Bio280 Week 1: Acids and Bases

The nurse is caring for the following group of clients. Select the client most likely to be diagnosed with respiratory alkalosis. A. A 26-year-old female with anxiety who has been hyperventilating B. A 63-year-old male with a 40-year history of smoking and chronic lung disease C. A 45-year-old male with pneumothorax after a car accident D. An 18-year-old female who has overdosed on narcotics

A. A 26-year-old female with anxiety who has been hyperventilating

A nurse is caring for a client who is retaining carbon dioxide (CO2) as a result of an obstructive respiratory disease. The nurse understands that as the client's CO2 level rises, what will occur with the blood pH? A. Fall B. Rise C. Double D. Remain unchanged

A. Fall

Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma PCO2 levels. What is a common cause of respiratory alkalosis? A. Hyperventilation B. Kussmaul breathing C. Cluster breathing D. Hypoventilation

A. Hyperventilation

In metabolic alkalosis, the blood pH level: A. Increases B. Decreases C. Stays the same

A. Increases

A client is in metabolic acidosis due to diabetic ketoacidosis. Which of the following signs and symptoms would you expect to see in this patient? A. Kussmaul's respirations B. Glucose of 110 mg/dL C. Hypoventilation D. Neuro-excitability

A. Kussmaul's respirations

When assessing a patient for metabolic alkalosis, the nurse would expect to find: A. Low serum potassium B. Changes in urine output C. Hypotension D. Increased CVP

A. Low serum potassium Rationale: Decreased serum potassium is a common symptom of metabolic alkalosis.

A client with diabetes mellitus has a blood glucose on admission of 596 mg/dL (high). The nurse anticipates that this client would be experiencing which of the following types of acid-base imbalance? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

A. Metabolic acidosis

Which of the following arterial blood gas (ABG) values indicates uncompensated metabolic alkalosis? A. pH 7.48, PaCO2 42, HCO3 30 B. pH 7.48, PaCO2 46, HCO3 30 C. pH 7.48, PaCO2 34, HCO3 20 D. pH 7.48, PaCO2 34, HCO3 26

A. pH 7.48, PaCO2 42, HCO3 30

The respiratory system regulates acid-base balance by: A. Increasing mucus production. B. Changing the rate and depth of respiration. C. Forming bicarbonate. D. Reabsorbing bicarbonate.

B. Changing the rate and depth of respiration.

The body's compensation of metabolic alkalosis involves: A. Increasing the respiratory rate B. Decreasing the respiratory rate C. Increasing urine output D. Decreasing urine output

B. Decreasing the respiratory rate Rationale: The body attempts to compensate for metabolic alkalosis by decreasing the respiratory rate and conserving carbon dioxide (an acid). Urine volume does not influence acid-base balance. The kidneys compensate for a respiratory acidosis by reabsorbing or making more HCO3 or secreting (in the urine) more H+

A client has the following arterial blood gases: HCO3 38, pH 7.50, PaCO2 50. Which of the following signs may this client exhibit as a compensatory mechanism? A. Hyperventilation B. Hypoventilation C. Increased potassium level D. Constipation

B. Hypoventilation The client is in metabolic alkalosis with partial compensation. The respiratory rate is going to decrease in order to hold onto CO2 which will drive the pH more acidic (lower) in hopes of returning it to normal range of 7.35-7.45

A client has a nasogastric tube. The nurse on duty notes that the nasogastric tube (NGT) is draining a large amount. STAT ABGs are ordered. The results from the ABGs show pH 7.57, PaCO2 37 mmHg and HCO3 30 mEq/L. What is your assessment? A. Metabolic Acidosis, Uncompensated B. Metabolic Alkalosis, Uncompensated C. Respiratory Alkalosis, Uncompensated D. Metabolic Alkalosis, Partially Compensated

B. Metabolic Alkalosis, Uncompensated

A client has a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath. Upon examination, crackles and wheezes can be heard in the lower lobes; he has tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg. How would you interpret this? A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

B. Respiratory Acidosis, Partially Compensated

A client is found at the scene of an automobile accident in a state of emotional distress. Respiratory rate is rapid at 34/minute. Which primary acid-base imbalance is the client at risk for if medical attention is not provided? A. Respiratory Acidosis B. Respiratory Alkalosis C. Metabolic Acidosis D. Metabolic Alkalosis

B. Respiratory Alkalosis Hyperventilation is typically the underlying cause of respiratory alkalosis as the client is breathing off too much CO2

The presence of which of the following electrolytes contributes to acidosis? A. Sodium B. Potassium C. Hydrogen D. Chloride

C. Hydrogen Rationale: The presence of hydrogen ions determines a solution's acidity. Acidosis is defined as an abnormal clinical process that causes a net gain in hydrogen ions (H+) in the extracellular fluid. Metabolic acidosis occurs when there is an accumulation of H+ or a loss of bicarbonate ions (HCO3)

A client has been suffering from persistent vomiting for two days. The client is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid-base disorder is shown? A. Respiratory Alkalosis, Uncompensated B. Respiratory Acidosis, Partially Compensated C. Metabolic Alkalosis, Uncompensated D. Metabolic Alkalosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated

A client falls and hits her head on the ground. the clien is unconsciou with shallow and slow respirations. Which primary acid-base imbalance is the client at risk for if medical attention is not provided? A. Metabolic Acidosis B. Metabolic Alkalosis C. Respiratory Acidosis D. Respiratory Alkalosis

C. Respiratory Acidosis Rationale: One of the risk factors of having respiratory acidosis is hypoventilation which may be due to brain trauma, opioid overdose, or respiratory conditions such as COPD, pneumonia, and status asthmaticus.

The lungs participate in acid-base balance by: A. Reabsorbing bicarbonate. B. Splitting carbonic acid in two. C. Using CO2 to regulate hydrogen ions. D. Sending hydrogen ions to the renal tubules.

C. Using CO2 to regulate hydrogen ions. Rationale: The lungs use carbon dioxide to regulate hydrogen ion concentration. The carbon dioxide formed during cellular respiration combines with water to create carbonic acid. Carbonic acid then dissociates into bicarbonate and a hydrogen ion. This reaction is one of the many buffer systems in the human body; it resists dramatic changes in pH to allow a person to remain within the narrow physiological pH range.

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/minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding? 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 increased HCO3

D. An increased pH with an increased HCO3 Rationale: Clients experiencing nausea and vomiting would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH and HCO3 to increase.

A child comes to the ER with rapid and deep breathing (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 23 mm Hg, and HCO3 12 mmol/L. What acid/base imbalance does the client have? A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially, Compensated

D. Metabolic Acidosis, Partially, Compensated

A client has severe vomiting. The nurse notes that the client has low potassium. Which primary acid-base imbalance is this boy at risk for if medical intervention is not carried out? A. Respiratory Acidosis B. Respiratory Alkalosis C. Metabolic Acidosis D. Metabolic Alkalosis

D. Metabolic Alkalosis Rationale: Vomiting, and NGT suctioning are considered risk factors of metabolic alkalosis. The serum buffer system will exchange potassium ions for hydrogen ions to try and compensate. This can lead to hypokalemia.

The nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul's respirations. Based on this documentation, which 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 rapid and deep with a regular pattern

D. Respirations that are rapid and deep with a regular pattern Rationale: Kussmaul's respirations are abnormally deep, regular, and increased in rate.

As asthma becomes severe and sustained, the nurse would expect which acid-base imbalance? A. Metabolic Alkalosis B. Respiratory Alkalosis C. Metabolic Acidosis D. Respiratory Acidosis

D. Respiratory Acidosis