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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Hypercalcemia: AKI is typically associated with hypocalcemia because the kidneys fail to convert vitamin D to its active form, reducing calcium absorption.
B. Elevated BUN: AKI leads to impaired renal filtration, causing elevated blood urea nitrogen (BUN) and creatinine levels due to the accumulation of nitrogenous waste.
C. Metabolic alkalosis: AKI usually causes metabolic acidosis, not alkalosis, due to the accumulation of acids (e.g., lactic acid, uremic toxins).
D. Hypokalemia: AKI commonly leads to hyperkalemia due to reduced potassium excretion.
Correct Answer is A
Explanation
A. Obtain vital signs: Dizziness and lightheadedness during dialysis suggest hypotension, a common complication. The nurse should first assess vital signs to determine the severity before taking further action.
B. Bolus the client with 1000 mL of normal saline: If the client is hypotensive, a smaller fluid bolus (e.g., 250–500 mL) would be more appropriate.
C. Turn off the dialysis machine immediately: Stopping dialysis abruptly may cause fluid overload and other complications. The rate may need adjustment but not immediate cessation.
D. Notify the health care provider as soon as possible: While important, assessing the client’s current status is the priority before contacting the provider.
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