How does the nurse expect the patient to try and compensate when they have a Metabolic Acidosis?
Decrease the respiratory rate.
Increase the renal retention of H+.
Increase the respiratory rate.
Decrease the renal reabsorption of HCO3.
The Correct Answer is C
Choice A rationale
Decreasing the respiratory rate would cause retention of carbon dioxide (CO2), a respiratory acid. This would further exacerbate the existing metabolic acidosis by adding a respiratory acid component, making the overall acidosis more severe and less compensated, which is counterproductive.
Choice B rationale
Increasing the renal retention of H+ would worsen the acidosis. The kidneys normally excrete H+ ions to regulate pH. Retaining more H+ would lead to a further decrease in pH, contributing to the acidic state rather than compensating for it, which is the opposite of the body's compensatory mechanism.
Choice C rationale
In metabolic acidosis, the body attempts to compensate by increasing the respiratory rate and depth. This hyperventilation leads to an increased elimination of carbon dioxide (CO2) from the lungs. By blowing off CO2, the body reduces carbonic acid levels, thereby increasing the pH towards the normal range.
Choice D rationale
Decreasing the renal reabsorption of HCO3- would also worsen metabolic acidosis. Bicarbonate (HCO3-) is a primary buffer in the blood, and its reabsorption by the kidneys is crucial for maintaining pH balance. Reducing its reabsorption would lead to greater bicarbonate loss and a further drop in pH.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Cyanosis, a bluish discoloration of the skin and mucous membranes, is a late and ominous sign of hypoxia. It becomes clinically apparent when there are approximately 5 grams per deciliter of desaturated hemoglobin. This indicates a significant reduction in oxygen saturation and severe tissue hypoxia, representing a decompensated physiological state.
Choice B rationale
Bradycardia, a slower than normal heart rate (normal range 60-100 beats per minute for adults), is typically a late sign of hypoxia, particularly in adults. Initially, the body often compensates for hypoxia with tachycardia to increase cardiac output and oxygen delivery. Profound and prolonged hypoxia can depress myocardial function, leading to bradycardia.
Choice C rationale
Hypotension, a low blood pressure (normal range systolic 90-120 mmHg, diastolic 60-80 mmHg), is generally considered a late sign of hypoxia. In the early stages, the sympathetic nervous system may initially increase blood pressure as a compensatory mechanism. However, prolonged or severe hypoxia can lead to myocardial depression and vasodilation, resulting in hypotension.
Choice D rationale
Agitation is an early neurological sign of hypoxia. As oxygen levels decrease, cerebral hypoxia affects brain function, leading to irritability, restlessness, and confusion. The brain is highly sensitive to oxygen deprivation, and these behavioral changes are often among the first indicators of inadequate oxygenation, preceding more overt physiological decompensation.
Correct Answer is D
Explanation
Choice A rationale
Bradycardia, a slow heart rate (typically below 60 beats per minute in adults), is a key component of Cushing's triad. It results from the body's compensatory response to increased intracranial pressure, where systemic hypertension triggers a reflex vagal response, leading to a decrease in heart rate.
Choice B rationale
Widening pulse pressure, defined as an increasing difference between systolic and diastolic blood pressure, is a hallmark of Cushing's triad. This occurs as the body attempts to maintain cerebral perfusion pressure by increasing systolic pressure against a relatively stable or slightly decreased diastolic pressure due to peripheral vasodilation.
Choice C rationale
Hypertension, specifically systolic hypertension, is a crucial component of Cushing's triad. It reflects the body's physiological attempt to overcome increased intracranial pressure and maintain adequate cerebral blood flow by increasing systemic arterial pressure, ensuring perfusion to the brain.
Choice D rationale
Hypothermia, a core body temperature below 35°C (95°F), is not a recognized component of Cushing's triad. Cushing's triad specifically describes a set of physiological responses to increased intracranial pressure: bradycardia, hypertension, and widening pulse pressure, all related to cardiovascular and respiratory regulation.
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