Acid Base Questions
A patient who comes to the clinic reports frequent, watery stools for 2 days. Which action should the nurse take first?
check the patients blood pressure
The nurse is caring for a client with a NG tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for?
metabolic alkalosis
The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for?
metabolic alkalosis
A patient is admitted to the emergency department with severe fatigue and confusion. Laboratory studies are done. Which laboratory value will require the most immediate action by the nurse?
serum calcium is 18
The nurse has telephone messages from four patients who requested information and assistance. Which one should the nurse refer to a social worker or community agency first?
"I ran out of money and am cutting my insulin dose in half"
A client is precepting a new graduate nurse and the new graduate is assigned to care for a client with chronic pain. Which statement, if made by the new graduate nurse, indicates the need for further teaching regarding pain management?
"I will be sure to cue in to any indicators that the client may be exaggerating their pain"
Spironolactone, an aldosterone antagonist, is prescribed for a patient. Which statement by the patient indicates that the teaching about this medication has been effective?
"I will drink apple juice instead of orange juice for breakfast"
The patient had diarrhea for 5 days and developed an acid-base imbalance. Which statement would indicate that the nurse's teaching about the acid-base imbalance has been effective?
"My blood became too acid because I lost some base in the diarrhea fluid"
Which statements said by patients indicate that the nurses teaching regarding prevention of acid-base imbalances is successful? SATA
-"I should take my insulin on time every day" -"My aspirin is on high shelf away from children" -"I have reliable transportation to dialysis sessions"
The nurse notes that a clients ABG results reveal: pH=7.50, PaCO2=30. The nurse monitors for which clinical manifestations associated with the results? SATA
-nausea -confusion -tachycardia -lightheadedness
The nurse notes that a clients ABG results reveal: pH=7.50, PaCO2=30. The nurse monitors the client for which clinical manifestations associated with these ABG results? SATA
-nausea -confusion -tachycardia -lightheadedness
The patient has type B COPD exacerbated by an acute upper respiratory infection. Which blood gas values should the nurse expect to see?
-pH low -PaCO2 is high -HCO3 is normal
The nurse is caring for a client with DKA and documents that the client is experiencing Kassmaul's respirations. Which patterns did the nurse observe? SATA
-respirations that are increased in rate -respiration that are abnormally deep
The nurse is caring for a client with a DKA and documents that the client is experiencing Kusmmaul's respirations. Which patterns did the nurse observe? SATA
-respirations that are increased in rate -respirations that are abnormally deep
The patient is hyperventilating from anxiety and abdominal pain. Which assessment findings should the nurse attribute to respiratory alkalosis? SATA
-tingling of the fingertips -numbness around mouth -cramping in feet
A client has been admitted to the hospital for gastroenteritis and dehydration. The nurse determines that the client has received adequate volume replacement if the BUN level drops to which value?
15 mg/dL
After placement of a centrally inserted IV catheter, a patient reports acute chest pain and dyspnea. Which action should the nurse take first?
auscultate the patients breath sounds
A patient with DM has an ABG results: pH=7.28, PaCO2=34, PaO2=85, HCO3=18. The nurse would expect which finding?
Kussmaul respirations
The nurse observes that a patient with respiratory disease experiences a decrease in SpO2 from 93% to 88% while ambulating. What is the priority action of the nurse?
administer PRN supplemental O2.
A patient with DKA has rapid, deep respirations. Which action should the nurse take?
administer the prescribed fluid bolus and insulin
A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths per minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats per minute. ABGs are drawn and the nurse reviews the results, expecting to note which finding?
an increased pH and an increased HCO3
A patient who has a history of COPD was hospitalized for increasing shortness of breath and chronic hypoxemia. In planning for discharge, which action by the nurse will be most effective in improving compliance with discharge teaching?
arrange for the patients caregiver to be present during the teaching
A patient with new-onset confusion and hyponatremia is being admitted. Which action should the charge nurse take when making room assignments?
assign the patient to a room near the nursing station
A patient who has been hospitalized for 2 days has a nasogastric tube to low suction and is receiving normal saline IV at 100 mL/hr. Which assessment finding would be a priority for the nurse to report to the health care provider?
decreased alertness since admission
An older adult patient who is malnourished presents to the emergency department with a serum protein level of 5.2. Which clinical manifestation should the nurse expect?
edema
A patient who had a transverse colectomy for diverticulosis 18 hours ago has nasogastric suction. The patient reports anxiety and incisional pain. The patient's respiratory rate is 32 breaths/min, the ABGs indicate respiratory alkalosis. Which action should the nurse take first?
