Patho M9: Acid-Base Imbalances

A nurse cares for a client with chronic respiratory acidosis who is placed on mechanical ventilation for an acute exacerbation of emphysema. Which​ acid-base abnormality will the nurse expect if the​ client's PaCO2 is corrected too​ quickly? A. pH 7.52 B. HCO3 18​ mmoL/L C. HCO3 24​ mmoL/L D. pH 7.35

A

The nurse cares for a client with metabolic acidosis and hyperphosphatemia. What pathophysiological process does the nurse recognize is the reason for the​ client's phosphate​ abnormality? A. Depression of glycolysis B. Ionized calcium is decreased C. Hydrogen ions move out of the cells D. Positive and negative ions enter the cells

A

The nurse reviews arterial blood gas results and notes the client has a metabolic acidosis. Which organ does the nurse expect will compensate for the​ client's acid-base​ imbalance? A. Lungs B. Brain C. Liver D. Kidneys

A

A client with renal impairment presents with an​ acid-base imbalance. Which mechanisms does the nurse recognize may be​ impaired? Select all that apply. A. Excretion of hydrogen buffered by ammonia. B. Secretion of bicarbonate into the urine. C. Resorption of hydrogen from the nephron into the blood. D. Secretion of hydrogen into the urine. E. Resorption of bicarbonate from the renal tubule into the blood.

A, D, & E

The nurse is caring for a client with uncompensated respiratory acidosis. Which​ acid-base findings will the nurse​ anticipate? Select all that apply. A. pH 7.29 B. pH 7.48 C. HCO3 18​ mmoL/L D. HCO3 23​ mmoL/L E. PaCO2 50 mmHg

A, D, & E

The nurse cares for a pediatric client who has accidentally taken an overdose of antacids. Which​ acid-base abnormality does the nurse anticipate the client will​ manifest? A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis

C

The nurse cares for four clients with​ acid-base imbalances. Which client is most likely experiencing metabolic​ alkalosis? A. Child with severe diarrhea. B. Older adult with a diagnosis of salicylate poisoning. C. Adult who has had lactated​ Ringer's solution infusing for 72 hours. D. Adolescent with a diagnosis of diabetic ketoacidosis.

C

The nurse is caring for a client with acute respiratory acidosis and notes the​ client's rate and depth of breathing are increased. What is the​ nurse's understanding of the cause of this​ finding? A. As the pH​ increases, the respiratory rate increases. B. As the carbon dioxide level​ decreases, the respiratory rate increases. C. Respiratory muscles increase the force of contraction with excess hydrogen levels in the blood. D. The diaphragm weakens with excess hydrogen levels in the blood.

C

A client with congestive heart failure is voiding large amounts of urine via indwelling urinary catheter. Which​ acid-base balance does the nurse recognize the client is at greatest risk for​ developing? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory alkalosis D. Respiratory acidosis

B

A client with liver failure is diagnosed with metabolic acidosis. What pathophysiological mechanism does the nurse recognize is the cause of the​ client's acid-base​ imbalance? A. Poor tissue perfusion and anaerobic metabolism. B. Impaired clearance of lactate. C. Volume deficit and loss of gastric acid. D. Impaired clearance of hydrogen ions.

B

A nurse cares for a client with hyperpyrexia due to pyelonephritis. Which​ acid-base imbalance is most likely with this​ client? A. Metabolic acidosis B. Respiratory alkalosis C. Respiratory acidosis D. Metabolic alkalosis

B

An older adult client presents to the emergency room with a severe​ acid-base imbalance after taking​ "cold medicine" for a week. The client has a history of arthritis and reports daily use of aspirin. Which late effect​ acid-base imbalance does the nurse suspect the client is​ experiencing? A. Respiratory alkalosis B. Metabolic acidosis C. Respiratory acidosis D. Metabolic alkalosis

B

The nurse cares for a critically ill client with a severe​ acid-base imbalance. When reviewing the​ client's anion​ gap, which additional laboratory value does the nurse recognize may skew the anion gap​ results? A. Hemoglobin B. Albumin C. PaCO2 D. PaO2

B

The nurse is caring for a client with respiratory acidosis. Which compensatory mechanism does the nurse understand will act to normalize the​ client's acid-base​ balance? A. Kidneys excrete bicarbonate. B. Kidneys reabsorb bicarbonate. C. Hypoventilation retains carbon dioxide. D. Hyperventilation releases carbon dioxide.

B

The nurse is caring for a client with an​ acid-base imbalance. The nurse recognizes that the client has an alteration in protein function due to the imbalance. Proteins are components of which pathophysiological concept or​ process? Select all that apply. A. Metabolic reaction catalysts B. Receptors C. Production of cellular energy D. Ion channels E. Ion pumps

B, D, & E

The nurse cares for a client with acute respiratory acidosis. Which central nervous system​ (CNS) manifestation will the nurse likely​ find? A. Parasthesias B. Anxiety C. Papilledema D. Dizziness

C

The nurse is caring for a client with metabolic alkalosis. The health care provider prescribes acetazolamide for the treatment of the​ client's condition. What is the​ nurse's understanding of the purpose of this​ treatment? A. It decreases carbonic acid levels in the blood. B. It increases renal resorption of bicarbonate. C. It increases renal excretion of bicarbonate. D. It decreases urinary output and hydrogen loss.

C

The nurse cares for a client experiencing prolonged vomiting resulting in metabolic alkalosis. Which physiologic effect of alkalosis does the nurse​ recognize? A. Decreased cardiac contractility. B. Movement of potassium out of the cells in exchange for hydrogen into the cells. C. Increased level of free calcium blocking sodium channels. D. Increased glycolysis and utilization of phosphate.

D

The nurse cares for a client with an​ acid-base imbalance. Which electrolyte imbalance will most likely cause respiratory​ acidosis? A. Hyponatremia B. Hypernatremia C. Hyperkalemia D. Hypokalemia

D

The nurse is reviewing the arterial blood gas results of a client. When comparing various components of the​ ABG, which statement does the nurse recognize is​ true? A. The lower the​ PaCO2, the lower the pH. B. The higher the​ HCO3, the lower the pH. C. The higher the​ pH, the higher the​ H+ concentration. D. The lower the​ pH, the higher the​ H+ concentration.

D