Acid-base Imbalance
The nurse is caring for a client admitted to the medical unit 72 hours ago with pyloric stenosis. A nasogastric tube was placed upon admission, and since that time the client has been on low intermittent suction. Upon review of the morning's blood work, the nurse notices that the client's potassium is below reference range. The nurse should assess for signs and symptoms of what imbalance?
A) Hypercalcemia
B) Metabolic acidosis
C) Metabolic alkalosis
D) Respiratory acidosis
C) Metabolic alkalosis
The nurse is caring for a client who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. The client reports a new onset of weakness with abdominal pain, and further assessment suggests that the client likely has a fluid volume deficit. The nurse should recognize that this client may be experiencing which electrolyte imbalance?
A) Hypernatremia
B) Hypomagnesemia
C) Hypophosphatemia
D) Hypercalcemia
D) Hypercalcemia
A client is diagnosed with type 1 diabetes mellitus (DM) experiences blurred vision, fatigue, increased thirst, and decreased urine output. Labs have been drawn and the client’s fasting blood glucose is 675 mg/dL (20.8 mmol/L). Which is the priority action by the nurse?
A) Begin regular insulin, per infusion pump as prescribed.
B) Administer the dextrose solution prescribed.
C) Collect a clean catch urine specimen for urinalysis.
D) Give prescribed potassium 40 mEq/L over 4 hours.
A) Begin regular insulin, per infusion pump as prescribed.
The nurse provides care for a client with lactic acidosis following prolonged cardiopulmonary resuscitation (CPR). Which arterial blood gas (ABG) result does the nurse anticipate for this client?
A) pH 7.22, PaCO2 60, HCO3 28
B) pH 7.21, PaCO2 33, HCO3 16
C) pH 7.55, PaCO2 30, HCO3 21
D)pH 7.49, PaCO2 47, HCO3 30
B) pH 7.21, PaCO2 33, HCO3 16
A client who is being treated for pneumonia reports sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, and HCO3 24 mm Hg. Which condition does the ABG reflect?
A) Respiratory acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis
D) Metabolic acidosis
A) Respiratory acidosis
The surgical nurse is caring for a client who is postoperative day 1 following a thyroidectomy. The client reports tingling in the lips and fingers. The client also reports an intermittent spasm in the wrist and hand and exhibits increased muscle tone. Which electrolyte imbalance should the nurse first suspect?
A) Hypophosphatemia
B) Hypocalcemia
C) Hypermagnesemia
D) Hyperkalemia
B) Hypocalcemia
The nurse provides care for a mechanically ventilated client who has a prescription for an arterial blood gas (ABG). Which action should the nurse perform when preparing to implement the prescription?
A) Administer 100% oxygen to the client and position the head of the bed at 45 degrees.
B) Refrain from suctioning the client until after the blood sample is drawn.
C) Decrease the rate of the client's propofol infusion.
D) Move the client from the bed to the chair.
B) Refrain from suctioning the client until after the blood sample is drawn.
The nurse provides for a client with a nasogastric (NG) tube connected to low intermittent suction that has been in place for the past 3 days. Which arterial blood gas (ABG) results does the nurse anticipate for this client?
A) pH 7.55, PaCO2 45, HCO3 30
B) pH 7.58, PaCO2 28, HCO3 24
C) pH 7.24, PaCO2 50, HCO3 28
D) pH 7.28, PaCO2 33, HCO3 18
A) pH 7.55, PaCO2 45, HCO3 30
The ABG has the following values: pH 7.51, PaCO2 44 mm Hg, and HCO3 32 mm Hg. Which condition does the ABG reflect?
A) Respiratory acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis
D) Metabolic acidosis
B) Metabolic alkalosis
Which electrolyte imbalance would a positive Trousseau sign indicate?
A) Hypermagnesemia
B) Hyponatremia
C) Hypocalcemia
D)Hyperkalemia
C) Hypocalcemia
The nurse provides care for a client who returns to the unit after a laparoscopic appendectomy. The nurse performs an assessment and obtains vital signs. Which additional action should the nurse implement in the provision of care for this client?
A) Instruct the client to stay in bed.
B) Draw an arterial blood gas (ABG) to monitor for retained carbon dioxide used to inflate the abdomen during the surgical procedure.
C) Administer 2 L/min of supplemental oxygen via a nasal cannula.
D) Educate the client on the importance of deep breathing exercises.
D) Educate the client on the importance of deep breathing exercises.
Which acid/base imbalance is correctly identified by a nurse caring for a post-surgical client who is crying uncontrollably in pain with the following arterial blood gases (ABGs) and vital signs?
Vitals signs: BP 148/94, HR 90 bpm, RR 30, SPO2 90% on room air.
Arterial Blood Gases: pH 7.50, PaCO2: 32 mm Hg, PaO2 80 mm Hg, HCO3 22 mEq/L,
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
D) Respiratory alkalosis
The ABG has the following values: pH 7.47, PaCO2 24 mm Hg, and HCO3 24 mm Hg. Which condition does the ABG reflect?
A) Respiratory acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis
D) Metabolic acidosis
C) Respiratory alkalosis
The nurse is assessing the client for the presence of a Chvostek sign. Which electrolyte imbalance would a positive Chvostek sign indicate?
A) Hypermagnesemia
B) Hyponatremia
C) Hypocalcemia
D) Hyperkalemia
C) Hypocalcemia
A client who returns to the unit immediately following a thyroidectomy appears anxious,reports a tingling sensation in the mouth, and muscle spasms in the left arm. Which is the priority action by the nurse based on the current data?
A) Call respiratory therapy to obtain an arterial blood gas (ABG).
B) Request a prescription from the health care provider for a calcium blood level.
C) Assess the client's surgical dressing for signs of hemorrhaging.
D) Report the client's data to the healthcare provider (HCP).
B) Request a prescription from the health care provider for a calcium blood level.
Which is the best diagnostic test to evaluate the efficiency of the client’s gas? exchange?
A) ABG
B) Chest CT
C) Chest X-ray
D) CBC
A) ABG
The nurse provides care for a client who is diagnosed with pneumonia. The latest arterial blood gas (ABG) analysis is as follows: pH 7.29, PaCO2 55, HCO3 26. Which acid-base imbalance, based on the client’s ABG values and diagnosis, does the nurse include in the client’s plan of care?
A) Respiratory alkalosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Metabolic acidosis
B) Respiratory acidosis
The nurse caring for a client post colon resection is assessing the client on the second postoperative day. The nasogastric tube remains patent and is draining moderate amounts of greenish fluid. Which assessment finding would suggest that the client's potassium level is too low?
A) Diarrhea
B) Paresthesias
C) Increased muscle tone
D) Joint pain
B) Paresthesias
A client with hypertension has been prescribed hydrochlorothiazide. What nursing action will best reduce the client's risk for electrolyte disturbances?
A) Maintain a low-sodium diet.
B) Encourage the use of over-the-counter calcium supplements.
C) Ensure the client has sufficient potassium intake.
D) Encourage fluid intake.
C) Ensure the client has sufficient potassium intake.
Which factors contribute to dehydration in older adults?
A) Increased kidney mass
B) Increased conservation of sodium
C) Decrease total ROM
D) Decreased renal blood flow
D) Decreased renal blood flow