Acid Base Balance and ABGs

When analyzing an arterial blood gas report of a pt with COPD & respiratory acidosis, the nurse anticipates that compensation will develop through which of the following mechanisms? a) The kidneys retain bicarbonate. b) The kidneys excrete bicarbonate. c) The lungs will retain carbon dioxide. d) The lungs will excrete carbon dioxide.

a) The kidneys retain bicarbonate.

Which of the following would be a potential cause for respiratory acidosis? a. Diarrhea b. Vomiting c. Hyperventilation d. Hypoventilation

d. Hypoventilation

The nurse is caring for a pt diagnosed with renal failure. Which of the following does the nurse recognize as compensation for the acid-base disturbance found in pts with renal failure? a) The pt breathes rapidly to eliminate carbon dioxide. b) The pt will retain bicarbonate in excess of normal. c) The pH will decrease from the present value. d) The pt's oxygen saturation level will improve.

a) The pt breathes rapidly to eliminate carbon dioxide.

An elderly postoperative pt is demonstrating lethargy, confusion, & a resp rate of 8 per minute. The nurse sees that the last dose of pain medication administered via a pt controlled anesthesia (PCA) pump was within 30 minutes. Which of the following acid-base disorders might this pt be experiencing? a) respiratory acidosis b) metabolic acidosis c) respiratory alkalosis d) metabolic alkalosis

a) respiratory acidosis

The nurse is reviewing a pt's blood pH level. Which of the systems in the body regulate blood pH? Select all that apply. a) renal b) cardiac c) buffers d) respiratory

a, c, d

Which of the following may occur with respiratory acidosis? a. Increased intracranial pressure b. Mental alertness c. Decreased pulse d. Decreased blood pressure

a. Increased intracranial pressure

A nurse caring for a client with an ileostomy understands that the client is most at risk for developing which acid-base disorder? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

a. Metabolic acidosis

A nurse notes that a client's arterial blood gas results reveal a pH of 7.50 and a PCO2 of 30 mm Hg. The nurse monitors that client for which clinical manifestations associated with these ABG results? Select all the apply. a. Nausea b. Confusion c. Bradypnea d. Tachycardia e. Hyperkalemia 6. Lightheadedness

a. Nausea b. Confusion d. Tachycardia 6. Lightheadedness

A nurse reviews the blood gas results of a client with atelactasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which of the following validates that nurse's findings? a. pH 7.25, PCO2 50 mm Hg b. 7.35, PCO2 40 mm Hg c. pH 7.50, PCO2 52 mm Hg d. pH 7.52, PCO2 28 mm Hg

a. pH 7.25, PCO2 50 mm Hg

When caring for a group of pts, the nurse realizes that which of the following health problems increases the risk for metabolic alkalosis? a. COPD b bulimia c. dialysis d. venous stasis ulcer

b bulimia

A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, PaCO2 of 43 mm Hg, PaO2 of 75 mm Hg, and HCO3− of 42 mEq/L. Based on these findings, the nurse documents that the patient is experiencing which type of acid-base imbalance? a) Respiratory alkalosis b) Metabolic alkalosis c) Respiratory acidosis d) Metabolic acidosis

b) Metabolic alkalosis

The nurse observes a pt's respirations & notes that the rate is 30 per minute & the respirations are very deep. The metabolic disorder this pt might be demonstrating is which of the following? a) hypernatremia b) increasing carbon dioxide in the blood c) hypertension d) pain

b) increasing carbon dioxide in the blood

A pt is prescribed 20 mEq of potassium chloride. The nurse realizes that the reason the pt is receiving this replacement is a) to sustain respiratory function. b) to help regulate acid-base balance. c) to keep a vein open. d) to encourage urine output.

b) to help regulate acid-base balance.

