Acid-Base Balance
A client comes to the emergency department with status asthmaticus. The client's respiratory rate is 48 breaths/minute, and the client is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3--) of 26 mEq/L. What disorder is indicated by these findings? -metabolic acidosis -respiratory acidosis -metabolic alkalosis -respiratory alkalosis
respiratory alkalosis
It is known that high levels of uric acid in the blood can cause gout, while high levels in the urine can cause kidney stones. What medication competes with uric acid for secretion into the tubular fluid, thereby reducing uric acid secretion? -Ibuprofen -Acetaminophen -Aspirin -Naproxen
Aspirin
The Emergency Department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? -PaO2 -PO2 -Carbonic acid -Bicarbonate
Bicarbonate
The emergency department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? -PaO2 -PO2 -Carbonic acid -Bicarbonate
Bicarbonate
The nurse is aware that fluid replacement is a hallmark treatment for shock. Which of the following is the crystalloid fluid that helps treat acidosis? -0.9% sodium chloride -Lactated Ringer's -Albumin -Dextran
Lactated Ringer's
A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? -Glargine -Regular -NPH -Lente
Regular
The nurse working with the child diagnosed with type 2 diabetes mellitus recognizes that most often the disorder can be managed by: -Taking oral hypoglycemic agents -Increasing protein in the diet, especially in the evening -Conserving energy with rest periods during the day -Decreasing amounts of daily insulin
Taking oral hypoglycemic agents
A patient is experiencing lower leg pain associated with lactic acid accumulation. When does the nurse expect the pain to decrease? -When aerobic metabolism is reinstated -When anaerobic metabolism becomes the major pathway for energy release -When muscle use and subsequent glucose catabolism increase -When vasoconstriction diminishes blood flow, thereby slowing the removal of waste products
When aerobic metabolism is reinstated
Which is a psychological factor affecting the body's response to a drug? -compliance -hydration -electrolyte balance -diurnal rhythm
compliance
Before seeing a newly assigned client with respiratory alkalosis, a nurse quickly reviews the client's medical history. Which condition is a predisposing factor for respiratory alkalosis? -myasthenia gravis -type 1 diabetes mellitus -extreme anxiety -opioid overdose
extreme anxiety
Which conditions increase the risk for respiratory alkalosis? Select all that apply. -Last trimester of pregnancy -Salicylate toxicity -Acute coronary syndrome -Anxiety -Crohn's disease
-Salicylate toxicity -Anxiety
The nurse tests the pH of fluid found on the vaginal exam and determines that the woman's membranes have ruptured based on which result? -5.0 -5.5 -6.0 -6.5
6.5
A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? -Neutral -Alkaline -Acidic -Basic
Acidic
A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, with a random blood glucose reading of 575 mg/dL (31.91 mmol/L), vomiting, and shortness of breath. This client has experienced which phenomenon? -Exacerbation -Morbidity -Infection -Risk factor
Exacerbation
High levels of acid in the gastrointestinal (GI) tract decrease the secretion of which enzyme? -Pancrease -Trypsin -Lipase -Gastrin
Gastrin
A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client? -Spironolactone -Dyazide -Hydrochlorothiazide -Bumetanide
Spironolactone
The nurse cares for a client with end-stage kidney disease (ESKD). Which acid-base imbalance is associated with this disorder? -pH 7.20, PaCO2 36, HCO3 14- -pH 7.31, PaCO2 48, HCO3 24- -pH 7.47, PaCO2 45, HCO3 33- -pH 7.50, PaCO2 29, HCO3 22-
pH 7.20, PaCO2 36, HCO3 14-
The nurse is caring for a client who reports pain as 10, on a 0 to 10 scale. After the administration of an opiod anesthesia, the nurse observes the client's respiratory rate decrease to 8 breaths per minute. What is the priority action by the nurse? -Administer a lower dose of the analgesic for the next dose -Begin CPR -Place the client in the supine position -Administration of 0.4 mg of naloxone
Administration of 0.4 mg of naloxone
The nurse caring for a client with metabolic alkalosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's metabolic alkalosis is improving? -pH has increased -CO2 has decreased -HCO3- has decreased -O2 has increased
HCO3- has decreased
The nurse is caring for a client with severe diarrhea. The nurse recognizes that the client is at risk for developing which acid-base imbalance? -Metabolic acidosis -Respiratory acidosis -Metabolic alkalosis -Respiratory alkalosis
Metabolic acidosis
A client is admitted to the psychiatric clinic for treatment of anorexia nervosa. At the beginning of the client's hospitalization, the most important nursing action is to: -severely restrict the client's physical activities. -weigh the client daily, after the evening meal. -monitor the client's vital signs, serum electrolyte levels, and acid-base balance. -instruct the client to keep an accurate record of food and fluid intake.
