Acid Base Adaptive Quizzing

Which prescribed intervention does the nurse implement first for a patient with metabolic acidosis from shock?

Administer intravenous fluids.

A patient currently taking acetazolamide develops metabolic acidosis. Which nursing interventions are appropriate for the nurse to include in the plan of care?

Administering IV fluids. Monitoring electrolyte levels. Placing the patient on fall precautions.

What is one of the causes of respiratory alkalosis?

Anxiety

The nurse is caring for a patient with hypoxemia and metabolic acidosis. Which task can be delegated to the nursing assistant who is helping with the patient's care?

Apply the pulse oximeter for continuous readings.

A patient has chronic respiratory acidosis. Which nursing assessments are appropriate for this patient?

Assessing the color of nail beds. Assessing for cyanosis of mucous membranes. Checking for the use of accessory muscles.

The nurse is reviewing assessment data for a patient who was admitted for emergency treatment of an acute asthmatic episode. Which assessment data suggest the patient is in an uncompensated acid-base imbalance?

Bicarbonate of 24 mEq/L

Which assessment finding requires priority nursing intervention in a patient with metabolic or respiratory acidosis?

Bradycardia with widened QRS complex

A patient in acute respiratory distress from an asthma attack becomes more confused. Respirations remain rapid, but are more shallow. The most recent blood gas results are pH 7.29, Pao 2 62 mm Hg, Paco 2 56 mm Hg, HCO 3 - 25 mEq/L. What is the nurse's priority intervention?

Call the Rapid Response Team.

A patient has been poisoned by botulinum toxins. What assessment findings suggest the patient has acidosis?

Confusion Warm, flushed, dry skin

Deep and rapid breaths consistent with Kussmaul respirations are found in patients with which type of acid-base imbalance?

Metabolic acidosis

A nurse is assessing a patient with metabolic and respiratory acidosis. What manifestations does the nurse anticipate finding in the patient?

Flaccid paralysis Kussmaul respirations Delayed electrical conduction

When caring for a patient with metabolic acidosis, what must the nurse keep in mind regarding acid-base chemistry?

Fluids with lower pH have higher acidity.

A patient is admitted from the emergency department for intravenous (IV) fluids to treat dehydration caused by several days of vomiting and diarrhea. The patient's admission venous blood work reveals a pH of 7.27 and bicarbonate of 26 mEq/L; potassium and chloride levels are within normal ranges. The provider has ordered adding bicarbonate to the IV fluids. Which action by the nurse is correct?

Hold the bicarbonate and report the laboratory values to the provider.

Which electrolyte abnormality does the nurse anticipate when reviewing laboratory data for a patient admitted with metabolic acidosis?

Hyperkalemia

Which electrolyte imbalance is the patient with metabolic acidosis at risk to develop?

Hyperkalemia

A patient admitted with diabetic ketoacidosis was treated for metabolic acidosis with IV fluids and insulin. Which electrolyte imbalance does the nurse monitor for as the acid-base imbalance resolves?

Hypokalemia

A morbidly obese patient has chosen gastric bypass surgery to promote weight loss. The nurse plans to teach the patient about the need to perform monitoring to detect what disturbance consistent with rapid weight loss associated with this procedure?

Ketosis

What is one of the causes of acidosis?

Kidney failure

The nurse is caring for a critically ill patient with septic shock. The serum lactate level is 6.2. For which acid-base disturbance should the nurse assess?

Metabolic acidosis

The nurse obtains lab results for a 50-year-old patient with the following results: pH 7.24; bicarbonate 20; Pao 2 82; Paco 2 35. These findings are consistent with which acid-base imbalance?

Metabolic acidosis

A patient is recovering from an acute episode of chronic obstructive pulmonary disease (COPD). Which nursing action is the greatest priority in the plan of care?

Monitor the respiratory rate and effort hourly.

The laboratory reports of a patient show the patient has metabolic alkalosis. What conditions may result in metabolic alkalosis?

Nasogastric suctioning Blood transfusion Total parenteral nutrition Prolonged Vomiting

An older patient is admitted with pneumonia. What changes in the patient does the nurse expect to assess when obtaining data about the patient's acid-base imbalance?

New-onset mental status changes Dry mucous membranes Dark, concentrated urine Thready peripheral pulses

When evaluating the laboratory results of a patient with diabetic ketoacidosis, which lab value indicates the body has fully compensated from this acid-base imbalance?

Normal pH on arterial blood gases

The nurse is caring for a patient with metabolic alkalosis. What manifestations of metabolic alkalosis is the nurse likely to assess?

Numbness around the mouth Hyperactivity of deep tendon reflexes

The nurse is assessing patients with acid-base imbalances. Which patient has a diagnosis that correctly correlates with the patient's manifestation?

Patient A has metabolic acidosis.

The nurse is assessing the laboratory profiles of patients with acid-base imbalances. Which patient diagnosis correctly correlates to the appropriate lab values?

Patient D has respiratory depression.

Which patient is most likely to exhibit the following ABG results: pH 7.30; Paco 2 49; HCO 3 - 26; Pao 2 76?

Patient taking hydromorphone

Which patient would be appropriate to assign to the new nurse working on the medical-surgical unit?

Patient with emphysema and cellulitis with a Paco 2 level of 58 mm Hg

What is taking place in the body when hyperventilation occurs?

The central nervous system is responding to a rise in carbon dioxide.

The nurse has just received a report on a patient being admitted from the emergency department (ED). Which items from the report would contribute to the development of metabolic acidosis?

Reported heavy alcohol consumption Chronic cirrhosis of the liver with liver failure Seizure in the ambulance en route to the hospital

A patient having continuous nasogastric (NG) suction after abdominal surgery has become irritable and anxious. An assessment reveals hyperreflexia, the patient's heart rate is 90 beats/min, and the respiratory rate is 24 breaths/min. Which action by the nurse is correct?

Request an order to evaluate serum electrolytes and disruption of NG suction.

Which acid-base imbalance does the nurse anticipate the patient with morbid obesity may develop?

Respiratory acidosis

After a motor vehicle crash, the nurse is consoling a patient in the emergency department who is hysterical and hyperventilating after being notified of the death of a family member. What acid-base imbalance is this patient likely to develop?

Respiratory alkalosis

Lab results for a 62-year-old patient show the following results: pH 7.48; bicarbonate 26; Pao 2 90; Paco 2 32. These findings are consistent with which acid-base imbalance?

Respiratory alkalosis

The nurse suspects that a patient has developed metabolic acidosis because of an overproduction of hydrogen ions. The nurse makes the conclusion based on what assessment findings?

The patient has been fasting for 30 days. The patient has diabetic ketoacidosis. The patient has salicylate intoxication.

While assessing a patient with metabolic acidosis, the nurse suspects that the patient has lactic acidosis. The nurse makes the conclusion based on what finding?

The patient has symptoms of hypoxia.

Which arterial blood gas result does the nurse anticipate in the care of a patient diagnosed with acute kidney failure?

pH 7.33, Pao 2 82 mm Hg, Paco 2 35 mm Hg, HCO 3 - 19 mEq/L

Which arterial blood gas reading does the nurse anticipate in a patient diagnosed with chronic obstructive pulmonary disease (COPD)?

pH 7.36, Pao 2 63 mm Hg, Paco 2 52 mm Hg, HCO 3 - 32 mEq/L

Which arterial blood gas laboratory values would be seen in metabolic alkalosis?

pH 7.49, HCO 3 -32