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

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is A

Explanation

(A) “Incorporate walking into your daily routine.”: This is the most appropriate instruction for a client with peripheral arterial disease (PAD). Regular exercise, such as walking, can help improve circulation, increase the distance a person can walk without pain, and promote overall cardiovascular health. It’s important to start slow and gradually increase the duration and intensity of the exercise as tolerated. The client should be advised to stop and rest if they experience any pain.

(B) “Elevate your legs while in bed.”: While elevating the legs can help reduce swelling in some conditions, it’s not typically recommended for clients with PAD. Elevation can actually decrease arterial blood flow to the legs, which could worsen symptoms.

(c) “Shop for new shoes during the morning hours.”: This instruction is more relevant for clients with conditions that cause foot swelling, such as heart failure or venous insufficiency. In PAD, the size of the feet does not typically change throughout the day.

(D) “Wear knee length stockings.”: Compression stockings are often used to improve venous circulation in conditions like deep vein thrombosis or chronic venous insufficiency. However, they’re not typically recommended for clients with PAD as they can restrict arterial blood flow.

A. Positive Kernig's sign B. Dull, aching calf pain C. Soft, pliable calf muscle D. Positive Homan's sign

Correct Answer is ["B","D"]

Explanation

A. Positive Kernig's sign:

Positive Kernig's sign is associated with meningitis, not thrombosis. It is a clinical sign where pain is elicited when the hip is flexed at a 90-degree angle and then the knee is extended. This sign is not relevant for identifying a thrombus.

B. Dull, aching calf pain:

Dull, aching calf pain is a common symptom of deep vein thrombosis (DVT). Pain, swelling, and tenderness in the calf are typical manifestations of a thrombus in the leg veins. This symptom should alert the nurse to the possibility of a thrombus.

C. Soft, pliable calf muscle:

A soft, pliable calf muscle is not indicative of a thrombus. In the case of DVT, the affected leg is usually swollen, firm, and tender. Thus, this manifestation does not suggest the presence of a thrombus.

D. Positive Homan's sign:

Positive Homan's sign is identified when there is pain in the calf upon dorsiflexion of the foot. This sign can be indicative of DVT. Although not highly specific or sensitive, it is one of the traditional signs used to assess for the presence of a thrombus in the leg.

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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?

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Correct Answer is A

Explanation

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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?