monitor the client's vital signs, serum electrolyte levels, and acid-base balance.
A client has these arterial blood gas values: pH, 7.30; PaO2, 89 mm Hg; PaCO2, 50 mm Hg; and HCO3-, 26 mEq/L. Based on these values, the nurse should suspect which condition? -respiratory acidosis -respiratory alkalosis -metabolic acidosis -metabolic alkalosis
respiratory acidosis
The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of: -HCO3− -H2CO3 -HCl -H+
HCO3−
Which alteration in acid-base balance could be expected as a compensatory response for a client with severe chronic respiratory impairment? -Decreased arterial blood pH -Increased arterial blood bicarbonate -Increased arterial blood oxygen -Decreased arterial blood carbon dioxide
Increased arterial blood bicarbonate
A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level? -No effect -Increases arterial pH -Decreases arterial pH -Provides long-term pH regulation
Increases arterial pH
The nurse is reviewing lab results of a client diagnosed with metabolic acidosis. The most important electrolyte for the nurse to assess would be: -Potassium (K+) -Calcium (Ca2+) -Sodium (Na+) -Magnesium (Mg2+)
Potassium (K+)
One form of renal tubular acidosis (RTA) results from aldosterone deficiency or resistance to its action, which leads to impaired reabsorption of which electrolyte? -Sodium -Potassium -Hydrogen -Glucose
Sodium
Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes? -The client continues medication therapy despite adequate food intake. -The client has not consumed sufficient calories. -The client has been exercising more than usual. -The client has eaten and has not taken or received insulin.
The client has eaten and has not taken or received insulin.
Which of these ions plays an important role in pH homeostasis? -potassium -bicarbonate -chloride -sodium
bicarbonate
A nurse is providing client teaching about the body's plasma pH and the client asks the nurse what is the major chemical regulator of plasma pH. What is the best response by the nurse? -renin-angiotensin-aldosterone system -bicarbonate-carbonic acid buffer system -sodium-potassium pump -ADH-ANP buffer system
bicarbonate-carbonic acid buffer system
A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? -nausea or vomiting -abdominal pain or diarrhea -hallucinations or tinnitus -light-headedness or paresthesia
light-headedness or paresthesia
The nurse is caring for a client with metabolic alkalosis whose breathing rate is 8 breaths per minute. Which arterial blood gas data does the nurse anticipate finding? -pH: 7.32; PaCO2: 28; HCO3: 24 -pH: 7.60; PaCO2: 64; HCO3: 42 -pH: 7.28; PaCO2: 52; HCO3: 32 -pH: 7.32; PaCO2: 26; HCO3: 18
pH: 7.60; PaCO2: 64; HCO3: 42
Trousseau's sign is elicited by which of the following? -Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff. -A sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth, nose, and eye. -After making a clenched fist, the palm remains blanched when pressure is placed over the radial artery. -The patient complains of pain in the calf when his foot is dorsiflexed.
Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
A 29-week-gestation client is admitted with moderate vaginal discharge. The nurse performs a nitrazine test to determine if the membranes have ruptured. The nitrazine tape remains yellow to olive green, with pH between 5 and 6. What should the nurse do next? -Prepare the client for birth. -Assess the client's cervical status. -Notify the health care provider. -Perform Leopold's maneuver.
