purpose of this type of breathing is to correct what imbalance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis Kussmaul's respirations cause respiratory compensation in an attempt to correct metabolic acidosis by exhaling carbon dioxide. This breathing pattern is very deep and rapid and is the respiratory system's attempt to correct metabolic acidosis by exhaling carbon dioxide.

The nurse is reviewing the laboratory results for an infant with suspected hypertrophic pyloric stenosis. What would the nurse expect to note as the most likely finding in this infant? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic alkalosis Laboratory findings in an infant with hypertrophic pyloric stenosis include metabolic alkalosis as a result of the vomiting that occurs in this disorder. Additional findings include decreased serum potassium and sodium levels, increased pH and bicarbonate levels, and decreased chloride level. The remaining options are incorrect.

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic alkalosis Metabolic alkalosis is defined as a deficit or loss of hydrogen ions or acids or an excess of base (bicarbonate) that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions resulting in hypovolemia, the loss of gastric fluid, excessive bicarbonate intake, the massive transfusion of whole blood, and hyperaldosteronism. Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis as a result of the loss of hydrochloric acid. The remaining options are incorrect interpretations.

A child is hospitalized because of persistent vomiting. The nurse would monitor the child closely for which priorityproblem? Diarrhea Metabolic acidosis Metabolic alkalosis Hyperactive bowel sounds

Metabolic alkalosis Vomiting causes the loss of hydrochloric acid and subsequent metabolic alkalosis. Metabolic acidosis would occur in a child experiencing diarrhea because of the loss of bicarbonate. Diarrhea might or might not accompany vomiting. Hyperactive bowel sounds are not associated with vomiting.

The nurse is caring for a client who has a small-bowel obstruction (SBO) and has reported vomiting for over the past 12 hours. The nurse assesses the client for signs and symptoms of which acid-base imbalance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic alkalosis Vomiting generates metabolic alkalosis by the loss of gastric secretions, which are rich in hydrochloric acid (HCl). Whenever a hydrogen is excreted, a bicarbonate ion is gained in the extracellular space. The decreased HCl level creates the actual base deficit of metabolic alkalosis. The client with severe vomiting is not at risk for developing the acid-base disorders identified in options 1, 3, and 4.

The nurse notes that a client's arterial blood gas (ABG) results reveal a pH of 7.50 and a Paco2 of 30 mm Hg. The nurse monitors the client for which clinical manifestations associated with these ABG results? Select all that apply. Nausea Confusion Bradypnea Tachycardia Hyperkalemia Light-headedness

Nausea Confusion Tachycardia Light-headedness Respiratory alkalosis is defined as a deficit of carbonic acid or a decrease in hydrogen ion concentration that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions that cause overstimulation of the respiratory system. Clinical manifestations of respiratory alkalosis include lethargy, light-headedness, confusion, tachycardia, dysrhythmias related to hypokalemia, nausea, vomiting, epigastric pain, and numbness and tingling of the extremities. Hyperventilation (tachypnea) occurs. Bradypnea describes respirations that are regular but abnormally slow. Hyperkalemia is associated with acidosis.

A client with coronavirus-2019 (COVID-19) has a prescription for a set of arterial blood gas (ABG) samples to be drawn on room air. The client currently is receiving oxygen by nasal cannula at a delivery rate of 3 L/min. After reading the prescription, the nurse would take which action? Remove the nasal cannula for 15 minutes; then have the ABG samples drawn. Change the nasal cannula to a shovel face mask; then have the ABG samples drawn. Leave the nasal cannula in place and have the ABG samples drawn. Change the nasal cannula to a Venturi face mask; then have the ABG samples drawn.

Remove the nasal cannula for 15 minutes; then have the ABG samples drawn. The client would have oxygen supplementation removed for at least 15 minutes before ABGs are drawn if the client has a prescription for the ABGs to be drawn on room air. This allows time for the client's system to equilibrate so that the ABG results will accurately reflect ventilatory status without the supplemental oxygen. This prescription may be given when the primary health care provider is trying to decide whether to discontinue oxygen therapy, and it allows staff to observe how the client tolerates oxygen removal. Therefore, the remaining options are incorrect.

The nurse is admitting to the hospital a client with a diagnosis of Guillain-Barré syndrome. The nurse knows that if the disease is severe, the client will be at risk for which acid-base imbalance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis Guillain-Barré is a neuromuscular disorder in which the client may experience weakening or paralysis of the muscles used for respiration. This could cause the client to retain carbon dioxide, leading to respiratory acidosis and ventilatory failure as the paralysis develops. Therefore, the remaining options are incorrect.

The nurse reviews the arterial blood gas results of a client with emphysema and notes that the laboratory report indicates a pH of 7.30, Paco2 of 58 mm Hg, Pao2 of 80 mm Hg, and Hco3 of 27 mEq/L. The nurse interprets that the client has which acid-base disturbance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis The normal pH is 7.35 to 7.45. Normal Paco2 is 35 to 45 mm Hg. In respiratory acidosis, the pH is low and Paco2 is elevated. Options 1, 2, and 4 are incorrect interpretations of the values identified in the question.

