Acid Base ATI (Semester 2)

Pt has severe nausea and vomiting from Chemo. Should monitor for which clinical manifestation?

Metabolic alkalosis Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid.

Creating POC for pt at 39 week gestation in active labor. What should the nurse include?

Check cervix prior to analgesic administration. Prior to administering an analgesic during active labor, the nurse must know how many centimeters the cervix has dilated. Administration too close to the time of delivery could cause respiratory depression in the newborn.

Pt has COPD with Emphysema who has frequent, productive cough and SOB. What should the nurse find in the assessment?

Increased anteroposterior diameter of the chest The nurse should anticipate an increased anteroposterior diameter of the chest (barrel chest) because of chronic hyperinflation of the lungs.

Reviewing ABG for pt in ICU with kidney failure. Pt has respiratory acidosis. What would you expect to find?

Widened QRS Complex. A client who has respiratory acidosis is likely to cardiac changes from delayed electrical conduction through the heart, such as widened QRS complexes, tall T waves, prolonged PR intervals, and a heart rate that ranges from bradycardia to heart block.

Pt has acute pancreatitis. What is priority for pt's pain plan?

Withhold oral fluids and food. To rest the pancreas and reduce secretion of pancreatic enzymes, NPO status must be initiated and maintained during the acute phase of pancreatitis. This is the priority intervention to address after the client's pain has been treated.

Reviewing ABG for CKD. What set of values should you expect?

pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg The nurse should expect a client who has renal failure to have metabolic acidosis, which is characterized by a low HCO3-, a low pH, and a low or normal PaCO2. Expected reference ranges for these laboratory values are as follows: pH 7.35 to 7.45, HCO3- 21 to 28 mEq/L, and PaCO2 35 to 45 mm Hg.

Pt has metabolic alkalosis. What clinical manifestations should the nurse monitor?

Bicarbonate excess is correct. Bicarbonate excess is a clinical manifestation for a client experiencing metabolic alkalosis. Circumoral paresthesia is correct. Circumoral paresthesia is a clinical manifestation for a client experiencing metabolic alkalosis. Lethargy is incorrect. Lethargy is a clinical manifestation for a client experiencing metabolic acidosis. Flushing is incorrect. Flushing is a clinical manifestation for a client experiencing respiratory acidosis. Kussmaul's respirations is incorrect. Kussmaul's respirations are a clinical manifestation for a client experiencing metabolic acidosis.

Pt has new script for Pancrelipase. What should they expect regarding GI changes?

Decreased fat in stools Pancrelipase is a combination of pancreatic enzymes used to increase digestion of fats, carbohydrates and proteins. The client should expect a reduction of fat in stools.

Pt has Urolithiasis. What increase risk for renal calculi?

Dehydration Dehydration can cause hypercalcemia which increases the risk for renal stone formation. Inadequate fluid intake can result in urinary stasis and promote the formation of calculi.

Pt has pneumonia. What would promote thinning of respiratory secretions?

Encourage pt to increase fluid intake. Increasing fluid intake to1,500 to 2,500 mL/day promotes liquefaction and thinning of pulmonary secretions, which improves the client's ability to cough and remove the secretions.

Caring for a macrosomic full term newborn. Mother had poorly controlled T2DM. Newborn is in respiratory distress. Why?

Hyperinsulinemia High levels of maternal glucose increase the production of fetal insulin. High fetal insulin levels interfere with the production of surfactant.

Adolecent child has long hx of DM and is admitted to ER with acetone breath, flushed, and confused. Diabetic ketoacidosis suspected. What insulin would you expect to administer?

Regular insulin Regular insulin is classified as a short-acting insulin. It can be given intravenously with an onset of action of less than 30 min. This is the insulin that is most appropriate in emergency situations of severe hyperglycemia or diabetic ketoacidosis.

Pt has AKI. What ABG's would a nurse expect?

pH 7.26, HCO3 14, PaCO2 30 AKI causes metabolic acidosis because the kidneys cannot adequately process and excrete the acidic substances the usual bodily functions produce every day. With metabolic acidosis, the pH is low, the bicarbonate is low, and the PaCO2 is low or in the expected range, as in these results.