The nurse is administering intravenous (IV) fluids to a patient undergoing hemodialysis. Which action is most important for the nurse to take to ensure patient safety during the procedure?

Check the patient's blood pressure before and after the IV administration.

Ensure the dialysis access site is used for IV administration when possible.

Verify the correct fluid type and rate as per the physician's order.

Monitor for signs of infiltration or extravasation at the IV site.

Answer and Explanation

The Correct Answer is C

Choice A reason: Checking the patient's blood pressure before and after IV administration is important, but it is not the most critical action to ensure safety during the procedure.

Choice B reason: Ensuring the dialysis access site is used for IV administration when possible is not standard practice. The dialysis access site is typically reserved for dialysis treatments to prevent complications.

Choice C reason: Verifying the correct fluid type and rate as per the physician's order is the most important action. Ensuring the right fluid type and rate prevents potential complications such as fluid overload, electrolyte imbalances, and adverse reactions.

Choice D reason: Monitoring for signs of infiltration or extravasation at the IV site is important, but verifying the correct fluid type and rate takes precedence to prevent any errors in the initial setup.

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Correct Answer is A

Explanation

Choice A reason: The lab results pH 7.48, PaCO2 30, HCO3 24 indicate respiratory alkalosis. Hyperventilation leads to excessive loss of carbon dioxide (PaCO2), resulting in an increase in pH (alkaline). This is consistent with pulmonary edema and hyperventilation due to heart failure.

Choice B reason: The lab results pH 7.41, PaCO2 45, HCO3 29 indicate a normal pH with compensated metabolic alkalosis. This is not consistent with hyperventilation in pulmonary edema.

Choice C reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical for a patient with hyperventilation and pulmonary edema.

Choice D reason: The lab results pH 7.25, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This would be consistent with hypoventilation rather than hyperventilation.

A. Respiratory alkalosis with partial compensation B. Metabolic alkalosis with partial compensation C. Metabolic alkalosis with no compensation D. Metabolic acidosis with partial compensation

Correct Answer is B

Explanation

Choice A reason: Respiratory alkalosis with partial compensation is characterized by a high pH, low PaCO2, and a compensatory decrease in HCO3. In this case, the pH is high (alkaline), PaCO2 is high, and HCO3 is elevated, indicating that the primary disorder is metabolic alkalosis, not respiratory alkalosis.

Choice B reason: Metabolic alkalosis with partial compensation is indicated by a high pH (alkaline), high HCO3 (bicarbonate), and a high PaCO2 (carbon dioxide) as a compensatory mechanism by the respiratory system. In this case, the pH is 7.52 (alkaline), PaCO2 is 55 mmHg, and HCO3 is 30 mEq/L, which fits the profile of metabolic alkalosis with the respiratory system attempting to compensate by retaining CO2.

Choice C reason: Metabolic alkalosis with no compensation would present with a high pH and high HCO3, but normal PaCO2. In this case, the PaCO2 is elevated, indicating that there is some level of respiratory compensation occurring, which rules out the "no compensation" scenario.

Choice D reason: Metabolic acidosis with partial compensation would present with a low pH, low HCO3, and low PaCO2 as a compensatory mechanism. In this case, the pH is high (alkaline), not low, which is inconsistent with metabolic acidosis.

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The nurse is administering intravenous (IV) fluids to a patient undergoing hemodialysis. Which action is most important for the nurse to take to ensure patient safety during the procedure?

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Naxlex Comprehensive Predictor Exams

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