The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?
Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L.
Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L.
Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L.
Sodium level of 144 mEq/L, potassium level of 3.7 mEq/L.
The Correct Answer is C
Choice A rationale:
The sodium level is within the normal range, but the potassium level is slightly elevated. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
Choice B rationale:
The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
Choice C rationale:
Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L is the correct answer. In this option, both sodium and potassium levels are within normal ranges. Changing the IV prescription to DSNS with 20 mEq KCl/L ensures that the patient receives adequate hydration (from the dextrose and normal saline) without causing hyperkalemia.
Choice D rationale:
The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
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Correct Answer is D
Explanation
Choice A rationale:
Adequate platelet production does not explain the prolonged bleeding times in von Willebrand disease. These patients often have normal platelet counts, but their platelets do not function properly due to the absence or dysfunction of von Willebrand factor.
Choice B rationale:
Deficiency in intrinsic clotting system factor is not the primary cause of prolonged bleeding times in von Willebrand disease. The deficiency or dysfunction of von Willebrand factor, a protein that helps platelets adhere to the blood vessel walls and clot properly, is the key issue in this disorder.
Choice C rationale:
Impairment of the thrombin fibrinogen reaction does not directly relate to von Willebrand disease. This disorder primarily involves platelet dysfunction and variable factor VIII deficiencies, leading to prolonged bleeding times.
Choice D rationale:
Variable factor VIII deficiencies and platelet dysfunction are characteristic of von Willebrand disease. Factor VIII helps with blood clotting, and its deficiency, along with impaired platelet function, contributes to the prolonged bleeding times in patients with von Willebrand disease.
Correct Answer is B
Explanation
Choice A rationale:
The base does interact with acids in the acid-base balance. Bases, by definition, are substances that can accept hydrogen ions (protons) and neutralize acids. In the context of acid-base balance, bases help regulate the pH of body fluids by counteracting the effects of acids.
Choice B rationale:
The role of the base in the acid-base balance is to promote the excretion of acid. Bicarbonate ions (HCO3-) are a vital component of the body's buffering system, helping to neutralize excess acid. The kidneys play a crucial role in excreting acids from the body, maintaining the acid-base balance.
Choice C rationale:
The base does not activate the system of acid-base balance; instead, it is part of the body's natural buffering system. The acid-base balance is regulated by the lungs and kidneys, which work together to maintain the pH of body fluids within a narrow range (7.35-7.45)
Choice D rationale:
Bases do not increase the action of hydrogen ions. In fact, bases neutralize hydrogen ions, which are acidic. By accepting these ions, bases help to decrease the acidity of a solution, playing a key role in maintaining the body's acid-base balance.
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