acid-base balance: metabolic imbalances practice questions

Which assessment finding in a laboring client indicates respiratory alkalosis? a. A change in the respiratory rate b. A tingling sensation in the hands c. Periodic changes in the fetal heart rate d. A pulse oximetry reading of less than 98%

b. A tingling sensation in the hands The presence of a tingling sensation in the hands indicates respiratory alkalosis due to a decrease in carbon dioxide. A change in respiratory rate is incorrect because although such a change may contribute to respiratory alkalosis, it is not evidence of an increase in pH. In the presence of maternal respiratory alkalosis, chemical changes in maternal erythrocytes facilitate oxygen release to the fetus, which assists in maintaining a normal fetal heart rate. A pulse oximetry reading of 98% is incorrect because this is a normal finding.

Which statement made by the nurse is accurate about the manifestation of alkalosis in the central nervous system? Select all that apply. One, some, or all may be correct. "A client's Chvostek sign would be negative." "A client's trousseau sign would be positive." "A client would be suffering from paresthesias." "A client would show signs of anxiety and irritability." "A client's central nervous system should have decreased activity."

"A client's trousseau sign would be positive." "A client would be suffering from paresthesias." "A client would show signs of anxiety and irritability." If clients suffer fromalkalosis, central nervous system activity increases, which manifests as a positive trousseau sign, paresthesias, anxiety, and irritability. The Chvostek sign would also be positive, not negative.

Which early sign of respiratory acidosis would the nurse expect the client with a restrictive airway disease to exhibit? Select all that apply. On, some, or all may be correct. Headache Irritability Restlessness Hypertension Lightheadedness

Headache Irritability Restlessness Headache is a symptom of cerebral hypoxia associated with early respiratory acidosis. Irritability is a sign of cerebral hypoxia associated with early respiratory acidosis. restlessness is a sign of cerebral hypoxia associated with early respiratory acidosis. Hypotension, not hypertension, is a key feature of acidosis. Lightheadedness is a symptom of respiratory alkalosis, not acidosis.

the nurse assesses a client who is experiencing profound (late) hypovolemic shock. When monitoring the client's arterial blood gas results, which response would the nurse expect? a. hypokalemia b. metabolic acidosis c. respiratory alkalosis d.decreased CO2 level

b. metabolic acidosis Decreased oxygen promotes the conversion of pyruvic acid to lactic acid, resulting in metabolic acidosis. Arterial blood gases do not assess serum potassium levels. Hyperkalemia will occur with shock because of renal shutdown. Respiratory alkalosis may occur in early shock because of rapid, shallow breathing, but in late shock metabolic or respiratory acidosis occurs. The carbon dioxide level will be increased in profound shock.

which complication will the nurse anticipate when caring for a client in late hypovolemic shock? a. hypokalemia b. metabolic acidosis c. respiratory alkalosis d. decreased Pco2 levels

b. metabolic acidosis decreased cellular oxygen caused by poor perfusion increases the conversion of pyruvic acid to lactic acid, resulting in metabolic acidosis. Hyperkalemia will occur because of renal shutdown; hypokalemia can occur in early shock. Respiratory alkalosis can occur in early shock because of rapid, shallow breathing, but in late shock, metabolic or respiratory acidosis occurs. The Pco2 level will increase in profound shock.

The nurse is caring for a client with the following arterial blood gas (ABG) values: PO2 89 mmHg, PCO2 35 mmHg, and pH of 7.37. These findings indicate that the client is experiencing what condition? a. respiratory alkalosis b. poor oxygen perfusion c. normal acid-base balance d. compensated metabolic acidosis

c. normal acid-base balance All data are within expected limits; PO2 is 80- 100 mmHg, PCO2 is 35-45 mmHg, and pH is 7.35- 7.45. None of the data are indicators of fluid balance, but of acid-base balance. Oxygen (PO2) is within the expected limits of 80-100 mmHg. With respiratory alkalosis, the blood pH is greater than 7.45 and the PCO2 is greatly decreased. With metabolic acidosis, the pH is less than 7.35.

Which blood gas report most likely reflects the acid-base balance of an infant with severe dehydration? a. pH of 7.50 and Pco2 of 34 mmHg b. pH of 7.23 and Pco2 of 70 mmHg c. pH of 7.20 and HCO3 of 20 .Eq/L (20 mmol/L) d. pH of 7.56 and HCO3 of 30 mEq/L (30 mmol/L)

c. pH of 7.20 and HCO3 of 20 mEq/L Low blood pH and bicarbonate levels indicate metabolic acidosis, which occurs with severe dehydration because the reduced urine output causes retention of hydrogen ions. The other options include findings that indicate respiratory alkalosis, respiratory acidosis, and metabolic alkalosis, respectively.

Assessment findings of a client wiht smoke inhalation include a negative chest x-ray and arterial blood gases that show a PO2 of 85 mmHg, a PCO2 of 45 mmHg, and a pH of 7.35. WHich interventions would the nurse anticipate will be prescribed? Select all that apply. One, some, or all may be correct. coughing deep breathing bronchodilators humidified oxygen bronchial suctioning

coughing deep breathing humidified oxygen coughing moves secretions toward the mouth to be expectorated. Deep breathing expands tha alveoli and increases the amount of oxygen being delivered to the alveolar capillary beds. Humidified oxygen increases the amount of oxygen that is being delivered to the alveolar capillary beds. Bronchodilators are not indicated at this time because the x-ray, PCO2, and pH are still WNLs. Bronchial suctioning is not indicated at this time because the x-ray, PCO2, and pH results are still within acceptable limits.

Which arterial blood gas result for a client receiving mechanical ventilation using the pressure support ventilation mode would indicate to the nurse that the client is hyperventilating? a. pH 7.28 b. Bicarbonate (HCO3) 24 mEq/L (24 mmol/L) c. Partial pressure of oxygen (PaO2) 60 mmHg (7.98 kPa) d. Partial pressure of carbon dioxide (PaCO2) 30 mmHg(3.99 kPa)

d. partial pressure of carbon dioxide (PaCO2) 30 mmHg(3.00 kPa) The normal PaCO2 is 35-45 mmHg. Hyperventilation leads to elimination of carbon dioxide, lowering of PaCO2, and causing respiratory alkalosis. A pH of 7.28 would indicate acidosis. An HCO3 of 24 is in normal range of 21-27 mEq/L and would not be consistent with hyperventilation. PaO2 is not directly affected by respiratory rate or depth, and the PaO2 of 60 could occur with normal rate and depth of ventilation or with either hypoventilation or hyperventilation.