Mylab M. 1.4 respiratory alkalosis

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the nurse is reviewing the ABG pH for several patients receiving care in a PostOp unit. which pH should indicate to the nurse that a patient is. experiencing. respiratory alkalosis? - 7.40 - 7.33 - 7.50 -7.25

7.50

The nurse is admitting a patient with a diagnosis of respiratory alkalosis. During the interview, the nurse asks the patient about any previous health issues. Which historical data should the nurse consider to be pertinent to the current diagnosis? ANSWER A hysterectomy A heart catheterization 2 years ago A tonsillectomy at age 6 A previous hospitalization for palpitations

A previous hospitalization for palpitations

A 7-year-old child is experiencing hyperventilation and showing clinical manifestations of respiratory alkalosis, but no neurological impairment. Which action by the nurse provides an appropriate distraction for the child? ANSWER Applying oxygen as ordered Having the child count to 10 out loud Having the child do 10 jumping jacks

Applying oxygen as ordered

Where in the kidneys does the regeneration or reabsorption of bicarbonate in response to changes in pH take place? ANSWER Adrenal glands Renal tubules Ureters Nephrons

Renal tubules

A college student is being released from the hospital after being treated for anxiety and respiratory alkalosis. The nurse is providing discharge teaching. Which statement by the patient indicates the need for further education? ANSWER "I can still attend the late-night study sessions, even if it means less sleep before exams." "I will reduce my hours at my part-time job, so I can rest and study for school and not overextend myself." "I will continue taking the anxiety medications after I leave the hospital." "I can attend a yoga class to learn breathing and relaxation techniques."

"I can still attend the late-night study sessions, even if it means less sleep before exams."

Which statement by the nurse indicates understanding of the response of the kidneys to alkalosis? ANSWER "The kidneys will retain hydrogen and bicarbonate." "The kidneys will retain bicarbonate and excrete of hydrogen ions." "The kidneys will excrete excess hydrogen and bicarbonate." "The kidneys will retain hydrogen ions and excrete bicarbonate."

"The kidneys will retain hydrogen ions and excrete bicarbonate."

A patient has a history of developing respiratory alkalosis as a result of hyperventilation due to panic attacks. The patient asks the nurse about ways of controlling anxiety that leads to the attacks. Which is the nurse's best response? ANSWER "When you first notice you are becoming anxious, try to redirect the anxiety and use relaxation techniques." "What do you think you should do?" "If you take your antianxiety medication as directed, you should not have anxiety." "Begin to breathe into a paper bag to prevent hyperventilation."

"When you first notice you are becoming anxious, try to redirect the anxiety and use relaxation techniques."

A patient has a tendency to develop hyperventilation as a result of anxiety and asks the nurse to explain the signs of this reaction. Which response by the nurse is best? ANSWER "Your breathing is rapid, and you begin to feel dizzy. Your hands and feet may cramp, and you may feel like you're going to black out." "Your breathing will become very rapid, and you will have trouble controlling your actions and motions." "The most important thing is to control the hyperventilation before it gets really bad." "You will begin to have neuromuscular symptoms and may pass out. If you don't get your breathing under control, you could have a seizure."

"Your breathing is rapid, and you begin to feel dizzy. Your hands and feet may cramp, and you may feel like you're going to black out."

A patient is diagnosed with pneumonia and is admitted for IV antibiotics and treatment for respiratory alkalosis. Which assessment finding most likely contributed to the patient's diagnosis of respiratory alkalosis? - Urinalysis negative for bacteria - Hyperthermia caused by infection - Sinus tachycardia - Chest computed tomography (CT) scan negative for pulmonary embolism

- Hyperthermia caused by infection

a patient presents with anxiety induced hyperventilation. which symptom should the nurse identify as being most consistent with an altered level of calcium due to respiratory. alkalosis - decreased urinary output - numbness and cramping in hands and feet - increased blood pressure - dilated pupils

- numbness and cramping in hands and feet

The nurse is caring for a patient admitted with respiratory alkalosis who reports numbness and tingling of the mouth and fingers. Based on this assessment, which of the patient's laboratory values should the nurse expect to be most likely altered? ANSWER Calcium Chloride Potassium Sodium

Calcium

A 35-year-old mother accompanying her child in the emergency department becomes very anxious. She begins hyperventilating, and her hands and feet begin to cramp. Which intervention should the nurse implement? ANSWER Call for assistance, and bring the mother a paper bag. Firmly tell the mother she must remain calm in front of her child. Engage the mother in positive conversation to provide distraction. Help the mother with guided imagery to provide calm.

Call for assistance, and bring the mother a paper bag.

The nurse is caring for a patient who is diagnosed with anxiety, panic attacks, and hyperventilation. Arterial blood gas (ABG) results reveal that the patient has developed respiratory alkalosis. Based on the relationship between carbon dioxide (CO2), hydrogen ion concentration, and respiration, which acid-base imbalance is most appropriate for the nurse to recognize as being the cause of the patient's respiratory alkalosis? ANSWER Bicarbonate (HCO3) deficit Carbonic acid (H2CO3) deficit Carbonic acid (H2CO3) excess Bicarbonate (HCO3) excess

Carbonic acid (H2CO3) deficit

The nurse is caring for a patient who is receiving mechanical ventilation for the treatment of respiratory alkalosis. Which ventilator setting should the nurse anticipate for this patient? ANSWER Increase in rate of respiration setting Decrease in oxygen setting Decrease in tidal volume setting Increase in the PEEP setting

