Metabolic Acidosis

The client is diagnosed with metabolic acidosis related to dehydration. Which is the priority action by the nurse?​

Initiate intravenous rehydration with 0.9% sodium chloride.​

Lab results are in. To prevent worsening metabolic acidosis, which is the priority nursing action pH 7.21​ PaCO2 19 mmHg​ HCO3- 15 mEq/L​ PaO2 92 mmHg

Initiate peripheral intravenous access and begin insulin infusion.​

Which assessment findings are consistent with metabolic acidosis? Select all that apply.

Deep, rapid respirations ​ Abdominal pain​ Hyporeflexia Nausea

Metabolic acidosis is a bicarbonate deficit and occurs when an acid other than carbonic acid accumulates in the body or when bicarbonate is lost in body fluids.

Metabolic acidosis is a bicarbonate deficit and occurs when an acid other than carbonic acid accumulates in the body or when bicarbonate is lost in body fluids.

The nurse is caring for a client who presents to the emergency department (ED) with confusion, lethargy, abdominal pain, and muscle weakness following a soccer game. The outside temperature is approximately 102 °F (38.9 °C). Urine output is minimal. Vital signs are T 100.9 °F (38.3 °C), P 115, R 29, and BP 89/62. Arterial blood gas results are pH 7.31, PaCO2 40 mmHg, and HCO3- 20 mEq/L.

Metabolic acidosis, uncompensated​

Which medical conditions may result in metabolic acidosis? Select all that apply. ​

Uncontrolled diabetes mellitus type 1​ Shock Chronic, excessive diarrhea​ kidney failure

The healthcare provider prescribes arterial blood gas analysis. The nurse anticipates the results will show _____ pH,_______ HCO3- , and _______PaCO2.

decreased decreasd decreased

metabolc acidosis results in ____ ph and ___ Hc03

decreased decreased

Samantha's metabolic acidosis is partially compensated. Which assessment finding is indicative of the body's attempt to compensate?

elevated resp rate The lungs attempt to compensate for metabolic acidosis by increasing the respiratory rate. Kussmaul respirations (deep, rapid breathing) develop as the body attempts to compensate for metabolic acidosis.

Jessie McAlvey (pronouns: she/her/hers) is a 19-year-old college student who presents to the emergency department (ED) stating that she does not feel well. She was exposed to the flu a few days ago by her roommate and has been nauseous and not eating. The client has a history of diabetes mellitus type 1, diagnosed when she was 9 years old. Since she is not eating much, she has not been taking her insulin regularly. Today, her serum blood sugar is 723 mg/dL. Vital signs are T 100.9 °F (38.43 °C), P 125, R 30, and BP 82/53. Her skin is warm and dry, and her breathing is deep and rapid with a rotten fruit smell.

history of diabetes not taking her insulin regularly serum blood sugar is 723mg.dl

Evaluating Outcomes Two hours after insulin administration begins, the nurse documents the following assessment:​ T 99.9 °F (37.7 °C), P 102, R 32, and BP 95/72​ Serum blood glucose 650 mg/dL​ Arterial blood gas is pH 7.30, PaCO2 25 mmHg, and HCO3- 20 mEq/L Based on the nurse's interpretation of these findings, the client's condition is

improving

The cause of Samantha's acid-base imbalance is ______

over elimination of bicarbonate Samantha's metabolic acidosis is caused by over-elimination of bicarbonate caused by excessive diarrhea. The overproduction of hydrogen ions is caused by diabetic ketoacidosis, lactic acidosis, shock, starvation, hypoxia, seizures, and salicylate poisoning. The underproduction of bicarbonate is caused by kidney failure, pancreatitis, liver failure, and dehydration

The cause of the client's acid-base imbalance is

over production of hydrogen ions Jessie's metabolic acidosis is caused by overproduction of hydrogen ions caused by diabetic ketoacidosis. Under-elimination of hydrogen ions is most often caused by kidney failure. Over-elimination of bicarbonate is most often caused by diarrhea.

Samantha Long (pronouns: she/her/hers) is a 29-year-old who presents to the emergency department (ED) with severe diarrhea for the past four days. She has a history of ulcerative colitis, iron-deficiency anemia, and pernicious anemia. She reports a headache and abdominal pain. ​ Vital signs are T 97.6 °F (36.4 °C), P 50, R 28, and BP 85/54. ​ Arterial blood gas results are pH 7.33, HCO3- 15 mEq/L, and PaCO2 30 mmHg. Samantha has ____ met acidosis

partially compensated

The nurse is caring for a client in the emergency department (ED) with a serum blood glucose of 848 mg/dL. ​ Arterial blood gas results are:​ pH 7.25​ PaCO2 25 mmHg​ HCO3- 18 mEq/L The client has ________ metabolic acidosis.​

partially compensated

Lab results are in. For each potential healthcare provider prescription, indicate if the prescription is essential, non-essential, or contraindicated at this time. pH 7.21​ PaCO2 19 mmHg​ HCO3- 15 mEq/L​ PaO2 92 mmHg

see pic for answer and rationale

The nurse is caring for a client in the emergency department (ED) who has acute pancreatitis. ​ Arterial blood gas results are:​ pH 7.28​ PaCO2 40 mmHg​ HCO3- 16 mEq/L​ The client has ________ metabolic acidosis.

uncompensated