A nurse is caring for a client who has acute kidney injury. The client's ABGS are:
PH:7.26
PaCO2: 30 mm Hg
HCO3: 14 mEq/L
Which of the following acid-imbalances should the nurse identify the client is experiencing?
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
The Correct Answer is D
(A) Metabolic alkalosis: This condition is characterized by a high blood pH (>7.45) and a high bicarbonate level (>26 mEq/L). The client’s pH and bicarbonate levels are both lower than normal, which rules out metabolic alkalosis.
(B) Respiratory acidosis: This condition is characterized by a low blood pH (<7.35) and a high PaCO2 level (>45 mm Hg). Although the client’s pH is low, the PaCO2 level is also low, which rules out respiratory acidosis.
(c) Respiratory alkalosis: This condition is characterized by a high blood pH (>7.45) and a low PaCO2 level (<35 mm Hg). The client’s pH is low, which rules out respiratory alkalosis.
(D) Metabolic acidosis: This condition is characterized by a low blood pH (<7.35) and a low bicarbonate level (<22 mEq/L). The client’s pH is 7.26 and bicarbonate level is 14 mEq/L, both of which are lower than normal. This indicates metabolic acidosis, which is common in clients with acute kidney injury as the kidneys are unable to excrete hydrogen ions and reabsorb bicarbonate. Therefore, the nurse should identify that the client is experiencing metabolic acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
(A) Bradycardia: Bradycardia, or a slower than normal heart rate, is not typically associated with metabolic acidosis. Metabolic acidosis often leads to an increased heart rate (tachycardia) as the body tries to compensate for the acid-base imbalance.
(B) Hyperventilation: This is the most appropriate answer. Hyperventilation is a common response to metabolic acidosis. The body attempts to compensate for the high acid levels by increasing the rate and depth of breathing to expel more carbon dioxide (which is acidic) and raise the blood pH.
(C) Increased blood pressure: Metabolic acidosis does not typically cause an increase in blood pressure. In fact, severe acidosis can lead to vasodilation and a decrease in blood pressure.
(D) Cool, clammy skin: While cool, clammy skin can be a sign of shock or other serious conditions, it is not a typical manifestation of metabolic acidosis. However, in severe cases, metabolic acidosis can lead to shock, which might present with cool, clammy skin.
Correct Answer is D
Explanation
A. Spirituality can increase feelings of hopelessness: This is generally not the case. Spirituality often provides a sense of hope and meaning, especially during challenging times such as the end of life.
B. Spirituality can increase depression: On the contrary, spirituality often serves as a source of comfort and strength, and can help individuals cope with emotional pain and feelings of depression.
C. Spirituality can increase the desire to hasten death: Spirituality typically helps individuals find meaning and purpose in their experiences, which can actually decrease the desire for a hastened death.
D. Spirituality can increase the quality of life: This is correct. Spirituality often enhances the quality of life, especially near the end of life. It can provide a sense of peace, comfort, and well-being. It can also help individuals make sense of their experiences and find meaning in them
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