give the patient the PRN IV morphine sulfate 4mg
A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/min. The ECG displays tachycardia, HR 120 bpm. ABGs are drawn and the nurse reviews the results, expecting to note which finding?
increased pH & increased HCO3
The lungs as an acid-base buffer by:
increasing respiratory rate and depth when CO2 levels in the blood are high reducing acid load
A patient who had surgery for a perforated gastric ulcer has been receiving nasogastric suction for 3 days. The patient's serum sodium level is 127. Which prescribed therapy should the nurse question?
infuse 5% dextrose in water intravenously at 125 mL/hr
The patient has severe hyperthyroidism and will have surgery tomorrow. What assessment is most important for the nurse to perform in order to detect development of the highest risk of acid-base imbalance?
level of consciousness
A nurse is assessing a newly admitted patient with chronic heart failure who forgot to take prescribed medications. The patient seems confused and short of breath with peripheral edema. Which assessment should the nurse complete first?
mental status
A patient who is lethargic and with deep, rapid respirations has the following ABG results: pH=7.32, PaO2=88, PaCO2= 35, HCO3=16. How should the nurse interpret these results?
metabolic acidosis
The nurse reviews the ABG results of a client with atelectasis. The nurse analyzes the results and analyzes the results and determines that the client is experiencing respiratory acidosis. Which result validates the nurses findings?
pH=7.25 PaCO2=50
The laboratory technician calls with ABG results on four patients. Which result is most important for the nurse to report immediately to the health care provider?
pH=7.31 PaO2=91 PaCO2=50 O2=96%
After receiving change-of-shift report, which patient should the nurse assess first?
patient with serum magnesium level of 1.1 who has tremors and hyperactive reflexes
A patient in metabolic alkalosis is admitted to the emergency department and pulse oximetry (SpO2) indicates that the O2 saturation is 94%. Which action should the nurse expect to take next?
place the patient on high-flow oxygen
The nurse is caring for a client who is on a mechanical ventilator. ABG results indicate: pH=7.50, PaCO2=30. The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition?
potassium level of 3.0
The nurse assesses a patient with COPD who has been admitted after increasing dyspnea over the past 3 days. Which finding is important for the nurse to report to the health care provider?
respirations are 36 breaths/minute
The nurse is caring for a client with several broken ribs. The client is most likely to experience what type of acid-base imbalance?
respiratory acidosis from inadequate ventilation
The nurse is caring for a client with severe broken ribs. The client is most likely to experience what type of acid base imbalance?
respiratory acidosis from inadequate ventilation
A client who is found unresponsive has ABGs drawn and the results are: pH=7.12, PaCO2=90, HCO3=22. The nurse interprets the results as indicating which condition?
respiratory acidosis without compensation
A patient has the following arterial blood gas results: pH=7.52, PaCO2=30, HCO3=24. The nurse determines that these results indicate:
respiratory alkalosis
A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow for continued mechanical ventilation. How should the nurse interpret the following ABG results: pH=7.48, PaO2=85, PaCO2=32, HCO3=25?
respiratory alkalosis
The nurse reviews the ABG results of a client and notes the following: pH=7.45, PaCO2=30, HCO3=20. The nurse analyzes these results as indicating which condition?
respiratory alkalosis, compensated
A patient with renal failure is on a low phosphate diet. Which food should the nurse instruct an UAP to remove from the patients food tray?
skim milk
A patient who is taking potassium-wasting diuretic for treatment of hypertension reports generalized weakness. Which action is appropriate for the nurse to take?
suggest that the health care provider order a BMP
Following a thyroidectomy, a patient complains of "a tingling feeling around my mouth." Which assessment should the nurse complete first?
test for presence of Chvostek's sign
The nurse is caring for a client having respiratory distress related to an anxiety attack. Recent ABG values are: pH=7.53, PaO2=72, PaCO2= 32, HCO3=28. Which conclusion about the client should the nurse make?
the client is probably hyperventilating
The nurse analyzes the results of a patient's ABG. Which finding requires immediate action?
the partial pressure of oxygen in arterial blood (PaO2) is 62
A pregnant patient with eclampsia is receiving IV magnesium sulfate. Which finding should the nurse report to the health care provider immediately?
the patellar and triceps reflexes are absent
The nurse is making a home visit to a child who has a chronic disease. Which finding has the most implication for acid-base aspects of this patients care?
urine output is very small today