The nurse is caring for a client with several broken ribs. The client is most likely to experience what type of acid-base imbalance? Respiratory acidosis from inadequate ventilation Respiratory alkalosis from anxiety and hyperventilation Metabolic acidosis from calcium loss due to broken bones Metabolic alkalosis from taking analgesics containing base products

Respiratory acidosis from inadequate ventilation Respiratory acidosis is most often caused by hypoventilation. The client with broken ribs will have difficulty with breathing adequately and is at risk for hypoventilation and resultant respiratory acidosis. The remaining options are incorrect. Respiratory alkalosis is associated with hyperventilation. There are no data in the question that indicate calcium loss or that the client is taking analgesics containing base products.

A client who is found unresponsive has arterial blood gases drawn, and the results indicate the following: pH is 7.12, Paco2 is 90 mm Hg, and HCO3- is 22 mEq/L (22 mmol/L). The nurse interprets the results as indicating which condition? Metabolic acidosis with compensation Respiratory acidosis with compensation Metabolic acidosis without compensation Respiratory acidosis without compensation

Respiratory acidosis without compensation The acid-base disturbance is respiratory acidosis without compensation. The normal pH is 7.35 to 7.45. The normal Paco2is 35 to 45 mm Hg. In respiratory acidosis the pH is decreased and the Pco2 is elevated. The normal bicarbonate HCO3-level is 21 to 28 mEq/L (21 to 28 mmol/L). Because the bicarbonate is still within normal limits, the kidneys have not had time to adjust for this acid-base disturbance. In addition, the pH is not within normal limits. Therefore, the condition is without compensation. The remaining options are incorrect interpretations.

The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Paco2 of 30 mm Hg, and HCO3- of 20 mEq/L (20 mmol/L). The nurse analyzes these results as indicating which condition? Metabolic acidosis, compensated Respiratory alkalosis, compensated Metabolic alkalosis, uncompensated Respiratory acidosis, uncompensated

Respiratory alkalosis, compensated The normal pH is 7.35 to 7.45. In a respiratory condition, an opposite effect will be seen between the pH and the Paco2. In this situation, the pH is at the high end of the normal value and the Pco2 is low. In an alkalotic condition, the pH is elevated. Therefore, the values identified in the question indicate a respiratory alkalosis that is compensated by the kidneys through the renal excretion of bicarbonate. Because the pH has returned to a normal value, compensation has occurred.

The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Paco2 of 30 mm Hg (30 mm Hg), and HCO3- of 20 mEq/L (20 mmol/L). The nurse analyzes these results as indicating which condition? Metabolic acidosis, compensated Respiratory alkalosis, compensated Metabolic alkalosis, uncompensated Respiratory acidosis, uncompensated

Respiratory alkalosis, compensated The normal pH is 7.35 to 7.45. In a respiratory condition, an opposite effect will be seen between the pH and the Paco2. In this situation, the pH is at the high end of the normal value, and the Pco2 is low. In an alkalotic condition, the pH is elevated. Therefore, the values identified in the question indicate a respiratory alkalosis that is compensated by the kidneys through the renal excretion of bicarbonate. Because the pH has returned to a normal value, compensation has occurred.

The nurse reviews a client's arterial blood gas values and notes a pH of 7.50 (7.50), a Paco2 of 30 mm Hg (30 mm Hg), and an HCO3 of 25 mEq/L (25 mmol/L). The nurse would interpret these values as an indication of which condition? Metabolic acidosis, uncompensated Respiratory acidosis, uncompensated Respiratory alkalosis, uncompensated Metabolic acidosis, partially compensated

Respiratory alkalosis, uncompensated In respiratory alkalosis, the pH will be higher than normal, and the Paco2 will be low. The normal pH is 7.35 to 7.45. The normal Paco2 is 35 to 45 mm Hg. The correct option is the only one that reflects these conditions.

The nurse is caring for a client who is experiencing metabolic alkalosis. Knowing the risks of this imbalance, the nurse plans to protect the client's safety by carefully implementing which prescribed precaution? Contact isolation Seizure precautions Bleeding precautions Neutropenic precautions

Seizure precautions The client with metabolic alkalosis is at risk for tetany and seizures. The nurse would maintain client safety by using seizure precautions with this client. The remaining options are unnecessary in the care of the client experiencing metabolic alkalosis.

The nurse is caring for a hospitalized client with chronic obstructive pulmonary disease who is retaining carbon dioxide (CO2). The nurse anticipates which physical response will initially occur? The client will lose consciousness. The client's sodium and chloride levels will rise. The client will complain of facial numbness and tingling. The client's arterial blood gas results will reflect acidosis.

The client's sodium and chloride levels will rise. When the client with respiratory disease retains CO2, a rise in CO2 will occur. This results in a corresponding fall in pH, thus respiratory acidosis. This concept forms the basis for key aspects of acid-base balance. The other options are incorrect and are not associated with this initial physical response.

The nurse is caring for a client who is retaining carbon dioxide (CO2) as a result of an obstructive respiratory disease. The nurse plans interventions, knowing that as the client's CO2 level rises, what will occur with the blood pH? The pH will fall The pH will rise The pH will double The pH will remain unchanged

The pH will fall CO2 acts as an acid in the body. A rise in blood CO2 will result in a fall in pH. The other options are incorrect.