Davis Ch. 9: Acid-Base Imbalances

The nurse is providing client teaching to a client with metabolic acidosis. What statement should the nurse include with teaching?

"Metabolic acidosis is any acidosis not due to a respiratory issue."

The nurse is caring for a client with respiratory alkalosis. What nursing interventions would the nurse expect to include? Select all that apply.

- Encouraging slow, deep breathing - Providing emotional support - Assisting with activities of daily living

Which statements are accurate with regard to acid-base imbalances? Select all that apply.

- Hypoventilation results in respiratory acidosis - Increase in bicarbonate levels is associated with alkalosis - Oxygen saturation is not used to evaluate acid-base balance

Which treatment method would be used for a client who is exhibiting respiratory acidosis?

Administering bronchodilators

Metabolic acidosis is indicated by which arterial blood gas result?

Decreased serum pH and bicarbonate levels

Ron was admitted with metabolic alkalosis from his frequent antacid use. His blood gas results reveal the following: pH ,7.44; PaCO2, 48; and HCO3-, 28. What is Ron's acid-base status?

Fully compensated Rationale: Since the pH is within the normal range, Ron's body has fully compensated from the previous metabolic alkalosis state.

If the body is in a state of alkalosis, the renal buffering system provides acid-base compensation by:

Making urine more alkaline.

A client's diagnostic test results indicate an increased anion gap. Based on this finding, what would the nurse anticipate that the client's labs reveal?

Metabolic acidosis

Amanda is admitted with diabetic ketoacidosis secondary to an upper respiratory infection. Her blood gas results reveal the following: pH, 7.25; PaCO2, 35; and HCO3-, 18. What is Amanda's acid-base status?

Metabolic acidosis Rationale: These blood gases indicate pH acidemia, a normal PACO2 level, and a decreased HCO3- level. Metabolic acidosis is indicated by the decreased pH and bicarbonate levels. Carbon dioxide is the respiratory component and is within normal range.

Jan is recovering from a bowel obstruction. She's had a nasogastric tube in place for several days, connected to suction. These are today's blood gas results: pH, 7.50; PaCO2, 40; and HCO3-, 30. What is her acid-base status?

Metabolic alkalosis Rationale: In metabolic alkalosis, one would expect to see increased pH levels representative of alkalosis and increases in the bicarbonate level.

Marvin has just learned that his wife died. He is hysterical and screaming and crying. His respiratory rate is 32. What part of his arterial blood gas will be low?

PaCO2 Rationale: With tachypnea, the body blows off PaCO2, causing a respiratory alkalosis.

Jessica is in the emergency department for severe asthma and has been receiving aggressive bronchodilator treatments. Her repeat blood gases are as follows: pH, 7.24; PaCO2, 50; and HCO3-, 27. What level of compensation is she showing?

Partially compensated Rationale: Although the pH is outside of normal range indicating acidemia, the carbon dioxide response is increased whereas bicarbonate is slightly increased, indicating an attempt to bring the pH value back to normal.

Kirk has chronic lung disease and is frequently admitted to the hospital. Today, his admission blood gas results reveal the following: pH, 7.18; PaCO2, 50; and HCO3-, 25. How should the nurse document this finding?

Respiratory acidosis Rationale: In respiratory acidosis, one would expect to see decreased pH levels representative of acidemia and increased carbon dioxide levels.

The nurse is reviewing a client's arterial blood gas measurements: pH, 7.48; PaCO2, 33 mm Hg; HCO3-, 22 mEq/L. What do the results indicate?

Respiratory alkalosis

Suzie is taking her NCLEX-RN exam and is tachypneic and hyperventilating. If blood gases were drawn, what acid-base imbalance would be expected?

Respiratory alkalosis Rationale: Respiratory alkalosis occurs primarily with acute alveolar hyperventilation from anxiety and is commonly referred to as hyperventilation syndrome. With this imbalance the pH is low and the PaCO2 is low.

What are the component parts of an arterial blood gas? Select all that apply.

Serum pH levels Bicarbonate level Carbon dioxide level Oxygen

Bill's arterial blood gases are: pH, 7.30; PaCO2, 65; and HCO3-, 24; from an acute pulmonary event. He is short of breath and having difficulty breathing. What is his compensation status?

Uncompensated Rationale: Uncompensated acid-base balance often occurs with an acute situation when the body does not have time to compensate for the changes occurring.

Which finding in a client's arterial blood gas result indicates a normal blood pH level?

pH value of 7.42