A nurse is caring for a 78-year-old client who was recently admitted from the emergency room and is reporting weakness.

Exhibits

Select words from the choices below to fill in each blank in the following sentence.

The nurse has reviewed the client's medical record.

The client is at risk for developing metabolic acidosis hypernatremia
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and
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Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"E"}

Correct choices are; Metabolic acidosis:

This can occur due to the client's diarrhea, leading to loss of bicarbonate (HCO3-) through the gastrointestinal tract. The ABG results show a pH slightly below normal (7.33) and a decreased bicarbonate level (19 mEq/L), indicative of metabolic acidosis.

Hypernatremia:

The client's sodium level is elevated at 149 mEq/L (normal range is 136-145 mEq/L). This indicates hypernatremia, which could be due to dehydration from diarrhea and possibly inadequate fluid intake.

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Correct Answer is A

Explanation

A. Diarrhea can lead to loss of bicarbonate from the body, resulting in metabolic acidosis. The loss of bicarbonate through gastrointestinal fluids causes an imbalance between acids and bases in the body.
B. Salicylates (such as aspirin) can cause metabolic acidosis by several mechanisms, including direct stimulation of the respiratory center in the brainstem (leading to hyperventilation and respiratory alkalosis initially) and later causing metabolic acidosis due to increased production of acids like lactic acid and ketoacids.
C. Vomiting can lead to loss of gastric acid (hydrochloric acid), which could initially lead to metabolic alkalosis due to loss of acid.
D. Thiazide diuretics can cause metabolic alkalosis rather than metabolic acidosis. They promote the loss of potassium and hydrogen ions (acid), leading to increased blood pH (alkalosis).

A. Metabolic acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Respiratory acidosis

Correct Answer is C

Explanation

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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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

Correct Answer is A

Explanation

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?

Correct Answer is C

Explanation

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