The nurse is caring for a patient with metabolic acidosis. Which laboratory findings will the nurse expect to support this diagnosis? (Select All That Apply)

pH less than 7.35

HCO3 less than 22 mEq/L

PaCO2 greater than 45 mmHg

PaO2 less than 80 mmHg

SpO2 greater than 95%

Answer and Explanation

Correct Answer : A,B,C

Choice A reason: A pH less than 7.35 indicates an acidic state, which is consistent with metabolic acidosis. The normal pH range is 7.35 to 7.45.

Choice B reason: HCO3 (bicarbonate) less than 22 mEq/L indicates a low level of bicarbonate, which is consistent with metabolic acidosis. Bicarbonate is a base, and lower levels indicate a loss of buffering capacity.

Choice C reason: PaCO2 greater than 45 mmHg is not a primary indicator of metabolic acidosis but can occur as a compensatory mechanism in response to respiratory acidosis. The primary indicators of metabolic acidosis are low pH and low bicarbonate.

Choice D reason: PaO2 less than 80 mmHg indicates hypoxemia but is not directly related to the diagnosis of metabolic acidosis. Hypoxemia can occur with various conditions, and while it may be present, it is not a defining characteristic of metabolic acidosis.

Choice E reason: SpO2 greater than 95% indicates normal oxygen saturation and is not relevant to the diagnosis of metabolic acidosis. Oxygen saturation primarily reflects respiratory function rather than acid-base balance.

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Correct Answer is C

Explanation

Choice A reason: Monitoring blood pressure weekly is important but does not directly help the patient accurately monitor their fluid balance. Daily weight monitoring provides more immediate feedback on fluid status changes.

Choice B reason: Limiting fluid intake to 3 liters per day may be appropriate for some patients but does not directly help the patient monitor their fluid balance. Accurate fluid monitoring involves tracking intake, output, and changes in body weight.

Choice C reason: Weighing yourself at the same time each day is crucial for accurately monitoring fluid balance. Daily weights provide consistent and immediate information about changes in fluid status, which is essential for managing hypervolemia in patients with chronic kidney disease.

Choice D reason: Increasing daily sodium intake is not appropriate for patients with hypervolemia, as it can lead to further fluid retention and worsen the condition. The focus should be on reducing sodium intake and monitoring fluid balance.

A. Normal blood pressure, deep respirations B. Increased alertness, normal heart rhythm C. High urine specific gravity, normal temperature D. Blood glucose of 250 mg/dL, disorientation

Correct Answer is B

Explanation

Choice A reason:

Normal blood pressure may indicate improved hydration, but deep respirations (often seen in metabolic acidosis or DKA) suggest that the patient is still experiencing distress. This combination does not reliably signal effective treatment for HHS.

Choice B reason:

Increased alertness shows that the patient’s mental status is improving, reflecting better cerebral perfusion and hydration.
A normal heart rhythm indicates that potassium levels are stable (thanks to the potassium chloride in the IV fluids) and that the insulin therapy is not causing dangerous shifts.
Together, these findings are the best indicators that the treatment is effective.

Choice C reason:

A high urine specific gravity reveals that the urine is still concentrated, which means dehydration persists.
Although the temperature is normal, the continued dehydration is not consistent with effective treatment of HHS.

Choice D reason:

A blood glucose of 250 mg/dL suggests that hyperglycemia is being corrected; however, persistent disorientation indicates that the patient’s mental status has not improved, meaning that the treatment has not fully resolved the critical aspects of HHS.

Thus, Choice B (Increased alertness, normal heart rhythm) is the best indicator of effective treatment.

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The nurse is caring for a patient with metabolic acidosis. Which laboratory findings will the nurse expect to support this diagnosis? (Select All That Apply)

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with a history of chronic kidney disease who was admitted with hypervolemia. As part of discharge planning, which instruction will the nurse provide to help the patient accurately monitor their fluid balance?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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