Notify the health care provider
The nurse is preparing clients for diagnostic testing for cancer. Which test is used to differentiate a neuroblastoma from other tumors? -Urine catecholamines metabolites homovanillic acid (HVA) and vanillylmandelic acid (VMA) -Urinalysis -Serum chemistries -Complete blood count (CBC) with differential
Urine catecholamines metabolites homovanillic acid (HVA) and vanillylmandelic acid (VMA)
A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects -metabolic acidosis. -metabolic alkalosis. -respiratory acidosis. -respiratory alkalosis.
respiratory alkalosis
A male client with a history of heavy alcohol use has been admitted to the hospital for malnutrition and suspected pancreatitis. The client's diagnostic workup suggests alcoholic ketoacidosis as a component of his current health problems. He is somewhat familiar with the effect that drinking has had on his nutrition and pancreas, but is wholly unfamiliar with the significance of acid-base balance. How best could his care provider explain the concept to him? -"The chemical processes that take place throughout your body are thrown off very easily when your body is too acidic or not acidic enough. -"The multitude of chemical reactions that take place in your body depend on your body fluids being slightly acidic." -"The healthy function of your kidneys and your lungs requires a specific level of pH in your body." -"Your body is highly dependent on what food and fluid you consume to keep itself at a functioning level of slight non-acidity."
"The chemical processes that take place throughout your body are thrown off very easily when your body is too acidic or not acidic enough.
A client with metabolic syndrome is encouraged to implement nonpharmacologic measures improve his risk factors. What do those non-pharmacologic measures include? (Select all that apply.) -Begin a low-fat diet -Walk regularly -Decrease intake of soluble fiber -Increase sodium intake
-Begin a low-fat diet -Walk regularly
The body regulates the pH of its fluids by what mechanism? Select all that apply. -Chemical buffer systems of the body fluids -The liver -The lungs -The cardiovascular system -The kidneys
-Chemical buffer systems of the body fluids -The lungs -The kidneys
The physician has prescribed 0.9% sodium chloride IV for a hospitalized client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply. -Compare ABG findings with previous results. -Maintain intake and output records. -Document presenting signs and symptoms. -Administer IV bicarbonate. -Suction the client's airway.
-Compare ABG findings with previous results. -Maintain intake and output records. -Document presenting signs and symptoms.
A client with AIDS has developed cytomegalovirus (CMV) retinitis and is receiving treatment with foscarnet. The nurse would monitor for which possible adverse drug effects? Select all that apply. -Hypercalcemia -Neutropenia -Hyperphosphatemia -Hypomagnesemia -Seizures
-Hyperphosphatemia -Hypomagnesemia -Seizures
A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply. -Ingestion of strong acids -Irritating foods -Overuse of aspirin -DASH diet -Participation in highly competitive sports
-Ingestion of strong acids -Irritating foods -Overuse of aspirin
A nurse cares for an obese client taking phentermine/topiramate-ER. Which laboratory findings will the nurse recognize as most concerning and will report to the health care provider? Select all that apply. -Potassium 3.3 mEq/L -Bicarbonate 19 mEq/L -Total cholesterol 220 -Calcium 9 mg/dL - Chloride 98 mEq/L
-Potassium 3.3 mEq/L -Bicarbonate 19 mEq/L
To calculate the H2CO3 content of the blood, the nurse needs to measure the PCO2 (partial pressure of CO2) by its solubility coefficient. What is the solubility coefficient of CO2? -0.03 -0.3 -0.04 -0.4
0.03
The nurse is preparing to administer IV fluids for a patient with ketoacidosis who has a history of hypertension and congestive heart failure. What order for fluids would the nurse anticipate infusing for this patient? -D5W -0.9% normal saline -0.45 normal saline -D5 normal saline
0.45 normal saline
A client with a respiratory condition is receiving oxygen therapy. While assessing the client's PaO2, the nurse knows that the therapy has been effective based on which of the following readings? -45 mm Hg -58 mm Hg -84 mm Hg -120 mm Hg
84 mm Hg
The nurse is caring for the following group of clients. Select the client most likely to be diagnosed with respiratory alkalosis. -A 26-year-old female with anxiety who has been hyperventilating -An 18-year-old female who has overdosed on narcotics -A 63-year-old male with a 40-year history of smoking and chronic lung disease -A 45-year-old male with pneumothorax after a car accident
A 26-year-old female with anxiety who has been hyperventilating
Which is a true statement regarding pharmacologic aspects of aging? -Elderly have a decreased percentage of body fat. -Potential for drug-drug reactions decreases with the number of drugs prescribed. -Absorption may be affected by changes in gastric pH. -Aged population tends to be compliant with their medication regimen.
