Funds- Acid Base Balance

A client is scheduled for blood to be drawn from the radial artery for an aterial blood gas determination. The nurse assists with performing Allen's test before drawing the blood to determine the adequacy of which? 1. ulnar circulation 2. carotid circulation 3. femoral circulation 4. brachial circulation

1 Rationale: before performing a radial puncture to obtain an arterial specimen for ABG's, Allen's test should be performed to determine adequate ulnar circulation. failure to assess collateral circulation could result in sever ischemic injury to the hand if damage to the radial artery occurs with arterial puncture.

The nurse is caring for a client with severe diarrhea. The nurse monitors the client closely, understanding that this client is at risk for developing which acid base disorder? 1. metabolic acidosis 2. metabolic alkalosis 3. resp acidosis 4. resp alkalosis

1 Rationale: intestinal secretions high in bicarbonate may be lost through enteric drainage tubes, an ileostomy, or diarrhea. the decreased bicarbonate level creates the actual base deficit of metabolic acidosis. the remaining options are unlikely to occur in a client with severe diarrhea

The nurse is caring for a client with resp insufficiency. The ABG results indicate a pH of 7.50 and a PCO2 of 30 and the nurse is told that the client is experiencing resp alkalosis. Which additional lab value should the nurse expect to note? 1. a sodium level of 145 2. a potassium level of 3.2 3. a magnesium level of 2.4 4 a phosphorus level of 4.0

2 Rationale: signs/symptoms of resp alkalosis include tachypnea, mental status changes, dizziness, pallor around the mouth, spasms of the muscles of the hands, and hypokalemia.

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client closely for which acid base disorder that is most likely to occur in this situation? 1. metabolic acidosis 2. metabolic alkalosis 3. resp acidosis 4. resp alkalosis

2 Rationale: the loss of gastric fluid via nasogastric suction or vomiting causes a metabolic condition. this also results in an alkalotic ondition due to the loss of hydrochloric acid through GI fluid losses. also, the options denoting an resp problem can be easily eliminated

The nurse is caring for a client with a diagnosis of COPD. The nurse should monitor the client for which acid base imbalance? 1. metabolic acidosis 2. metabolic alkalosis 3. resp acidosis 4. resp alkalosis

3 Rationale: resp acidosis most often occurs as a result of primary defects in the function of the lungs or changes in normal resp patters from secondary problems. chronic resp acidosis is most commonly caused by COPD. acute resp acidosis occirs in clients with COPD when superimposed resp infection or concurrent resp disease increases the work of breathing.

The RN reviews the lab results of the ABG with the LPN and tells the LPN that the client is experiencing resp acidosis. The LPN should expect to note which on the lab result report? 1. pH 7.50, PCO2 52 2. pH 7.35, PCO2 40 3. pH 7.25, PCO2 50 4. pH 7.50, PCO2 30

3 Rationale: the normal pH is 7.35-7.45 and the normal PCO2 is 35-45. in resp acidosis the pH is down and the PCO2 is up. therefore, the optio with the ph of 7.25 and the pco2 of 50 is the only option that reflects an acidotic condition.

The nurse is caring for a client with DKA and observes that the client is experiencing abnormally deep, regular, rapid respirations. How should the nurse correctly document this observation in the medical record? 1. apnea observed 2. bradypnea noted 3. cheyne stokes demonstrated 4. kussmaul's resp observed

4 Rationale: abnormally deep, regular, rapid respirations observed in the client with DKA are documented as kussmaul's resp. in apnea, resp cease for several seconds. in bradypnea, resp are regular but normally slow. cheyne stokes resp gradually become more shallow and are followed by periods of apnea (no breathing), with repitition of pattern

A client has the following lab values: a pH of 7.55, an HCO3 level of 22, and a PCO2 of 30. Which action should the nurse take? 1. perform Allen's test 2. prepare the client for dialysis 3. administer insulin as prescribed 4. encourage the client to slow down breathing

4 Rationale: the client is in respiratory alkalosis based on the lab results of a high pH and a low PCO2 level. interventions for resp. alkalosis are the voluntary holding of breath or slowed breathing and the rebreathing of exhaled CO2 by methods such as using a paper bag or a rebreathing mask as prescribed. performing allen's test would be incorrect, because the blood specimen has already been drawn, and the lab results have been completed. dialysis and insulin administration are interventions for metabolic acidosis

The nurse is told that the blood gas results indicate a pH of 7.50 and a PCO2 of 32. The nurse determines that these results are indicative of which acid base disturbance? 1. metabolic acidosis 2. metabolic alkalosis 3. resp acidosis 4. resp alkalosis

4 Rationale: the normal pH is 7.35-7.45 In a resp condition, an opposite relationship will be seen between the ph and the PCO2, as is seen in the correct option. in an alkalotic condition, the pH is increased. in an acidotic condition, the pH is decreased so both metabolic acidosis and resp acidosis can be eliminated. metabolic alkalosis can also be eliminated because both the pH and HCO3 are increased above the normal values

When caring for the following group of clients, who does the nurse determine is at risk for development of metabolic alkalosis? SATA 1. client with emphysema 2. client who is hyperventilating 3. client with chronic kidney disease 4. client who has been vomiting for 2 days 5. client receiving furosemide 40mg daily 6. client admitted with (aspirin) overdose

4, 5 Rationale: metabolic alkalosis is caused by any condition that creates the acid base imbalance through either increase in bases or a deficit of acids, such as the client who has been vomiting for 2 days and the client receiving furosemide daily. recall that clients with emphysema and hyperventilation are at risk for a resp acid base disturbance. chronic kidney disease and aspirin overdose will result in metabolic acidosis