Chat with AIExam 1: Acidbase Balance
The client has been vomiting for several days.The nurse knows that the client is at risk for metabolic alkalosis because gastric secretions have which characteristic?
(31) 
VerifiedC
The nurse assumes care for a client who was brought to the hospital after a morphine overdose.What acid-base imbalance does the nurse expect to observe in this client?
(31) VerifiedB
The nurse is preparing to analyze a client's arterial blood gas results.List the steps in the order that the nurse should follow when analyzing this laboratory test.
1) Look at the PaCO2.
2) Look at the pH.
3) Evaluate the relationship between pH and PaCO2.
4) Look for compensation.
5) Evaluate the pH,HCO3,and base excess for a possible metabolic problem.
6) Look at the bicarbonate.
7) Evaluate oxygenation.
(29) Verified2,1,3,6,5,4,7
Explanation:
1. The second step is to look at the PaCO₂. If the PaCO₂ is less than 35, then more carbon dioxide is being exhaled. If the PaCO₂ is greater than 45, then more carbon dioxide is being retained.
2. The pH is the first step and is analyzed to determine if acidosis or alkalosis is present. A pH of less than 7.35 is acidosis. A pH greater than 7.45 is alkalosis.
3. The third step is to evaluate the relationship between the pH and the PaCO₂. This relationship could indicate a respiratory problem. If the pH is acidotic and the carbon dioxide level is greater than 45, then the client could be experiencing respiratory acidosis. If the pH is alkalotic and the carbon dioxide level is below 35, then the client could be experiencing respiratory alkalosis.
4. The sixth step is to look for compensation. Two things can occur in renal compensation. In respiratory acidosis, the kidneys retain HCO₃ to buffer the excess acid, so the HCO₃ is > 28 mEq/L. In respiratory alkalosis, the kidneys excrete HCO₃ to minimize the alkalosis, so the HCO₃ is < 24 mEq/L. Two things can also occur in respiratory compensation. In metabolic acidosis the rate and depth of respirations increase, increasing carbon dioxide elimination, so the PaCO₂ is < 35 mmHg. In metabolic alkalosis respirations slow and carbon dioxide is retained, so the PaCO₂ is > 45 mmHg.
5. The fifth step is to evaluate the pH, HCO₃, and base excess for a possible metabolic problem.If the pH is < 7.35, the HCO₃ is < 24 mEq/L, and the BE is < −2 mEq/L, then low bicarbonate levels and high H + concentrations are causing metabolic acidosis. If the pH is > 7.45, the HCO₃ is > 28 mEq/L, and the BE is > +2 mEq/L, then high bicarbonate levels are causing metabolic alkalosis.
6. The fourth step is to look at the bicarbonate level. If the bicarbonate level is less than 24, then the levels are lower than normal. If the bicarbonate level is greater than 28, then the bicarbonate levels are higher than normal.
7. The final step is to evaluate oxygenation. If the PaO₂ is less than 75 mmHg, then the client is experiencing hypoxemia and possible hypoventilation. If the PaO₂ is greater than 100 mmHg, then the client is hyperventilating.
While reviewing laboratory results,the nurse notes that a client's potassium level is 2.8 mEq/L and chloride level is 100 mEq/L.Based on this data,which intervention does the nurse plan for this client?
(37) The client is admitted to the emergency department (ED)with symptoms of a panic attack,including hyperventilation.Based on this data,the nurse plans care for which health problem?
(28) A client with metabolic acidosis has been admitted to the unit from the emergency department (ED).The client is experiencing confusion and weakness.Which nursing intervention is the priority for this client?
(33) The mother of a 1-month-old infant calls the nurse who works in the health clinic.The mother is concerned because the infant has had vomiting and diarrhea for 1 days.The nurse knows that this infant is at risk for metabolic acidosis.Which is the priority nursing action?
(34) A client is admitted to the hospital with sudden,severe abdominal pain.The client is diagnosed with respiratory alkalosis.Which arterial blood gas value does the nurse document to support this diagnosis?
(40) The nurse is reviewing new prescriptions provided by the healthcare provider for a client with metabolic acidosis.Which prescription should the nurse question before implementing it for the client?
(38) A client with metabolic alkalosis is experiencing numbness around the mouth and tingling of the fingers.What should the nurse explain as the reason for these manifestations?
(37) The nurse instructs a client with a history of acute respiratory acidosis and lung infections on ways to prevent further episodes of the health problem.Which client statement indicates that teaching has been effective?
(28) The nurse has completed discharge teaching for a client with an anxiety disorder.Which client statement indicates that client teaching about respiratory alkalosis has been effective?
(38) Upon entering a room,the nurse quickly scans the environment and then immediately assesses the client for manifestations of metabolic acidosis.Which did the nurse observe to precipitate this client assessment?
(44) The nurse is preparing to discharge a client with congestive heart failure on furosemide (Lasix).The nurse determines that teaching has been effective if the client makes which statement?
(40) A client is admitted to the emergency department for treatment of an overdose.The client's arterial blood gas results indicate acute respiratory acidosis.Which substance found on the nurse's review of the toxicology analysis is most likely the cause for the client's current condition?
(39) The nurse identifies the diagnosis Risk for Impaired Gas Exchange to guide the care of a client with metabolic alkalosis.Which assessment data supports this nursing diagnosis? Select all that apply.
(37) The nurse is caring for a comatose client with respiratory acidosis.For which intervention will the nurse need to collaborate when caring for this client?
(43) The client is receiving sodium bicarbonate intravenously (IV)for correction of acidosis secondary to diabetic coma.The nurse assesses the client to be lethargic,confused,and breathing rapidly.Which is the nurse's priority response to the current situation?
(31) A client has been admitted with chronic obstructive pulmonary disease.Diagnostic tests have been ordered.Which of the tests will provide the most accurate indicator of the client's acid-base balance?
(37) During a home visit,the nurse evaluates care provided to a client with type 1 diabetes mellitus and a history of metabolic acidosis.Which outcome indicates that the care of this client has been successful?
(25) 
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