Absorption may be affected by changes in gastric pH
The nurse is caring for a patient with a metabolic acidosis (pH 7.25). Which of the following values is useful to the nurse in determining whether the cause of the acidosis is due to acid gain or to bicarbonate loss? -Anion gap -PaCO2 -Bicarbonate level -Serum sodium level
Anion gap
The nurse is caring for a client who has a compromised cardiopulmonary system and needs to assess the client's tissue oxygenation. The nurse would use which appropriate method to assess this client's oxygenation? -Hematocrit values -Hemoglobin levels -Pulmonary function -Arterial blood gas
Arterial blood gas
A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA? -Give prescribed antiemetics. -Begin fluid replacements. -Administer prescribed dose of insulin. -Administer bicarbonate to correct acidosis.
Begin fluid replacements.
Diabetic ketoacidosis (DKA) is a condition that mostly occurs in type 1 diabetics. What are the definitive diagnostic criteria for DKA? -Blood glucose level greater than 350 mg/dL (19.43 mmol/L); bicarbonate less than 5 mEq/L (5 mmol/L) and pH less than 7.4 -Blood glucose level greater than 250 mg/dL (13.88 mmol/L); bicarbonate less than 25 mEq/L (25 mmol/L) and pH less than 7.3 -Blood glucose level greater than 350 mg/dL (19.43 mmol/L); bicarbonate less than 5 mEq/L (5 mmol/L) and pH less than 7.4 -Blood glucose level greater than 250 mg/dL (13.88 mmol/L); bicarbonate less than 15 mEq/L (15 mmol/L) and pH less than 7.3
Blood glucose level greater than 250 mg/dL (13.88 mmol/L); bicarbonate less than 15 mEq/L (15 mmol/L) and pH less than 7.3
The nurse caring for a client with respiratory acidosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's respiratory acidosis is improving? -pH has decreased -CO2 has decreased -HCO3- has decreased -O2 has decreased
CO2 has decreased
A client is admitted to hospital with signs of acidosis. Compensation takes place in the kidney as well as in the lungs. Which action takes place specifically at the respiratory membrane? -CO2 and H2O are produced -CO2 is eliminated -Carbonic acid is produced -H+ combines with filtered HCO3-
CO2 is eliminated
When explaining how carbon dioxide combines with water to form carbonic acid as part of an acid-base lecture, the faculty instructor emphasizes that which enzyme is needed as a catalyst for this reaction? -Carbonic anhydrase -Phenylalanine hydroxylase -Hydrolases -Trypsin
Carbonic anhydrase
Upon shift report, the nurse states the following laboratory values: pH, 7.44; PCO2, 30mmHg; and HCO3,21 mEq/L for a client with noted acid-base disturbances. Which acid-base imbalance do both nurses agree is the client's current state? -Compensated respiratory alkalosis -Uncompensated respiratory alkalosis -Compensated metabolic acidosis -Compensated metabolic alkalosis
Compensated respiratory alkalosis
At what point in shock does metabolic acidosis occur? -Compensation -Irreversible -Early -Decompensation (Progressive)
Decompensation (Progressive)
A client has been diagnosed with metabolic acidosis. What assessment finding does the nurse expect? -Increased pH above 7.45 -Increased PCO2 above 45 mm/Hg (5.99 kPa) -Decreased pH below 7.35 -Decreased PCO2 below 35 mm/Hg (4.66 kPa)
Decreased pH below 7.35
You are an ICU nurse who has just admitted a new client with an acid/base imbalance. What would you do to provide accurate baseline data for this client? -Record intake and output -Monitor lab values -Document presenting signs and symptoms -Implement medication ordered
Document presenting signs and symptoms
Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes melitus. Which of the following explains the cause of this secondary diabetes? -Dysfunction of the pancreatic islet cells -Ingestion of foods high in sugar -Inability for the liver to reabsorb serum glucose -Renal failure
Dysfunction of the pancreatic islet cells
A client has been taking famotidine at home. What teaching should the nurse include with the client? -Famotidine will inhibit gastric acid secretions. -Famotidine will neutralize acid in the stomach. -Famotidine will shorten the time required for digestion in the stomach. -Famotidine will improve the mixing of foods and gastric secretions.
