Metabolic Acidosis

The nurse is analyzing the client's arterial blood gas report, which reveals a pH of 6.58. The client has just suffered a cardiac arrest. Which of the following consequences does the nurse consider for this client? A) Decreased cardiac output B) Increase magnesium levels C) Decreased free calcium in the ECT D) Increased myocardial contractility

A) Decreased cardiac output

The nurse is preparing to instruct a client with type 1 diabetes mellitus on the mechanism behind the development of ketoacidosis. List the order in which the nurse should provide this information. 1. Production of lactate and hydrogen ions 2. Development of lactic acidosis 3. Breakdown of fatty tissue 4. Reduction in intracellular glucose 5. Fatty acids converted to ketones

Answer: 2, 1, 4, 3, 5

The nurse is caring for a client admitted with renal failure and metabolic acidosis. Which of the following signs would indicate to the nurse that planned interventions to relieve the metabolic acidosis have been effective? A) Decreased respiratory depth B) Palpitations C) Increased deep tendon reflexes D) Respiratory rate of 38

Answer: A A) Decreased respiratory depth

The nurse is assessing an African-American client whose cultural background is different from the cultural background of the nurse. The client has symptoms of metabolic acidosis. Which of the following situations would illustrate stereotypical behavior on the nurse's part? Select all that apply. A) Understanding that all culture members will have the same beliefs B) Bringing previous negative information and experiences into this situation C) Making an assumption that all members of each culture are alike D) Taking general knowledge from literature and applying it to the situation E) Discussing the client's health status with family members

Answer: A, B, C, D A) Understanding that all culture members will have the same beliefs B) Bringing previous negative information and experiences into this situation C) Making an assumption that all members of each culture are alike D) Taking general knowledge from literature and applying it to the situation

The nurse is caring for the client experiencing hypovolemic shock and metabolic acidosis. Which of the following therapies would the nurse question if planned for this client? Select all that apply. A) Monitor weight on admission and discharge. B) Monitor ECG for conduction problems. C) Limit the intake of fluids. D) Administer sodium bicarbonate. E) Keep the bed in the locked and low position.

Answer: A, C A) Monitor weight on admission and discharge. C) Limit the intake of fluids.

The nurse is caring for a client who has been admitted with persistent diarrhea lasting 3 days. Which of the following are appropriate nursing diagnoses for this client during the acute phase of the illness? Select all that apply. A) Decreased Cardiac Output B) Ineffective Airway Clearance C) Deficient Fluid Volume D) Knowledge Deficit E) Risk for Injury

Answer: A, E A) Decreased Cardiac Output E) Risk for Injury

A client with metabolic acidosis has been admitted to the unit from the Emergency Department. The client is experiencing confusion and weakness. Which of the following does the nurse implement as a priority of care for this client? A) Place the client in a high-Fowler's position. B) Protect the client from injury. C) Administer sodium bicarbonate. D) Give the client skin care.

Answer: B B) Protect the client from injury.

The nurse is caring for a client with metabolic acidosis. Which of the following are appropriate goals for this client? Select all that apply. A) The client will maintain a respiratory rate of 30 or more. B) The client will describe preventative measure for the underlying chronic illness. C) The client will maintain baseline cardiac rhythm. D) pH will range from 7.25 to 7.35. E) The client will take potassium supplements to increase potassium levels.

Answer: B, C B) The client will describe preventative measure for the underlying chronic illness. C) The client will maintain baseline cardiac rhythm.

During a home visit, the nurse evaluates care provided to a client with type 1 diabetes mellitus and a history of metabolic acidosis. Which outcome indicates that the care of this client has been successful? A) The client is injecting insulin into thigh muscle. B) The client is taking laxatives three times a week to ensure adequate bowel movements. C) The client is eating three balanced meals per day with two snacks. D) The client is taking aspirin 325 mg every 6 hours to treat arthritis pain.

Answer: C C) The client is eating three balanced meals per day with two snacks.

The nurse identifies the diagnosis Risk for Injury as appropriate for a client with metabolic acidosis. Which strategies should the nurse use to support this diagnosis? Select all that apply. A) Apply wrist restraints and secure to the bed frame. B) Discuss chemical restraint use with the healthcare provider. C) Keep the bed in the lowest position. D) Keep bed side rails raised. E) Place a clock and calendar at the bedside.

Answer: C, D, E C) Keep the bed in the lowest position. D) Keep bed side rails raised. E) Place a clock and calendar at the bedside.

Upon entering a room, the nurse quickly scans the environment and then immediately assesses the client for manifestations of metabolic acidosis. What observation did the nurse make that precipitated this assessment of the client? A) Client sleeping with the head of the bed flat B) Half of the client's lunch tray uneaten C) One formed stool in the bedside commode D) 1000 mL of intravenous 0.9% normal saline infused in 2 hours

Answer: D D) 1000 mL of intravenous 0.9% normal saline infused in 2 hours

The nurse is reviewing orders written by the healthcare provider for a client with metabolic acidosis. Which order should the nurse question before implementing it for the client? A) Begin intravenous infusion of 0.9% normal saline. B) Draw serum potassium levels every 2 hours. C) Draw arterial blood gas samples every 2 hours. D) Administer 1 ampule of sodium bicarbonate now.

Answer: D D) Administer 1 ampule of sodium bicarbonate now.

The mother of a 1-month-old infant calls the nurse who works in the health clinic. The mother is concerned because the infant has had vomiting and diarrhea for 2 days. The nurse knows that this infant is at risk for metabolic acidosis. Which of the following is the priority nursing action? A) Instruct the mother to provide the infant with 50 mL of glucose water. B) Instruct the mother to measure the infant's urine output for 24 hours. C) Instruct the mother to give the infant at least 2 ounces of juice every 2 hours. D) Instruct the mother to bring the infant to the clinic for evaluation.

D) Instruct the mother to bring the infant to the clinic for evaluation.