Decrease in tidal volume setting

The nurse is providing care to a patient who is diagnosed with respiratory alkalosis. Which intervention should the nurse implement first? ANSWER Administering an antianxiety medication Administering a sedative medication Having patient rebreathe into a paper bag Encouraging slow, deep breaths

Encouraging slow, deep breaths

A patient presents with a respiratory rate of 48 breaths/min. The patient has been hyperventilating for the past hour and is experiencing muscle spasms and tremors in her extremities, and cramping in her hands. Which process related to respiratory alkalosis should the nurse recognize as the cause of the neuromuscular symptoms? ANSWER Ionized calcium levels increase, resulting in hyperreflexia and muscle spasms. Intravascular calcium levels increase, causing increased reabsorption of bicarbonate. This results in muscle excitability. Extracellular calcium binds with albumin, reducing ionized calcium levels and resulting in neuromuscular excitability. Increased calcium levels cause a decrease in phosphate levels, causing muscle weakness and spasms.

Extracellular calcium binds with albumin, reducing ionized calcium levels and resulting in neuromuscular excitability.

The nurse is caring for a patient who is diagnosed with respiratory alkalosis. Which item in the patient's history supports this diagnosis? ANSWER Use of antianxiety medications Frequent use of NSAIDs for chronic pain Well-controlled diabetes mellitus History of anxiety disorder

History of anxiety disorder

A patient is admitted to a medical floor with a fever and pH of 7.48. Which intervention should the nurse implement? ANSWER Lowering the lighting and speaking in a calm voice Instructing the patient to breathe into a paper bag Administering supplemental oxygen Engaging the patient in distracting conversation

Lowering the lighting and speaking in a calm voice

The nurse is caring for a 72-year-old patient who is admitted to the emergency department. The patient reports repeated panic attacks during which she experiences a rapid heart rate and feelings of terror, as well as uncontrolled hyperventilation. Which arterial blood gas (ABG) results best correlate with an uncompensated acid-base imbalance that is directly related to the patient's hyperventilation? ANSWER PaCO2 of 32 mmHg and serum pH of 7.55 PaCO2 of 52 mmHg and serum pH of 7.55 PaCO2 of 52 mmHg and serum pH of 7.32 PaCO2 of 32 mmHg and serum pH of 7.32

PaCO2 of 32 mmHg and serum pH of 7.55

A patient is experiencing shortness of breath following a heart attack. Which intervention should the nurse implement? ANSWER Positioning the patient in an upright sitting position and applying oxygen Instructing the patient to try to take slow, deep breaths Engaging the patient in conversation as a distraction Having the patient breathe into a paper bag

Positioning the patient in an upright sitting position and applying oxygen

The nurse is performing an assessment on a patient with respiratory alkalosis. Which assessment finding supports this diagnosis? ANSWER Positive Chvostek sign Positive Babinski reflex Negative patellar reflex Negative Trousseau reflex

Positive Chvostek sign

The nurse should administer antianxiety medications cautiously in older adult patients for which reason? ANSWER Older adult patients often have vision disturbances and are not able to properly read a medication label. Brain function is slower, and older adult patients are not able to quickly identify the cause of hyperventilation as anxiety. Renal function is slower, and decreasing the rate and depth of respirations may result in inadequate oxygenation. Older adult patients are more likely to become addicted to antianxiety medications.

Renal function is slower, and decreasing the rate and depth of respirations may result in inadequate oxygenation.

A 25-year-old male patient is in the preoperative holding area, about to have an IV started. The patient states that he is very anxious and "hates needles." As the nurse begins to gather supplies, the patient begins to breathe rapidly and forcefully. To prevent manifestations of respiratory alkalosis, which technique should the nurse use to calm the patient? ANSWER Sit at the bedside, and speak calmly to the patient about things in which the patient is interested. Call the healthcare provider to ask for anxiety medications. Tell the patient that his procedure will be canceled if he doesn't calm down. Firmly instruct the patient that he needs to calm down and be still.

Sit at the bedside, and speak calmly to the patient about things in which the patient is interested.

The nurse is writing a plan of care for a patient admitted to the hospital with respiratory alkalosis. Which outcome would be appropriate for this patient? ANSWER The patient will restore a normal respiratory rate and rhythm. The patient will report a pain level of 3 on a 0-10 scale after pain medication administration. The patient will have no further reports of vomiting. The patient's incision will remain free from infection.

The patient will restore a normal respiratory rate and rhythm.

A patient is being treated for a panic attack. She is hyperventilating, so the nurse instructs her to take slow, regular breaths and breathe into cupped hands. The patient's family member asks why this will help. The nurse's response should be based on which understanding? ANSWER This causes the patient to retain and rebreathe exhaled nitrogen, thus increasing HCO3 and reducing pH. This causes the patient to retain and rebreathe exhaled hydrogen, thus increasing HCO3 and reducing pH. This causes the patient to retain and rebreathe exhaled oxygen, thus increasing PaO2 and reducing pH. This causes the patient to retain and rebreathe exhaled carbon dioxide, thus increasing PaO2 and reducing pH.

This causes the patient to retain and rebreathe exhaled oxygen, thus increasing PaO2 and reducing pH.

Which pharmacologic treatment should the nurse expect to administer to a patient with respiratory alkalosis to restore balance? ANSWER IV insulin Diazepam Sodium bicarbonate A bronchodilator

diazepam

Which arterial blood gas (ABG) result would indicate that respiratory alkalosis has been corrected and is not just compensated? ANSWER pH 7.42, CO2 22 mmHg pH 7.40, CO2 44 mmHg pH 7.25, CO2 28 mmHg pH 7.35, CO2 60 mmHg

pH 7.40, CO2 44 mmHg


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