Famotidine will inhibit gastric acid secretions
A client is receiving a diuretic as the first-line treatment of mild hypertension. The nurse monitors the client for signs and symptoms of hypokalemia with which agent? -Amiloride -Spironolactone -Triamterene -Hydrochlorothiazide
Hydrochlorothiazide
The nurse is caring for a client with ketoacidosis who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet. The nurse understands which phenomenon is most likely occurring? -High fat, low carbohydrate dietary intake is associated with respiratory acidosis. -In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids. -Metabolism of dietary fats without the buffer action of carbohydrates results in the catabolism of ketoacids. -Decreased carbohydrate intake induces insulin deficiency and consequent ketoacidosis.
In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids.
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? -A partial or complete intestinal obstruction occurs. -A thickened, elongated muscle causes an obstruction at the end of the stomach. -There are recurrent paroxysmal bouts of abdominal pain. -In this disorder the sphincter that leads into the stomach is relaxed.
In this disorder the sphincter that leads into the stomach is relaxed.
Which is the priority nursing diagnosis for a client undergoing a laryngectomy? -Imbalanced nutrition: Less than body requirements -Impaired verbal communication -Ineffective airway clearance -Anxiety and depression
Ineffective airway clearance
A client experiencing an acute panic attack develops respiratory alkalosis. The nurse measures a respiratory rate of 46 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 162/90 mm Hg, and a temperature of 98.6°F (37°C). Which action will the nurse implement first to help improve respiratory alkalosis? -Apply oxygen via nasal cannula. -Administer albuterol inhaler. -Instruct the client to breathe into a paper bag. -Administer sodium bicarbonate intravenously.
Instruct the client to breathe into a paper bag
A nurse is providing care for a client who has been diagnosed with metabolic alkalosis after several days of antacid use. Which treatment should the nurse prepare to give? -Intravenous or oral administration of free hydrogen ions -Intravenous administration of a KCl solution -Administration of oxygen and NaHCO3 solution -Supplementary oxygen and possible mechanical ventilation
Intravenous administration of a KCl solution
A client has an increased serum lactic acid level. The physician understands this is indicative of which disease process? -Ischemia -Toxicity of lead exposure -Free radical injury -Apoptosis
Ischemia
A client has an increase in her anion gap (AG). What does the nurse determine is the significance of this finding? -It indicates the client has metabolic alkalosis. -It indicates the client has respiratory alkalosis. -It indicates the client has metabolic acidosis. -It indicates the client has respiratory acidosis.
It indicates the client has metabolic acidosis.
The nurse notes a client's PaCO2 on an arterial blood gas is 55 mm Hg (7.32 kPa). The client asks if this means he or she has carbon dioxide poisoning. How should the nurse explain how carbon dioxide became present in the client's blood? -It is a normal end-product of aerobic cellular respiration but you are not eliminating it efficiently. -It develops due to lack of oxygen and anaerobic metabolism, so administering oxygen will help. -It is inhaled from the atmosphere, but your lungs are not properly converting the carbon dioxide to oxygen. -Carbon dioxide builds up in the blood when cells are not performing cellular respiration properly.
It is a normal end-product of aerobic cellular respiration but you are not eliminating it efficiently.
The nurse is evaluating a client's blood gases. The client has a pH of 7.35. How does the nurse interpret this value? -It indicates alkalosis. -It indicates acidosis. -It is within a normal range. -It indicates a respiratory problem.
It is within a normal range
A client has been ill for several days and has not had anything to eat, consuming only about 6 oz of water per day. The client has been vomiting and having diarrhea. Which condition is the nurse most concerned about the client developing? -Respiratory alkalosis -Salicylate toxicity -Ketoacidosis -Metabolic alkalosis
Ketoacidosis
The nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone? -Morphine sulfate -Aspirin -Ketoralac (Toradol) -Meperidine (Demerol)
Ketoralac (Toradol)
A woman who is 10 weeks' pregnant calls the physician's office reporting "morning sickness" but, when asked about it, tells the nurse that she is nauseated and vomiting all the time and has lost 5 pounds. What interventions would the nurse anticipate for this client? -Lab work will be drawn to rule out acid-base imbalances. -An ultrasound will be done to reassess the correctness of gestational dates. -Since morning sickness is a common problem for pregnant women, the nurse will suggest the woman drink more fluids and eat crackers. -The nurse will encourage the woman to lie down and rest whenever she feels ill.
