A nurse is admitting a client who has gastroenteritis and is reporting numbness and tingling of the toes and fingers. The nurse should recognize the client is experiencing which of the following acid-base imbalances?

Metabolic acidosis

Respiratory alkalosis

Metabolic alkalosis

Respiratory acidosis

Answer and Explanation

The Correct Answer is C

A.   Metabolic acidosis is characterized by a decrease in bicarbonate or an increase in acids, which can be caused by conditions like kidney failure or diabetic ketoacidosis, but it is not typically associated with numbness and tingling.
B.   Respiratory alkalosis is characterized by a high pH (>7.45) and a decreased PaCO2 (<35 mm Hg). It typically results from hyperventilation, which leads to excessive elimination of CO2 and subsequent alkalosis. This condition is less likely to occur in gastroenteritis unless there are other complicating factors such as anxiety or pain causing increased respiratory rate.
C.   In the context of gastroenteritis, where there may be a loss of stomach acids through vomiting or diarrhea, the most likely acid-base imbalance would be metabolic alkalosis.
D.   Respiratory acidosis is characterized by a low pH and an elevated PaCO2 (>45 mm Hg). It results from hypoventilation, leading to retention of CO2 and subsequent acidosis. Respiratory acidosis would not typically present with numbness and tingling in the extremities in the context of gastroenteritis.

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Correct Answer is A

Explanation

A. A potassium level of 2.9 mEq/L is below the normal range (typically 3.5-5.0 mEq/L). Abnormal potassium levels can affect cardiac function, leading to arrhythmias (irregular heartbeats), especially if the potassium level drops further or if there is rapid fluctuation. This is a critical finding that requires immediate attention from the surgical team to assess the client's cardiac status and determine if potassium replacement is needed before proceeding with surgery.
B. Creatinine levels are used to assess kidney function. A creatinine level of 1.2 mg/dL is within the normal range (typically 0.6-1.2 mg/dL). While kidney function is important to evaluate before surgery, this result is not immediately concerning enough to require an urgent call to the surgical team.
C. Hemoglobin levels are assessed to evaluate oxygen-carrying capacity of the blood. A hemoglobin level of 14.8 g/dL is within the normal range (typically 12-16 g/dL for women and 13-18 g/dL for men). This result indicates adequate oxygen-carrying capacity and does not require immediate communication with the surgical team.

D. Sodium levels are important for fluid balance and nerve function. A sodium level of 134 mEq/L is within the normal range (typically 135-145 mEq/L). While sodium levels should be monitored, this result is not critically abnormal and does not necessitate an urgent call to the surgical team.

A. Deferasirox B. Protamine sulfate C. Acetylcysteine D. Vitamin K

Correct Answer is B

Explanation

A. Deferasirox is a medication used to treat chronic iron overload due to blood transfusions. It is not used as an antidote for heparin.
B. Protamine sulfate is the antidote for heparin. It works by binding to heparin, neutralizing its anticoagulant effects. Protamine sulfate is typically used in cases of heparin overdose or when rapid reversal of heparin's effects is necessary, such as during surgery or if there is active bleeding.
C. Acetylcysteine is used as an antidote for acetaminophen (paracetamol) overdose due to its ability to replenish glutathione stores in the liver and protect against liver damage. It has no role in reversing heparin's effects.
D. Vitamin K is the antidote for warfarin, not heparin. It promotes the synthesis of clotting factors in the liver that are inhibited by warfarin, thus reversing its anticoagulant effects.

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A nurse is admitting a client who has gastroenteritis and is reporting numbness and tingling of the toes and fingers. The nurse should recognize the client is experiencing which of the following acid-base imbalances?

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