Patho Ch. 8

The nurse is caring for the following group of clients. Select the client most likely to be diagnosed with respiratory alkalosis.

A 26-year-old female with anxiety who has been hyperventilating

A client's arterial blood gases reveal normal oxygen level, pH 7.50, CO2 level of 50 and HCO3 level of 30. The patient's respiratory rate is 12 breaths per minute with all other vital signs within normal range. What is this client's most likely diagnosis?

Metabolic alkalosis

The nurse is administering a unit of packed red blood cells to a patient and piggybacks the unit of blood through a solution of 0.9% NaCl. Blood cells placed in a solution of 0.9% saline will do which of the following?

Neither shrink nor swell

The nurse at a long term care facility encourages the older adults to drink even though they may not feel thirsty at the time. Which of the following statements supports the nurse's action?

Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high.

The renal control mechanism of restoring the acid-base balance is accomplished through which process?

Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms.

The effective circulating volume is the major regulator of water balance in the body. What else does it regulate?

Sodium

When caring for patients with disorders of sodium balance, the nurse asks the provider which of the following findings are consistent with hypernatremia?

Sodium 158 mEq/L and serum osmolality of 320 mOsm/kg

The condition of a client with metabolic acidosis from an intestinal fistula is not improving. The pulse is 125 beats/min and the BP 84/56mm Hg. ABG values are: pH 7.1, HCO3- 18 mEq/L, PCO2 57mm Hg. What IV medication should the nurse expect to provide next?

Sodium bicarbonate

Hypothalamic sensory neurons that promote thirst when stimulated are called:

osmoreceptors

The nurse is caring for a client with metabolic alkalosis. Which of these arterial blood gas results supports this diagnosis?

pH of 7.50 and HCO3 of 45 mEq/L

When caring for the client with a hyperkalemia, the nurse recognizes the body should respond in which of these ways?

secrete potassium in the distal tubules for excretion

A 77 year-old female hospital patient has contracted Clostridium difficile during her stay, and is experiencing severe diarrhea. Which of the following statements best conveys a risk that this woman faces?

she is susceptible to isotonic fluid volume deficit

The nurse is caring for a client who is experiencing an increased level of aldosterone secretion. The nurse anticipates that the client may develop:

sodium and water retention

A patient is admitted to the emergency department after being involved in an automobile accident with possible internal bleeding. What type of isotonic intravenous (IV) solution does the nurse prepare to infuse?

0.9% NaCl

Body weight consists of which of the following percentages of body water?

60%

The nurse is caring for a client with an acid base imbalance. Which of these does the nurse recognize is correct regarding compensation?

A pH moves toward the normal range

Serum phosphorus level has a reciprocal relationship with which of the following serum electrolytes?

Calcium

When explaining how carbon dioxide combines with water to form carbonic acid as part of acid-base lecture, the faculty instructor emphasized that which enzyme is needed as a catalysis for this reaction?

Carbonic anhydrase.

When caring for a patient with hyperkalemia, the nurse prioritizes assessment of which of the following body systems?

Cardiovascular

Which of the following is an anion?

Chloride

A client has an increase in respiratory rate. What assessment findings does the nurse expect?

Decreased PCO2

A client has been diagnosed with metabolic acidosis. What assessment finding does the nurse expect?

Decreased pH below 7.35

The nurse is caring for a patient who receives hemodialysis. The nurse knows that hemodialysis involves movement of charged or uncharged particles along a concentration gradient. Which of the following best describe this process?

Diffusion

The nurse is caring for a patient with a tumor obstructing the lymphatic system. For which of the following consequences does the nurse assess?

Fluid accumulating in the interstitial spaces distal to the tumor

The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of:

HCO3−

A middle-aged woman has presented to the emergency department following a panic attack. Her blood pressure, respiratory rate and heart rate are all highly elevated, while her temperature and oxygen saturation are within normal ranges. What is the woman's body most likely doing to address the changes in pH associated with her situation?

Her kidneys will limit the amount of bicarbonate that they reabsorb.

The nurse is caring for a patient who takes lithium to manage his bipolar disorder. The nurse carefully observes the patient for which of the following electrolyte imbalance?

Hypercalcemia

A nurse observes peaked, narrow T waves on the electrocardiogram of a patient suffering from renal failure. The nurse suspects that the client is experiencing which of the following conditions?

Hyperkalemia

A community health nurse who is attending a marathon recognizes which of the following types of hypotonic hyponatremia is likely when a patient reports muscle weakness, cramping, and general fatigue in spite of adequate water hydration during the run?

Hypovolemic

The nurse is caring for a patient with ketoacidosis, who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet. The nurse understands which of the following phenomena is most likely occurring?

In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids

A client with ethylene glycol toxicity is restless, and stating he has flank pain. What intervention should the nurse perform to minimize complications?

Increase IV fluids

During the assessment of a client with heart failure, the nurse uses finger pressure to determine if edema is present in the lower extremities. When would the nurse document pitting edema?

Indentation remains after the finger has been removed.

Which of the following volumes represents the greatest percentage of water in the extracellular compartment?

Interstitial

The nurse is performing an assessment for a patient that is experiencing shortness of breath. The nurse notes a full and bounding pulse, crackles in the lung fields, and jugular vein distention. The nurse recognizes symptoms of which of these problems?

Isotonic fluid volume excess

The nurse is evaluating a client's blood gases. The client has a pH of 7.35. How does the nurse interpret this value?

It is within normal range

The nurse is administering the medications to a patient on the cardiac unit. Giving which of the following medications causes the nurse to be alert for hypokalemia?

Loop Diuretics

The nurse is caring for a client who has excessive diarrhea. Which of these acid base disturbances does the nurse anticipate uncovering during evaluation of the arterial blood gas?

Metabolic acidosis

Pressure generated as water moves across a membrane is also known as which of the following?

Osmotic pressure

Vitamin D, officially classified as a vitamin, functions as a hormone in the body. What other hormone is necessary in the body for vitamin D to work?

Parathyroid hormone

What is the nurse's expectation about a client's ability to compensate for a metabolic blood gas disorder?

The client will compensate with the respiratory system.

Potassium is the major cation in the body. It plays many important roles, including the excitability of nerves and muscles. Where is this action particularly important?

The heart

The nurse is teaching the client about Vitamin D. Which of these topics should the nurse include in the teaching plan? Select all that apply.

Vitamin D is present in the skin or intestine. Absorption of calcium from the intestine increases. Vitamin D is transported to the kidneys. Calcitriol is produced

The nurse is assessing a client with fluid volume excess. The nurse anticipates the client would manifest:

Weight gain

The nurse is reviewing the following lab results of a client diagnosed with renal failure: pH: 7.24 PCO2: 38 mm Hg HCO3: 18 mEq/L The nurse would interpret this as? a) metabolic alkalosis b) respiratory alkalosis c) metabolic acidosis d) respiratory acidosis

c) metabolic acidosis