ACID-BASE BALANCE EAQ

An adolescent with a history of type 1 diabetes is admitted in ketoacidosis. What does the nurse suspect as a precipitating cause of this episode of ketoacidosis? A. Infection B. Increased exercise C. Recent weight loss D. Overdose of insulin

A

The nurse caring for a client with diabetic ketoacidosis (DKA) can expect to implement which intervention? A. Intravenous administration of regular insulin B. Administer insulin glargine subcutaneously at hour of sleep C. Maintain nothing prescribed orally (NPO) status D. Intravenous administration of 10% dextrose

A

A client is in a state of uncompensated acidosis. What approximate arterial blood pH does the nurse expect the client to have? A. 7.20 B. 7.35 C. 7.45 D. 7.48

A

What is a nursing priority to prevent complications in clients with respiratory acidosis? A. Assessing the nail beds B. Listening to breath sounds C. Monitoring breathing status D. Checking muscle contractions

C

The healthcare provider orders an insulin infusion for a patient admitted to the emergency department in ketoacidosis. The rate of infusion in units per hour is is calculated as: Glucose mg/dL ÷ 100. The pharmacy dispensed 100 units regular insulin in 100 mL normal saline and the client's glucose level is 350 mg/dL. At how many milliliters per hour should the nurse set the IV infusion device to administer the correct amount of medication? Record your answer using one decimal place. _____ mL/hr

3.5

The nurse is teaching a group of students about assessing for respiratory system manifestations of alkalosis as a nursing priority. Which statement made by the student nurse indicates the need for further teaching? Select all that apply. A. "I should assess for low blood pressure." B. "I should assess for increased digitalis toxicity." C. "I should assess for a decreased rate of ventilation in respiratory alkalosis." D. "I should assess for an increased depth of ventilation in respiratory alkalosis." E. "I should assess for a decreased respiratory effort associated with skeletal muscle weakness in metabolic alkalosis."

A, B, C

The nurse is providing teaching to a client who recently has been diagnosed with type 1 diabetes. The nurse reinforces the importance of monitoring for ketoacidosis. What are the signs and symptoms of ketoacidosis? Select all that apply. A. Confusion B. Hyperactivity C. Excessive thirst D. Fruity-scented breath E. Decreased urinary output

A, C, D

A client develops respiratory alkalosis. When the nurse is reviewing the laboratory results, which finding is consistent with respiratory alkalosis? A. An elevated pH, elevated PCO2 B. A decreased pH, elevated PCO2 C. An elevated pH, decreased PCO2 D. A decreased pH, decreased PCO2

C

A client is admitted with metabolic acidosis. The nurse considers that two body systems interact with the bicarbonate buffer system to preserve healthy body fluid pH. What two body systems should the nurse assess for compensatory changes? A. Skeletal and nervous B. Circulatory and urinary C. Respiratory and urinary D. Muscular and endocrine

C

A client presents with gastric pain, vomiting, dehydration, weakness, lethargy, and shallow respirations. Laboratory results indicate metabolic alkalosis. The diagnosis of gastric ulcer has been made. What is the primary nursing concern? A. Chronic pain B. Risk for injury C. Electrolyte imbalance D. Inadequate gas exchange

C

A client who is prescribed diuretic therapy develops metabolic alkalosis. To which intervention should the nurse give priority as the healthcare team corrects the alkalosis? A. Preventing falls B. Monitoring electrolytes C. Administering antiemetics D. Adjusting the diuretic therapy

A

A client with diabetic ketoacidosis who is receiving intravenous fluids and insulin complains of tingling and numbness of the fingers and toes and shortness of breath. The cardiac monitor shows the appearance of a U wave. What complication does the nurse suspect? A. Hypokalemia B. Hypoglycemia C. Hypernatremia D. Hypercalcemia

A

A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis? A. Increased serum lipids B. Decreased hematocrit level C. Increased serum calcium levels D. Decreased blood urea nitrogen level

A

Which blood gas result should the nurse expect an adolescent with diabetic ketoacidosis to exhibit? A. pH 7.30, CO2 40 mm Hg, HCO3- 20 mEq/L (20 mmol/L) B. pH 7.35, CO2 47 mm Hg, HCO3- 24 mEq/L (24 mmol/L) C. pH 7.46, CO2 30 mm Hg, HCO3- 24 mEq/L (24 mmol/L) D. pH 7.50, CO2 50 mm Hg, HCO3- 22 mEq/L (22 mmol/L)

A

The nurse is teaching a group of students about the manifestation of alkalosis in the central nervous system. Which statements by a student nurse are accurate? Select all that apply. A. "The client's Chvostek sign would be negative." B. "The client's Trousseau sign would be positive." C. "The client would be suffering from paresthesias." D. "The client would show signs of anxiety and irritability." E. "The client's central nervous system should have a decrease activity in case alkalosis."

B, C, D

Client 1: Tachypnea Client 2: Pursed lip-breathing Client 3: Kussmaul Respirations Client 4: Abdominal paradox The nurse is assessing four clients in a healthcare setting who have respiratory disorders. Which client's findings indicate possible metabolic acidosis? A. Client 1 B. Client 2 C. Client 3 D. Client 4

C

On admission to the intensive care unit, a client is diagnosed with compensated metabolic acidosis. During the assessment, what is the nurse most likely to identify? A. Muscle twitching B. Mental instability C. Deep and rapid respirations D. Tachycardia and cardiac dysrhythmias

C

The nurse is assessing a client's arterial blood gases and determines that the client is in compensated respiratory acidosis. The pH value is 7.34; which other result helped the nurse reach this conclusion? A. PO2 value is 80 mm Hg. B. PCO2 value is 60 mm Hg. C. HCO3 value is 50 mEq/L (50 mmol/L). D. Serum potassium value is 4 mEq/L (4 mmol/L).

C

A client's blood gases reflect diabetic ketoacidosis. Which clinical indicator should the nurse identify when monitoring this client's laboratory values? A. Increased pH B. Decreased PO2 C. Increased PCO2 D. Decreased HCO3

D

A nurse administers the prescribed regular insulin to a client in diabetic ketoacidosis. In addition, an intravenous (IV) solution with potassium is prescribed even though the serum potassium level is within normal limits. What does the nurse recognize as the reason for potassium administration? A. Potassium loss occurs rapidly from diaphoresis present during coma. B. Potassium is carried with glucose to the kidneys to be excreted in the urine in increased amounts. C. Potassium is quickly used up during the rapid series of catabolic reactions stimulated by insulin and glucose. D. Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.

D