Lab work will be drawn to rule out acid-base imbalances.
The nurse is reviewing laboratory data for the client with an anion gap of 17. The nurse recognizes which condition is associated with an increased anion gap mEq/L (mmol/L)? -Lactic acidosis -Hyperkalemia -Multiple myeloma -Hypermagnesium
Lactic acidosis
Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? -Low oxalate -Low purine -High protein -High sodium
Low purine
A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient? -Low-calcium diet -High-protein diet -Low-phosphorus diet -Low-purine diet
Low-purine diet
The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation? -Kidney and liver -Heart and lungs -Lungs and kidney -Pancreas and stomach
Lungs and kidney
A child accidentally consumes a container of wood alcohol. The ED physician knows that the child is at risk of developing which of the following? -Metabolic acidosis -Respiratory acidosis -Metabolic alkalosis -Respiratory alkalosis
Metabolic acidosis
A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? -Respiratory alkalosis -Respiratory acidosis -Metabolic alkalosis -Metabolic acidosis
Metabolic acidosis
A nurse is caring for a client with bulimia nervosa who has been admitted to the hospital with weakness, hypotension, and abdominal discomfort. Which type of acid-base imbalance should the nurse assess the client for? -Respiratory alkalosis -Metabolic alkalosis -Respiratory acidosis -Metabolic acidosis
Metabolic acidosis
The nurse is caring for a client with renal failure experiencing shortness of breath and increased respiratory rate. The arterial blood gas reflects a pH of 7.10 and HCO3 level of 18 mEq/L (18 mmol/L). How does the nurse interpret these findings? -Metabolic acidosis -Respiratory acidosis -Metabolic alkalosis -Respiratory alkalosis
Metabolic acidosis
The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. What condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for? -Respiratory acidosis -Respiratory alkalosis -Metabolic acidosis -Metabolic alkalosis
Metabolic acidosis
The nurse is reviewing the following lab results of a client diagnosed with renal failure, The nurse would interpret this as: pH: 7.24 PCO2: 38 mm Hg (5.05 kPa) HCO3: 18 mEq/L (18 mmol/L) -Metabolic acidosis -Respiratory acidosis -Metabolic alkalosis -Respiratory alkalosis
Metabolic acidosis
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, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance? -Respiratory alkalosis -Metabolic alkalosis -Respiratory acidosis -Metabolic acidosis
Metabolic alkalosis
A client is admitted to the unit with a diagnosis of intractable vomiting for 3 days. What acid-base imbalance related to the loss of stomach acid does the nurse observe on the arterial blood gas (ABG)? -Metabolic acidosis -Respiratory acidosis -Metabolic alkalosis -Respiratory alkalosis
Metabolic alkalosis
The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction Which acid-base imbalance is most likely to occur? -Respiratory alkalosis -Metabolic alkalosis -Respiratory acidosis -Metabolic acidosis
Metabolic alkalosis
Vomiting results in which of the following acid-base imbalances? -Metabolic alkalosis -Metabolic acidosis -Respiratory acidosis -Respiratory alkalosis
Metabolic alkalosis
A client has meconium-stained amniotic fluid. Fetal scalp sampling indicates a blood pH of 7.12; fetal bradycardia is present. Based on these findings, the nurse should take which action? -Administer amnioinfusion. -Prepare for cesarean birth. -Reposition the client. -Start I.V. oxytocin infusion as ordered.
