Nokea
The nurse recognizes which of the following are potential causes of metabolic alkalosis? Select all that apply.
- A. Vomiting
- B. Diarrhea
- C. Antacids
- D. Starvation
- E. Hypokalemia
Correct Answer: A,C,E
Rationale: Metabolic alkalosis is caused by an increase in bicarbonate or loss of acid. Vomiting (A) leads to loss of gastric acid, increasing bicarbonate. Antacids (C) neutralize acid, raising bicarbonate levels. Hypokalemia (E) can cause hydrogen ion shifts, contributing to alkalosis. Diarrhea (B) causes bicarbonate loss, leading to acidosis, not alkalosis. Starvation (D) is associated with ketoacidosis, not alkalosis.
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The nurse should interpret these results to indicate that the client has? Laboratory: pH 7.30 [7.35-7.45], PaCO2 50 mmHg [35-45 mm Hg], HCO3- 24 mEq/L [22-28 mEq/L]
- A. Respiratory Acidosis
- B. Respiratory Alkalosis
- C. Metabolic Acidosis
- D. Metabolic Alkalosis
Correct Answer: A
Rationale: Low pH (7.30) and high PaCO2 (50 mm Hg) with normal HCO3- indicate uncompensated respiratory acidosis (A).
The nurse would anticipate which of the following arterial blood gas (ABG) results?
- A. pH 7.29, PCO2 56, PaO2 83, HCO3 22
- B. pH 7.38, PCO2 40, PaO2 92, HCO3 25
- C. pH 7.49, PCO2 30, PaO2 96, HCO3 28
- D. pH 7.50, PCO2 44, PaO2 93, HCO3 34
Correct Answer: A
Rationale: Acute respiratory failure causes CO2 retention and hypoxemia, leading to respiratory acidosis. Option A (pH 7.29, PaCO2 56, HCO3 22) reflects uncompensated respiratory acidosis.
The nurse in the emergency department (ED) is caring for a client with dyspnea and coughing up purulent sputum. The nurse reviews the arterial blood gas (ABG) results: pH 7.25 [7.35-7.45], PaO2 93 mmHg [80-100 mmHg], PaCO2 69 mmHg [35-45 mm Hg], HCO3 25 mmol/L [22-28 mEq/L]. The nurse should interpret these results to indicate that the client has
- A. respiratory alkalosis
- B. respiratory acidosis
- C. metabolic alkalosis
- D. metabolic acidosis
Correct Answer: B
Rationale: The ABG shows low pH (7.25) and high PaCO2 (69 mm Hg), indicating respiratory acidosis (B) due to CO2 retention, likely from impaired ventilation due to pneumonia.
Based on the results, which of the following orders should the nurse anticipate the physician would order? Laboratory: pH 7.33 [7.35-7.45], PaCO2 53 mm Hg [35-45 mm Hg], HCO3 24 mEq/L [22-28 mEq/L], PaO2 95 mm Hg [80-100 mm Hg]
- A. supplemental oxygen
- B. bronchodilator
- C. regular insulin
- D. sodium polystyrene
Correct Answer: B
Rationale: The ABG shows respiratory acidosis (pH 7.33, PaCO2 53 mm Hg). Bronchodilators (B) improve ventilation, reducing PaCO2. Supplemental oxygen (A) is unnecessary as PaO2 is normal. Insulin (C) and sodium polystyrene (D) address metabolic issues, not respiratory acidosis.
The nurse should recognize that the client is experiencing Laboratory: pH 7.19 [7.35-7.45], PaCO2 36 mm Hg [35-45 mm Hg], HCO3 12 mEq/L [22-28 mEq/L], PaO2 90 mm Hg [80-100 mm Hg]
- A. compensated metabolic acidosis
- B. uncompensated metabolic acidosis
- C. compensated respiratory acidosis
- D. uncompensated respiratory alkalosis
Correct Answer: B
Rationale: Low pH (7.19) and low HCO3- (12 mEq/L) with normal PaCO2 indicate uncompensated metabolic acidosis (B). No compensation is evident as PaCO2 is normal.