For which of the following patients would the RN anticipate an order for sodium bicarbonate IVP?
A patient with a PH of 6.9 per arterial blood gas (ABG)
A patient who did not respond to calcium carbonate
A patient with a PH of 7.6 per arterial blood gas (ABG)
A patient who has extremely low serum sodium (Na) levels
The Correct Answer is A
Choice A rationale:
Severe acidemia: A pH of 6.9 indicates severe acidemia, a condition where the blood is too acidic. Sodium bicarbonate is an alkalizing agent that can help raise the blood pH back to a normal range.
Rapid correction: Intravenous (IVP) administration of sodium bicarbonate allows for rapid correction of acidemia, which is crucial in severe cases to prevent life-threatening complications.
Buffering action: Sodium bicarbonate acts as a buffer, accepting excess hydrogen ions (H+) in the blood and converting them into water and carbon dioxide (CO2), which can be exhaled.
Specific indications: Sodium bicarbonate is typically used in cases of severe acidemia caused by metabolic acidosis, such as diabetic ketoacidosis or lactic acidosis. It may also be considered in cases of respiratory acidosis, but other interventions like ventilatory support are often prioritized.
Choice B rationale:
Calcium carbonate is not a direct treatment for acidemia: It is primarily used as an antacid to neutralize stomach acid and as a calcium supplement for bone health. While it can have a mild alkalizing effect, it is not as effective as sodium bicarbonate in rapidly correcting severe acidemia.
Choice C rationale:
Alkalemia: A pH of 7.6 indicates alkalemia, a condition where the blood is too alkaline. Administration of sodium bicarbonate in this situation would worsen the alkalemia and potentially lead to serious complications.
Choice D rationale:
Hyponatremia: Low serum sodium levels do not directly require treatment with sodium bicarbonate. Sodium bicarbonate is primarily used to address acid-base imbalances, not electrolyte imbalances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Insulin lispro is a rapid-acting insulin that begins to work within 15 minutes of injection. If administered 15 minutes after eating, it may not be able to effectively control the rise in blood glucose levels that occurs after a meal. This could lead to hyperglycemia, which can have negative short-term and long-term health consequences.
Administering insulin lispro 15 minutes after eating would delay its action and potentially lead to suboptimal blood glucose control. It's crucial to match the timing of insulin administration with the meal to ensure optimal glucose management.
Choice C rationale:
Administering insulin lispro 10 minutes after eating would also delay its action. While not as delayed as 15 minutes, it still wouldn't align with the peak of meal-related glucose absorption, potentially leading to suboptimal glucose control.
Choice D rationale:
Insulin lispro has a shorter duration of action compared to regular insulin. Administering it 30 minutes before eating could lead to hypoglycemia, a condition characterized by low blood glucose levels. Hypoglycemia can cause a variety of symptoms, including shakiness, sweating, dizziness, confusion, and even loss of consciousness.
It's essential to closely align the timing of rapid-acting insulins like insulin lispro with mealtimes to minimize the risk of hypoglycemia.
Correct Answer is D
Explanation
Rationale for Choice A:
It is not recommended to always consume levothyroxine with food. In fact, food can interfere with the absorption of levothyroxine, leading to decreased efficacy of the medication.
Consuming levothyroxine with food can decrease its absorption by up to 30%, which can significantly impact its ability to manage hypothyroidism symptoms.
Certain foods, such as those high in fiber, calcium, or iron, can be particularly problematic, as they can bind to levothyroxine in the gut and further reduce its absorption.
While taking levothyroxine with a small amount of food may be necessary for some individuals who experience gastrointestinal side effects, it's generally recommended to take it on an empty stomach for optimal absorption.
Rationale for Choice B:
Milk is not an ideal beverage to take with levothyroxine, as it can also interfere with absorption. Milk contains calcium, which can bind to levothyroxine and reduce its absorption.
It's best to avoid consuming milk or other calcium-rich beverages within a few hours of taking levothyroxine.
Rationale for Choice C:
Similar to milk, juice and crackers are not ideal choices to take with levothyroxine.
Juice, especially those high in acidity, can affect the absorption of levothyroxine in the gut.
Crackers, often made with refined grains, can be high in fiber, which can also interfere with absorption.
Rationale for Choice D:
Taking levothyroxine on an empty stomach, typically 30-60 minutes before breakfast, is generally recommended to ensure optimal absorption.
This allows the medication to be absorbed more efficiently in the small intestine without being affected by the presence of food.
By taking levothyroxine on an empty stomach, patients can maximize its effectiveness in treating hypothyroidism.
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