Prepare for cesarean birth
A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer? -Regular insulin -Lispro -NPH -Detemir
Regular insulin
A client arrives in the emergency department by ambulance with a family member stating, "He took an overdose of sleeping pills and I found him breathing very shallowly." For which type of acid-base disturbance will the nurse anticipate this client will be treated? -Respiratory acidosis -Respiratory alkalosis -Metabolic acidosis -Metabolic alkalosis
Respiratory acidosis
A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance? -Metabolic acidosis -Metabolic alkalosis -Respiratory acidosis -Respiratory alkalosis
Respiratory acidosis
As status asthmaticus worsens, the nurse would expect which acid-base imbalance? -Respiratory alkalosis -Metabolic alkalosis -Respiratory acidosis -Metabolic acidosis
Respiratory acidosis
The nurse is caring for a client who complains of headache and blurred vision. The nurse recognizes that these symptoms, accompanied by increased plasma partial pressure carbon dioxide (PCO2) level and decreased pH level, are consistent with which diagnosis? -Respiratory acidosis -Respiratory alkalosis -Metabolic alkalosis -Metabolic acidosis
Respiratory acidosis
The nurse is caring for a client with chronic obstructive pulmonary disease. The client reports that he is having difficulty breathing and is feeling fatigued. The nurse realizes that this client is at high risk for which condition? -Respiratory alkalosis -Respiratory acidosis -Metabolic acidosis -Metabolic alkalosis
Respiratory acidosis
A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What disorder is indicated by these findings? -Metabolic acidosis -Respiratory acidosis -Metabolic alkalosis -Respiratory alkalosis
Respiratory alkalosis
A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia: pH, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm Hg; and HCO3--, 24 mEq/L. What do these values indicate? -Metabolic acidosis -Metabolic alkalosis -Respiratory acidosis -Respiratory alkalosis
Respiratory alkalosis
The condition of a client with metabolic acidosis from an intestinal fistula is not improving. The pulse is 125 beats/min and the BP 84/56 mm Hg. ABG values are: pH 7.1, HCO3- 18 mEq/L (18 mmol/L), PCO257 mm Hg (7.58 kPa). What IV medication should the nurse expect to provide next? -Epinephrine -Antibiotics -Sodium bicarbonate -Potassium chloride
Sodium bicarbonate
When describing the characteristics of the amniotic fluid to a pregnant woman, the nurse would include which information? -It is usually an acidic fluid. -It is composed primarily of organic substances. -The amount gradually fluctuates during pregnancy. -It limits fetal movement in utero.
The amount gradually fluctuates during pregnancy.
The nurse is assessing a client with abnormal blood gas values. Which of these interpretations does the nurse make regarding the client's physiologic status? -The client has a decreased hemoglobin. -The client has alterations in vital signs. -The client has abnormalities in his buffer system. -The client has abnormalities in his cardiovascular system.
The client has abnormalities in his buffer system
The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The client asks what is making the acidotic state. The nurse is most correct to identify which result of the disease process that causes the fall in pH? -The lungs are unable to breathe in sufficient oxygen. -The lungs are unable to exchange oxygen and carbon dioxide. -The lungs have ineffective cilia from years of smoking. -The lungs are not able to blow off carbon dioxide.
The lungs are not able to blow off carbon dioxide.
A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? -The man may be experiencing a paradoxical effect of aspirin -The man may be allergic to aspirin -The man may be experiencing liver toxicity from the aspirin -The man may be experiencing nephrotoxic effects of aspirin
The man may be experiencing nephrotoxic effects of aspirin
A client visits a clinic complaining of excessive perspiration. Which of the following actions helps to remove sebum and reduce the acid mantle of protection? -Use hot soaks. -Use tepid bathwater. -Prevent exposure to sun. -Wash with alkaline soaps.
Wash with alkaline soaps.
A client with emphysema is at a greater risk for developing which acid-base imbalance? -chronic respiratory acidosis -metabolic alkalosis -metabolic acidosis -respiratory alkalosis
chronic respiratory acidosis
The nurse is conducting a review class for a group of perinatal nurses about factors that place a pregnant woman at risk for infection in the postpartum period. The nurse determines that additional teaching is needed when the group identifies which factor? -increased vaginal acidity leading to growth of bacteria -loss of protection with premature rupture of membranes -prolonged labor with multiple vaginal examinations to evaluate progress -retained placental fragments
increased vaginal acidity leading to growth of bacteria
A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition? -ketoacidosis -hyperosmolar hyperglycemic nonketotic syndrome -hepatic disorder -All options are correct.
