A child who has been vomiting for 3 days is admitted for correction of fluid and electrolyte imbalances. Which acid-base imbalance is this child likely to exhibit?
Respiratory acidosis.
Metabolic alkalosis
Metabolic acidosis.
Respiratory alkalosis.
The Correct Answer is B
Rationale:
A. Respiratory acidosis: Respiratory acidosis occurs when hypoventilation leads to CO₂ retention and carbonic acid buildup in the blood. It is associated with conditions like pneumonia, asthma, or neuromuscular weakness rather than gastrointestinal losses.
B. Metabolic alkalosis: Metabolic alkalosis occurs when prolonged vomiting leads to the loss of gastric hydrochloric acid, reducing hydrogen ion concentration in the blood. This loss of acid causes a relative excess of bicarbonate, making it the most likely imbalance for a child vomiting for 3 days.
C. Metabolic acidosis: Metabolic acidosis occurs when there is either excessive acid production or loss of bicarbonate, as in diarrhea or diabetic ketoacidosis. Because vomiting removes stomach acid instead of bicarbonate, this imbalance would not be expected here.
D. Respiratory alkalosis: Respiratory alkalosis occurs when hyperventilation causes excessive exhalation of CO₂, leading to elevated blood pH. Since vomiting does not impact ventilation directly, respiratory alkalosis is not the likely disturbance in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Reduction of fever: Albumin administration does not treat fever. Fever may indicate infection, which is a concern in children with nephrotic syndrome, but it is not an expected effect of albumin therapy.
B. Reduction of edema: Albumin 25% IV increases plasma oncotic pressure, drawing fluid from the interstitial spaces back into the intravascular compartment. A decrease in edema demonstrates that the medication is effectively restoring fluid balance.
C. Improved caloric intake: While improved nutrition supports overall health, albumin therapy does not directly influence the child’s appetite or caloric intake. Nutritional status should be monitored separately.
D. Weight gain: Weight gain in nephrotic syndrome may indicate fluid retention rather than therapeutic effect. The desired outcome of albumin therapy is fluid mobilization and reduction of edema, not increased weight.
Correct Answer is A
Explanation
Rationale:
A. Ultrasound: Ultrasound provides the most accurate assessment of fetal position at 29 weeks, as it allows visualization of the fetus, placenta, and amniotic fluid. It is especially useful when Leopold’s maneuvers are inconclusive due to maternal obesity, uterine shape, or fetal movement.
B. Doppler: Doppler is primarily used to assess fetal heart rate and blood flow, not the position of the fetus. While it can confirm fetal presence, it does not provide reliable information about orientation or lie.
C. Leopold’s maneuvers: Leopold’s maneuvers can help estimate fetal position through abdominal palpation. However, at 29 weeks, the fetus is still relatively small and mobile, making this method less precise than ultrasound.
D. Vaginal examination: Vaginal examination can detect fetal presentation only when the fetus is low in the pelvis, usually near labor. At 29 weeks, the fetus is typically high in the uterus, so a vaginal exam would not accurately determine fetal position.
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