NUR 112 - FINAL EXAM PREP: Acid-Base,
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Fluid & Electrolytes Review exam with
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100%correct answers |
A |client |presents |to |the |ED |with |respiratory |distress |and |suddenly |becomes |unconscious. |
Arterial |blood |gases |are |drawn |and |the |nurse |review |the |results: |pH |7.12, |PaO2 |56 |mmHg, |
PaCO2 |65 |mmHg, |HCO3 |22 |mEq/L. |What |does |the |nurse |suspect |due |to |these |results?a) |
diabetic |ketoacidosisb) |bronchial |obstruction |related |to |aspirationc) |drug |overdosed) |heart |
attack |- |correct |answersb) |bronchial |obstruction |related |to |aspiration |[causing |respiratory |
acidosis]Rationale: |Arterial |blood |gas |values |indicate |that |the |client |has |respiratory |acidosis |
with |normal |levels |of |bicarbonate, |suggesting |that |the |problem |is |not |metabolic. |Arterial |
concentrations |of |oxygen |(PaO2) |and |carbon |dioxide |(CO2) |are |abnormal, |with |low |oxygen |and
|high |carbon |dioxide |levels. |This |client |has |respiratory |acidosis |from |inadequate |gas |exchange |
due |to |obstruction. |The |fact |that |the |bicarbonate |level |is |normal |indicates |that |this |is |an |acute
|respiratory |problem |rather |than |a |chronic |problem, |because |no |renal |compensation |has |
occurred.
S&S |of |____ |include |muscle |weakness/lethargy/absent |or |decreased |DTRs, |confusion, |
abdominal |distention |d/t |constipation, |Ca |deposits, |and |kidney |stone |formation. |Often |
correlated |with |hyper |magnesemia. |- |correct |answershypercalcemia
muscle |spasm, |decreased |urine |output, |decreased |DTRs, |increased |bowel |motility, |weakness, |
shallow |respirations, |and |orthostatic |hypotension |are |common |symptoms |for |____ |and |are |
often |correlated |with |hyperkalemia. |- |correct |answershyponatremia
A |client |with |a |3-day |history |of |nausea |and |vomiting |presents |to |the |emergency |department. |
The |client |is |hypoventilating |with |a |respiratory |rate |of |10. |ABGs |are |drawn |and |the |nurse |
reviews |the |results, |expecting |to |note |which |of |the |following?a) |a |decreased |pH |and |an |
increased |CO2b) |an |increased |pH |and |a |decreased |CO2c) |a |decreased |pH |and |a |decreased |
HCO3d) |an |increased |pH |with |an |increased |HCO3 |- |correct |answersd) |an |increased |pH |with |an
|increased |HCO3 |[metabolic |alkalosis]Rationale: |Clients |experiencing |N&V |(or |NG |tube |suction)
|would |most |likely |present |with |metabolic |alkalosis |resulting |from |loss |of |gastric |hydrochloric |
, acid |(hydrogen |chloride), |causing |the |pH |and |HCO3- |to |increase. |Symptoms |experienced |by |
the |client |would |include |hypoventilation |(to |retain |CO2) |and |tachycardia.
S&S |for |___ |include |positive |Trousseaus |and |Chvostek's |signs, |tetany/spasm/increased |DTR, |
confusion, |and |arrhythmias, |and |it |is |often |correlated |with |hypomagnesemia. |- |correct |
answershypocalcemia
An |increased |pH |and |a |decreased |CO2 |indicates |__ |__ |- |correct |answersrespiratory |alkalosis
In |a |man |undergoing |surgery, |it |was |necessary |to |aspirate |the |contents |of |the |upper |gastro-
intestinal |tract. |After |surgery, |the |following |values |were |obtained |from |an |arterial |blood |
sample: |pH |7.55, |PCO2 |52 |mm |Hg |and |HCO3- |40 |mmol/l. |What |is |the |underlying |disorder?a) |
Metabolic |acidosisb) |Respiratory |alkalosisc) |Metabolic |alkalosisd) |Respiratory |acidosis |- |correct
|answersc) |metabolic |alkalosisRationale: |The |pH |is |higher |than |normal, |so |there |is |alkalosis. |In |
addition, |the |PCO2 |and |bicarbonate |concentration |are |higher |than |normal, |so |the |patient |is |
suffering |from |metabolic |alkalosis. |Since |the |PaCO2 |is |higher |than |45, |this |tells |us |the |lungs |
are |trying |to |compensate.
