The nurse is caring for a patient with respiratory alkalosis. What will the nurse recognize as the potential cause of this acid-base imbalance?

Hypoventilation

Panic attacks

Pneumonia

Congestive heart failure

Answer and Explanation

The Correct Answer is B

Choice A reason: Hypoventilation is not a cause of respiratory alkalosis. Hypoventilation leads to respiratory acidosis due to the retention of carbon dioxide (CO2). Respiratory alkalosis occurs when there is excessive exhalation of CO2, leading to a higher pH (alkaline).

Choice B reason: Panic attacks can cause respiratory alkalosis due to hyperventilation. During a panic attack, a person may breathe rapidly and deeply, leading to excessive loss of CO2. This reduces the CO2 levels in the blood and increases the pH, resulting in respiratory alkalosis.

Choice C reason: Pneumonia is more likely to cause respiratory acidosis or metabolic acidosis rather than respiratory alkalosis. Pneumonia can impair gas exchange, leading to CO2 retention and decreased oxygen levels, which are not typical triggers for respiratory alkalosis.

Choice D reason: Congestive heart failure can lead to respiratory alkalosis, but it is more commonly associated with metabolic acidosis due to poor perfusion and anaerobic metabolism. Hyperventilation in heart failure patients can lead to respiratory alkalosis, but panic attacks are a more direct and common cause.

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Correct Answer is C

Explanation

Choice A reason: Large, bulky stools are not uncommon after a barium enema, as the barium can cause temporary changes in stool consistency and volume. This finding would not necessarily warrant immediate reporting to the healthcare provider unless there are other concerning symptoms.

Choice B reason: Three formed stools in eight hours may indicate increased bowel activity but is not an unusual finding after a barium enema. This would not typically be a cause for concern unless accompanied by other symptoms.

Choice C reason: Streaks of blood present in the stool is a concerning finding that should be reported to the healthcare provider. The presence of blood may indicate mucosal injury, inflammation, or other complications that need to be addressed promptly.

A. pH 7.21, PaCO2 36, HCO3 14 B. pH 7.50, PaCO2 29, HCO3 22 C. pH 7.47, PaCO2 45, HCO3 33 D. pH 7.31, PaCO2 48, HCO3 24

Correct Answer is A

Explanation

Choice A reason: The ABG results of pH 7.21, PaCO2 36, HCO3 14 indicate metabolic acidosis, which is common in patients with end-stage kidney disease (ESKD). In ESKD, the kidneys lose their ability to excrete acid and maintain bicarbonate levels, leading to an accumulation of acid in the blood. This condition results in a low pH (acidic), normal PaCO2 (as the respiratory system attempts to compensate), and low HCO3 (bicarbonate).

Choice B reason: The ABG results of pH 7.50, PaCO2 29, HCO3 22 indicate respiratory alkalosis, which is not typically associated with ESKD. Respiratory alkalosis occurs when there is excessive exhalation of carbon dioxide, leading to a higher pH (alkaline). This condition is more likely to be seen in situations such as hyperventilation, anxiety, or certain lung diseases.

Choice C reason: The ABG results of pH 7.47, PaCO2 45, HCO3 33 indicate metabolic alkalosis, which is not typically associated with ESKD. Metabolic alkalosis occurs when there is an excess of bicarbonate or a loss of acid. This condition can result from factors such as vomiting, diuretic use, or excessive antacid consumption. It is not a common finding in patients with ESKD.

Choice D reason: The ABG results of pH 7.31, PaCO2 48, HCO3 24 indicate respiratory acidosis, which is not typically associated with ESKD. Respiratory acidosis occurs when there is an accumulation of carbon dioxide due to impaired respiratory function. This condition is more likely to be seen in chronic obstructive pulmonary disease (COPD) or other respiratory disorders. It is not a common finding in patients with ESKD.

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The nurse is caring for a patient with respiratory alkalosis. What will the nurse recognize as the potential cause of this acid-base imbalance?

Nursing Test Bank

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Correct Answer is C

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Correct Answer is A

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