The nurse is caring for a client who is post-operative following a bowel resection. The client is NPO with a nasogastric tube connected to suction. Which acid base imbalance is this client at risk to develop?

Metabolic alkalosis

Metabolic acidosis

Respiratory alkalosis

Respiratory acidosis

Answer and Explanation

The Correct Answer is A

a. Metabolic alkalosis: Metabolic alkalosis can occur due to loss of gastric acid through suctioning of gastric contents via the nasogastric tube. Continuous suctioning of gastric contents can lead to loss of hydrogen ions (H+) and chloride ions (Cl-) from the stomach, resulting in metabolic alkalosis.

b. Metabolic acidosis: Metabolic acidosis is less likely in this scenario unless there are other factors contributing to acidosis, such as renal dysfunction or excessive administration of certain medications. Suctioning of gastric contents would lead to loss of acid, which could potentially predispose the client to metabolic alkalosis rather than metabolic acidosis.

c. Respiratory alkalosis: Respiratory alkalosis is less likely to occur in this scenario. Although the client is NPO and may be experiencing some respiratory compensation due to metabolic alkalosis, the primary acid-base disturbance would be metabolic rather than respiratory.

d. Respiratory acidosis: Respiratory acidosis is not typically associated with suctioning of gastric contents. Instead, it occurs due to inadequate alveolar ventilation, leading to retention of carbon dioxide (CO2) and subsequent respiratory acidosis. This imbalance is more commonly seen in conditions such as respiratory depression, neuromuscular disorders, or airway obstruction.

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Correct Answer is D

Explanation

a. Check groin dressing: While monitoring the dressing is important, it is not the top priority immediately after the procedure. The nurse should assess other critical aspects first.
b. Review current H&H (hemoglobin and hematocrit): Although monitoring hemoglobin and hematocrit levels is essential, it is not the highest priority at this moment. Immediate post-procedure concerns take precedence.
c. Check blood glucose: Blood glucose monitoring is important, especially if the client has diabetes or other risk factors. However, it is not the priority right after the procedure.
d. Assess pain level: This is the priority intervention. The nurse should assess the client’s pain level, especially at the insertion site. Pain could indicate complications such as bleeding, hematoma, or vascular injury.

A. Uncompensated respiratory alkalosis B. Uncompensated metabolic alkalosis C. Uncompensated metabolic acidosis D. Uncompensated respiratory acidosis

Correct Answer is D

Explanation

a. Uncompensated respiratory alkalosis: Respiratory alkalosis is characterized by a high pH (above 7.45) and a low PaCO2 (below 35mmHg). In this case, the pH is below the normal range and the PaCO2 is elevated, which does not support the diagnosis of respiratory alkalosis.

b. Uncompensated metabolic alkalosis: Metabolic alkalosis is characterized by a high pH and an elevated bicarbonate (HCO3) level. In this case, the pH is below the normal range and the HCO3 level is within the normal range, which does not support the diagnosis of metabolic alkalosis.

c. Uncompensated metabolic acidosis: Metabolic acidosis is characterized by a low pH and a low bicarbonate (HCO3) level. In this case, the pH is below the normal range, but the HCO3 level is within the normal range, which does not support the diagnosis of metabolic acidosis.

d. Uncompensated respiratory acidosis: The pH is below the normal range (7.35-7.45), indicating acidosis. The PaCO2 is elevated at 49mmHg (normal range: 35-45mmHg), indicating respiratory acidosis. The HCO3 is within the normal range at 26mEq/L (normal range: 22-26mEq/L), indicating that compensation has not occurred. Therefore, the ABG results suggest uncompensated respiratory acidosis.

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The nurse is caring for a client who is post-operative following a bowel resection. The client is NPO with a nasogastric tube connected to suction. Which acid base imbalance is this client at risk to develop?

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a client who is one hour post percutaneous valvuloplasty via a left groin site. Which intervention does the nurse consider the priority?

Correct Answer is D

Explanation

A client is admitted to the hospital with an acid base imbalance. Arterial blood gas (ABG) results are: Ph 7.33 (7.35-7.45), PaCO2 49mmHg (35-45mmHg), HCO3 26mEq/L (22-26mEq/L). How should the nurse interpret these results?

Correct Answer is D

Explanation

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