The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction. Which acid-base imbalance is most likely to occur?

Metabolic acidosis

Respiratory acidosis

Respiratory alkalosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is D

A. Metabolic acidosis: This condition typically results from excessive acid accumulation or bicarbonate loss, such as in kidney failure or diarrhea. It is not associated with gastric fluid loss via suction.
B. Respiratory acidosis: Respiratory acidosis is caused by hypoventilation leading to CO₂ retention. It is unrelated to nasogastric suction and does not reflect the primary concern for this client.
C. Respiratory alkalosis: This occurs due to hyperventilation and excessive loss of CO₂, often from anxiety or pain. It is not a risk in a client with GI fluid loss from suction.
D. Metabolic alkalosis: Nasogastric suction removes hydrochloric acid from the stomach, leading to a loss of hydrogen ions. This results in an increased bicarbonate concentration, predisposing the client to metabolic alkalosis.

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Correct Answer is ["A","C","D"]

Explanation

A. Right extremity comparable in size to left: Reduction in swelling indicates improved venous return and resolution of the thrombus. Symmetry between extremities suggests successful clot dissolution and reduced obstruction in the affected vein.
B. No bleeding or bruising noted: While this is a desirable side effect outcome, it is not a direct measure of thrombolytic effectiveness. Thrombolytics carry bleeding risk, but the absence of bruising doesn’t confirm clot resolution.
C. Right extremity pink: A pink, well-perfused extremity suggests adequate blood flow, which reflects successful reperfusion. This indicates improved circulation after clot breakdown and is a positive therapeutic result.
D. Client denies pain: Pain is a hallmark symptom of DVT due to inflammation and obstruction. Decreased or absent pain after thrombolytic therapy reflects clinical improvement and reduced clot burden.
E. Pedal pulse thready: A thready pulse may indicate decreased perfusion and is not a reassuring finding. Effective thrombolytic therapy should lead to strong, palpable pulses if circulation has improved.

A. Maintain activity restriction to bedrest. B. Limit interaction with visitors. C. Avoid heavy meals. D. Arrange personal care supplies nearby.

Correct Answer is A

Explanation

A. Maintain activity restriction to bedrest: Bedrest reduces the heart's workload by minimizing physical exertion, thereby decreasing myocardial oxygen demand. This is crucial in cardiogenic shock, where the heart's pumping ability is severely compromised.
B. Limit interaction with visitors: While excessive stimulation can be stressful, limiting social interaction has a minimal impact on myocardial oxygen consumption compared to physical activity. Emotional support from visitors can actually benefit the client’s overall well-being.
C. Avoid heavy meals: Heavy meals may cause postprandial increases in metabolic demand, but they are not as directly impactful on cardiac workload as restricting physical activity. Meal composition should still be considered, but it's not the most immediate priority.
D. Arrange personal care supplies nearby: Placing supplies within reach helps minimize exertion during ADLs, but this is a supportive measure. Complete activity restriction is a more direct and effective intervention to reduce cardiac oxygen demand in the acute phase.

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The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction. Which acid-base imbalance is most likely to occur?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is evaluating the expected outcomes following thrombolytic therapy for a right leg deep vein thrombosis. Which finding(s) confirms a positive outcome? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

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Correct Answer is A

Explanation

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