A client is in a motor vehicle accident with a severe kidney injury and develops acute renal failure. Which acid-base imbalance is most likely to develop?

Respiratory Acidosis

Metabolic Alkalosis

Respiratory Alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is D

A. Respiratory Acidosis: Respiratory acidosis results from inadequate ventilation leading to CO₂ retention, which is unrelated to kidney failure.

B. Metabolic Alkalosis: Metabolic alkalosis occurs due to excessive loss of acids (e.g., vomiting) or excess bicarbonate intake. Acute renal failure causes acid retention, not loss.

C. Respiratory Alkalosis: Respiratory alkalosis is caused by hyperventilation and excessive CO₂ loss, not renal dysfunction.

D. Metabolic acidosis: The kidneys play a vital role in acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. Acute renal failure impairs these functions, leading to acid retention and metabolic acidosis.

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Correct Answer is C

Explanation

A. Administer scheduled medications: Some medications (e.g., antihypertensives, water-soluble vitamins, and antibiotics) should be held before dialysis to prevent removal during treatment.

B. Explain that dialysis occurs via the peritoneum: This describes peritoneal dialysis, not hemodialysis.

C. Weigh the client to determine a baseline for comparison: Pre-dialysis weight is crucial to determine fluid removal needs during dialysis. Weight differences before and after dialysis indicate fluid loss or retention.

D. Obtain a serum creatinine to determine kidney function: Serum creatinine levels are monitored regularly but are not a required step before every dialysis session.

A. Fluid will be pushed in the interstitial spaces B. Fluid will be pulled out of the cells and into the blood stream. C. Fluid will be pushed out of the blood stream into the extravascular spaces. D. Fluid will be pulled out of the bloodstream into the cells

Correct Answer is B

Explanation

A. Fluid will be pushed into the interstitial spaces. Hypertonic solutions draw water into the bloodstream, not into tissues.

B. Fluid will be pulled out of the cells and into the bloodstream: Hypertonic solutions (e.g., 3% NaCl, D10W) have a higher osmolarity than blood plasma. This pulls fluid from cells into the intravascular space, causing cell shrinkage and increasing blood volume.

C. Fluid will be pushed out of the bloodstream into extravascular spaces. This describes a hypotonic solution’s effect.

D. Fluid will be pulled out of the bloodstream into the cells. This describes an isotonic or hypotonic effect.

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A client is in a motor vehicle accident with a severe kidney injury and develops acute renal failure. Which acid-base imbalance is most likely to develop?

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