A nurse is caring for a client in the emergency department (ED) who has high anxiety and shallow respirations at a rate of 30/min. Which of the following acid-base disturbances is the client most likely experiencing?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
The Correct Answer is B
A. Respiratory acidosis occurs due to hypoventilation, resulting in carbon dioxide retention. This condition is characterized by slow, shallow breathing and confusion, which is not consistent with the client's rapid respiratory rate of 30/min.
B. Respiratory alkalosis is typically caused by hyperventilation, where excessive breathing leads to a decrease in carbon dioxide levels. The client's symptoms of high anxiety and rapid, shallow respirations are indicative of hyperventilation, making respiratory alkalosis the most likely diagnosis.
C. Metabolic acidosis is characterized by deep, rapid breathing (Kussmaul respirations) as the body attempts to expel excess acid. The client's shallow respirations are inconsistent with the breathing pattern seen in metabolic acidosis.
D. Metabolic alkalosis usually presents with symptoms such as dizziness and tingling, often with compensatory slow respirations. The rapid respiratory rate in this case does not suggest metabolic alkalosis, making this option unlikely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
A. The client who has renal failure: Renal failure can lead to hypocalcemia due to the kidneys' reduced ability to convert vitamin D to its active form, leading to decreased calcium absorption.
B. The client who is postoperative following a thyroidectomy: Hypocalcemia can occur after thyroidectomy if the parathyroid glands are inadvertently damaged or removed, as they regulate calcium levels.
C. The client who has hyperparathyroidism: Hyperparathyroidism typically leads to hypercalcemia, not hypocalcemia, as excessive parathyroid hormone (PTH) increases calcium levels in the blood.
D. The client who has vitamin D deficiency: Vitamin D is essential for calcium absorption in the intestines, so a deficiency can lead to hypocalcemia.
E. The client who is receiving bisphosphonate medications: Bisphosphonates inhibit bone resorption, which can lead to a decrease in calcium levels, potentially causing hypocalcemia.
F. The client who has Addison's disease: Addison's disease is primarily associated with electrolyte imbalances like hyponatremia and hyperkalemia, not hypocalcemia.
Correct Answer is ["C","D"]
Explanation
A. Blood urea nitrogen (BUN) 25 mg/dl (10 to 20 mg/dL): Elevated BUN can indicate dehydration or kidney issues, but it is not directly related to metabolic alkalosis.
B. Serum potassium level 4.8 mg/dL (3.5 to 5 mg/dL): This potassium level is within the normal range and does not indicate a cause of metabolic alkalosis. Metabolic alkalosis is more commonly associated with hypokalemia rather than normal potassium levels.
C. History of vomiting: Vomiting can lead to metabolic alkalosis due to the loss of stomach acid (hydrochloric acid), which reduces the body's acidity and raises the pH.
D. Overuse of antacids: Excessive use of antacids can contribute to metabolic alkalosis because antacids neutralize stomach acid, leading to an increase in blood pH.
E. Polycythemia: Polycythemia, an increased concentration of red blood cells, is not typically associated with metabolic alkalosis. It is related to other conditions such as chronic hypoxia or bone marrow disorders.
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