Mrs. Kalen is a 70-year-old female who has arrived at the ER due to persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. Based on the acid-base interruption from Mrs. Kalen, what can the nurse anticipate the treatment will be for correcting this imbalance?

administration of antiemetics

administration of diuretics

Possible Electrolyte replacement if warranted

Administration of IV 0.9 Saline Solution infusion

Have the patient go home and rest. It will resolve itself shortly.

Answer and Explanation

The Correct Answer is D

Mrs. Kalen is diagnosed with gastroenteritis and dehydration, and the arterial blood gas results indicate metabolic alkalosis (elevated pH and HCO3-). This suggests that there is an excessive loss of gastric acid and chloride ions from vomiting, leading to an imbalance of electrolytes and an increase in bicarbonate levels.

To correct the imbalance and treat dehydration, the primary intervention is fluid replacement. Administration of IV 0.9 Saline Solution, also known as normal saline, is commonly used for fluid resuscitation and rehydration. This isotonic solution helps restore fluid balance and electrolyte levels in the body.

Administration of antiemetics may help control vomiting, but the primary treatment focus in this case is fluid and electrolyte replacement to correct dehydration and the associated metabolic alkalosis.

Administration of diuretics, which increase urine output, would not be appropriate in this case as the patient is already experiencing dehydration.

Electrolyte replacement may be necessary if there are specific electrolyte imbalances identified, but the primary treatment is fluid replacement with IV saline solution.

Having the patient go home and rest without addressing the underlying dehydration and metabolic alkalosis would not be appropriate as it can lead to further complications.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","D","E","F"]

Explanation

1. Alcohol: Alcohol can relax the LES, leading to increased reflux symptoms. 2. Chocolate: Chocolate contains compounds that can relax the LES and contribute to reflux symptoms.

3. Peppermint: Peppermint, including peppermint oil and peppermint-flavored foods, can relax the LES and worsen reflux symptoms.

4. Citrus fruits: Citrus fruits and juices, such as oranges, grapefruits, and lemons, are acidic and can irritate the esophagus, exacerbating GERD symptoms.

5. Cola sodas: Cola sodas, including both regular and diet varieties, can contribute to reflux symptoms due to their carbonation and acidic content.

6. Fatty foods: High-fat foods, such as fried foods, fatty meats, and full-fat dairy products, can delay stomach emptying and increase pressure on the LES, leading to reflux.

A. Weight 98Lbs B. Dehydrated C. Admitted to the ER D. Lethargy E. HR 122 F. Shortness of Breath G. Temperature 100 H. Thirsty I. Female J. BP 90/50

Correct Answer is ["A","B","D","E","F","G","H","J"]

Explanation

● Weight 98 lbs: This information helps determine the patient's baseline weight and assess for potential weight loss associated with dehydration.

● Dehydrated: The diagnosis of dehydration indicates a critical condition that requires immediate attention and intervention.

● Lethargy: Lethargy suggests a decreased level of consciousness and could indicate a severe state of dehydration or other underlying issues that need to be addressed promptly.

● HR 122: A heart rate of 122 beats per minute is elevated and may indicate compensatory mechanisms in response to dehydration or other underlying conditions. It requires further evaluation and intervention.

● Shortness of Breath: This symptom suggests respiratory distress and may be related to the patient's dehydration or underlying conditions. It requires immediate assessment and intervention.

● Temperature 100: An elevated temperature may indicate an underlying infection or inflammatory response. It requires further evaluation to determine the cause and guide appropriate treatment.

● Thirsty: The patient's report of feeling thirsty is an important symptom indicating dehydration and the need for fluid replacement.

● BP 90/50: A blood pressure of 90/50 is low and may be indicative of hypotension, which can occur in dehydration. It requires close monitoring and intervention to stabilize the patient's blood pressure.

The following items are not immediate concerns based on the given information: ● Admitted to the ER: While it is important information, it is not a current concern as the patient is already in the ER.

● Female: The patient's gender is not an immediate concern for the assessment and management of dehydration.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning to teach the patient with gastroesophageal reflux disease (GERD) about foods or beverages that decrease lower esophageal sphincter (LES) pressure. What should be included in this list (select all that apply)?

Correct Answer is ["A","B","C","D","E","F"]

Explanation

Correct Answer is ["A","B","D","E","F","G","H","J"]

Explanation

A nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD) and is diagnosed with pneumonia. The client has been on a long-term regimen of methylprednisolone. Which precautions should the nurse take to prevent complications? Select all that apply.

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