A client's ABGs reveal: pH 7.38, PO2 65, PCO2 55, HCO3 32. The nurse's interpretation of the blood gases is that he or she has: a. Uncompensated respiratory acidosis b. Compensated respiratory acidosis c. Uncompensated metabolic alkalosis d. Compensated metabolic alkalosis

b. Compensated respiratory acidosis

A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder. a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

b. Metabolic alkalosis

A nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a PCO2 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? a. Sodium level of 145 mEq/L b. Potassium level of 3 mEq/L c. Magnesium level of 2 mg/dL d. Phosphorus level of 4 mg/dL

b. Potassium level of 3 mEq/L

A nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, PCO2 of 30 mm Hg, and HCO3 of 22 mEq/L. The nurse analyzes these results as indicating which condition? a. Metabolic acidosis, compensated b. Respiratory alkalosis, compensated c. Metabolic alkalosis, uncompensated d. Respiratory acidosis, uncompensated

b. Respiratory alkalosis, compensated

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? a. PaCO2 36 b. pH 7.48 c. HCO3 21 mEq/L d. O2 sat 95%

b. pH 7.48

The nurse is caring for a pt who is anxious & dizzy following a traumatic experience. The arterial blood gas findings include: pH 7.48, PaO2 110, PaCO2 25, & HCO3 24. The nurse would anticipate which initial intervention to correct this problem? a) Immediately administer oxygen via a mask & monitor oxygen saturation. b) Prepare to start an intravenous fluid bolus using isotonic fluids. c) Encourage the pt to breathe in & out slowly into a paper bag. d) Anticipate the administration of intravenous sodium bicarbonate.

c) Encourage the pt to breathe in & out slowly into a paper bag.

The blood gases of a pt with an acid-base disorder show a blood pH outside of normal limits. The nurse realizes that this pt is a) fully compensated. b) demonstrating anaerobic metabolism. c) partially compensated. d) in need of intravenous fluids

c) partially compensated.

The 30 year old client with asthma is brought into the emergency department by a friend because of difficulty breathing throughout the day and is now confused. The client's ABGs are: pH 7.19, PaO2 46, PaCO2 88, HCO3 25. The nurse would anticipate that the client's immediate treatment will be directed at. a. increasing O2 via nasal cannula to maintain pulse oximetry saturation greater than 94% b. Starting IV with Solu-Medrol c. Intubation and mechanical ventilation d. Administration of STAT bronchodilator via handheld nubulizer

c. Intubation and mechanical ventilation

A nurse plans care for a client with COPD, understanding that the client is most likely to experience that type of acid-base imbalance? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

c. Respiratory acidosis

A pt's blood gases show a pH greater of 7.53 & bicarbonate level of 36 mEq/L. The nurse realizes that the acid-base disorder this pt is demonstrating is which of the following? a) respiratory acidosis b) metabolic acidosis c) respiratory alkalosis d) metabolic alkalosis

d) metabolic alkalosis

A client with a 3-day history or nausea and vomiting presents to the emergency department. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which of the following? a. A decreased pH and an increased CO2 b. An increased pH and a decreased CO2 c. A decreased pH and a decreased HCO3- d. An increased pH with an increase HCO3-

d. An increased pH with an increase HCO3-

A nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul's respirations. Based on this documentation, which of the following did the nurse observe? a. Respirations that cease for several seconds. b. Respirations that are regular but abnormally slow. c. Respirations that are labored and increased in depth and rate. d. Respirations that are abnormally deep, regular, and increased in rate.

d. Respirations that are abnormally deep, regular, and increased in rate.

A client's ABGs are: pH 7.34, PaCO2 57 mm Hg, 22 HCO3. What is the correct interpretation? a. Metabolic alkalosis b. Respiratory alkalosis c. Metabolic acidosis d. Respiratory acidosis

d. Respiratory acidosis

A client who is found unresponsive has arterial blood gases drawn and the results indicate the following: pH is 7.12, PCO2 is 90 mm Hg, and HCO3- is 22 mEq/L. The nurse interprets the results as indicating which condition? a. Metabolic acidosis with compensation b. Respiratory acidosis with compensation c. Metabolic acidosis without compensation d. Respiratory acidosis without compensation

d. Respiratory acidosis without compensation