ketoacidosis
A nurse is caring for a newborn whose chest X-ray reveals marked hyperaeration mixed with areas of atelectasis. The infant's arterial blood gas analysis indicates metabolic acidosis. For which dangerous condition should the nurse prepare when providing care to this newborn? -choanal atresia -diaphragmatic hernia -meconium aspiration syndrome -pneumonia
meconium aspiration syndrome
The nurse is admitting a client with newly diagnosed diabetes mellitus and left-sided heart failure. Assessment reveals low blood pressure, increased respiratory rate and depth, drowsiness, and confusion. The client reports headache and nausea. Based on the serum laboratory results, how would the nurse interpret the client's acid-base balance? -metabolic alkalosis -metabolic acidosis -respiratory acidosis -respiratory alkalosis
metabolic acidosis
A client who complains of an "acid stomach" has been taking baking soda (sodium bicarbonate) regularly as a self-treatment. This may place the client at risk for which acid-base imbalance? -metabolic alkalosis -metabolic acidosis -respiratory acidosis -respiratory alkalosis
metabolic alkalosis
An adolescent is admitted for treatment of bulimia nervosa. When developing the care plan, the nurse anticipates including interventions that address which metabolic disorder? -hypoglycemia -metabolic alkalosis -metabolic acidosis -hyperkalemia
metabolic alkalosis
A client presents to the emergency department, reporting that they have been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts this client at risk for which imbalances? -metabolic acidosis and hyperkalemia -metabolic acidosis and hypokalemia -metabolic alkalosis and hyperkalemia -metabolic alkalosis and hypokalemia
metabolic alkalosis and hypokalemia
A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for: -metabolic alkalosis. -hypocalcemia. -hypercholesterolemia. -metabolic acidosis.
metabolic alkalosis.
A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms? -azithromycin -valacyclovir -penicillin -metronidazole
metronidazole
A client informs the nurse of a problem with acid indigestion, stating he has been taking large amounts of calcium carbonate antacids daily but still has no relief. The client states that he can consume a bottle of 100 antacids in 4 days. Which blood gas result does the nurse anticipate assessing? -pH 7.6 -pH 7.25 -PCO2 38 mm Hg (5.05 kPa) -PO2 80 mm Hg (10.64 kPa)
pH 7.6
The nurse is caring for a client with respiratory alkalosis. Which arterial blood gas data does the nurse anticipate finding? -pH less than 7.35; HCO3 low; PaCO2 low -pH greater than 7.45; HCO3 high; PaCO2 high -pH less than 7.35; HCO3 high; PaCO2 high -pH greater than 7.45; HCO3 low; PaCO2 low; hyperventilation
pH greater than 7.45; HCO3 low; PaCO2 low; hyperventilation
The nurse caring for a client with respiratory alkalosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's respiratory alkalosis is improving? -pH has decreased -CO2 has decreased -HCO3- has increased -O2 has increased
pH has decreased
The nurse caring for a client with metabolic acidosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's metabolic acidosis is improving? -pH has increased -CO2 has increased -HCO3- has decreased -O2 has increased
pH has increased
A client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis? -pH, 7.5; PaCO2 30 mm Hg -pH, 7.29; PaCO2 30 mm Hg -pH, 7.35; PaCO2 70 mm Hg -pH, 7.25; PaCO2 50 mm Hg
pH, 7.25; PaCO2 50 mm Hg
A client is receiving supplemental oxygen. When determining the effectiveness of oxygen therapy, which arterial blood gas value is most important? -pH -bicarbonate (HCO3-) -partial pressure of arterial oxygen (PaO2) -partial pressure of arterial carbon dioxide (PaCO2)
partial pressure of arterial oxygen (PaO2)
A client with respiratory acidosis is admitted to the intensive care unit for close observation. The nurse should stay alert for which complication associated with respiratory acidosis? -shock -stroke -seizures -hyperglycemia
shock
During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will: -stimulate pancreatic enzymes to release more insulin. -stimulate the release of secretin, which then inhibits release of gastrin. -stimulate the release of glucagon-like peptide 1 to lower blood glucose levels. -inhibit the release of glucose-dependent insulinotropic peptide to slow gastric emptying.
stimulate the release of secretin, which then inhibits release of gastrin
A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? -specific gravity of 1.03 -urine pH of 3.0 -absence of protein -absence of glucose
urine pH of 3.0