Cases |of |acidosis |often |result |in |___ |(low/high) |potassium, |except |in |cases |with |diarrhea. |- |
correct |answershigh
Determining |underlying |cause |(ask |about |antacid |use), |treating |underlying |cause: |if |vomiting, |
administer |antiemetics; |if |due |to |thiazide |diuretics, |stop |thiazide |and |start |K+ |sparing |
diuretics, |and |safety |to |prevent |falls |are |interventions |for |which |acid-base |imbalance? |- |correct
|answersmetabolic |alkalosis
A |decreased |pH |and |an |increased |CO2 |indicates |__ |__ |- |correct |answersrespiratory |acidosis
A |decreased |pH |and |a |decreased |HCO3- |indicates |__ |- |correct |answersmetabolic |acidosis
| | | | | | |
Fluid & Electrolytes Review exam with
| | | | | |
100%correct answers |
A |client |presents |to |the |ED |with |respiratory |distress |and |suddenly |becomes |unconscious. |
Arterial |blood |gases |are |drawn |and |the |nurse |review |the |results: |pH |7.12, |PaO2 |56 |mmHg, |
PaCO2 |65 |mmHg, |HCO3 |22 |mEq/L. |What |does |the |nurse |suspect |due |to |these |results?a) |
diabetic |ketoacidosisb) |bronchial |obstruction |related |to |aspirationc) |drug |overdosed) |heart |
attack |- |correct |answersb) |bronchial |obstruction |related |to |aspiration |[causing |respiratory |
acidosis]Rationale: |Arterial |blood |gas |values |indicate |that |the |client |has |respiratory |acidosis |
with |normal |levels |of |bicarbonate, |suggesting |that |the |problem |is |not |metabolic. |Arterial |
concentrations |of |oxygen |(PaO2) |and |carbon |dioxide |(CO2) |are |abnormal, |with |low |oxygen |and
|high |carbon |dioxide |levels. |This |client |has |respiratory |acidosis |from |inadequate |gas |exchange |
due |to |obstruction. |The |fact |that |the |bicarbonate |level |is |normal |indicates |that |this |is |an |acute
|respiratory |problem |rather |than |a |chronic |problem, |because |no |renal |compensation |has |
occurred.
S&S |of |____ |include |muscle |weakness/lethargy/absent |or |decreased |DTRs, |confusion, |
abdominal |distention |d/t |constipation, |Ca |deposits, |and |kidney |stone |formation. |Often |
correlated |with |hyper |magnesemia. |- |correct |answershypercalcemia
muscle |spasm, |decreased |urine |output, |decreased |DTRs, |increased |bowel |motility, |weakness, |
shallow |respirations, |and |orthostatic |hypotension |are |common |symptoms |for |____ |and |are |
often |correlated |with |hyperkalemia. |- |correct |answershyponatremia
A |client |with |a |3-day |history |of |nausea |and |vomiting |presents |to |the |emergency |department. |
The |client |is |hypoventilating |with |a |respiratory |rate |of |10. |ABGs |are |drawn |and |the |nurse |
reviews |the |results, |expecting |to |note |which |of |the |following?a) |a |decreased |pH |and |an |
increased |CO2b) |an |increased |pH |and |a |decreased |CO2c) |a |decreased |pH |and |a |decreased |
HCO3d) |an |increased |pH |with |an |increased |HCO3 |- |correct |answersd) |an |increased |pH |with |an
|increased |HCO3 |[metabolic |alkalosis]Rationale: |Clients |experiencing |N&V |(or |NG |tube |suction)
|would |most |likely |present |with |metabolic |alkalosis |resulting |from |loss |of |gastric |hydrochloric |
, acid |(hydrogen |chloride), |causing |the |pH |and |HCO3- |to |increase. |Symptoms |experienced |by |
the |client |would |include |hypoventilation |(to |retain |CO2) |and |tachycardia.
S&S |for |___ |include |positive |Trousseaus |and |Chvostek's |signs, |tetany/spasm/increased |DTR, |
confusion, |and |arrhythmias, |and |it |is |often |correlated |with |hypomagnesemia. |- |correct |
answershypocalcemia
An |increased |pH |and |a |decreased |CO2 |indicates |__ |__ |- |correct |answersrespiratory |alkalosis
In |a |man |undergoing |surgery, |it |was |necessary |to |aspirate |the |contents |of |the |upper |gastro-
intestinal |tract. |After |surgery, |the |following |values |were |obtained |from |an |arterial |blood |
sample: |pH |7.55, |PCO2 |52 |mm |Hg |and |HCO3- |40 |mmol/l. |What |is |the |underlying |disorder?a) |
Metabolic |acidosisb) |Respiratory |alkalosisc) |Metabolic |alkalosisd) |Respiratory |acidosis |- |correct
|answersc) |metabolic |alkalosisRationale: |The |pH |is |higher |than |normal, |so |there |is |alkalosis. |In |
addition, |the |PCO2 |and |bicarbonate |concentration |are |higher |than |normal, |so |the |patient |is |
suffering |from |metabolic |alkalosis. |Since |the |PaCO2 |is |higher |than |45, |this |tells |us |the |lungs |
are |trying |to |compensate.
Cases |of |acidosis |often |result |in |___ |(low/high) |potassium, |except |in |cases |with |diarrhea. |- |
correct |answershigh
Determining |underlying |cause |(ask |about |antacid |use), |treating |underlying |cause: |if |vomiting, |
administer |antiemetics; |if |due |to |thiazide |diuretics, |stop |thiazide |and |start |K+ |sparing |
diuretics, |and |safety |to |prevent |falls |are |interventions |for |which |acid-base |imbalance? |- |correct
|answersmetabolic |alkalosis
A |decreased |pH |and |an |increased |CO2 |indicates |__ |__ |- |correct |answersrespiratory |acidosis
A |decreased |pH |and |a |decreased |HCO3- |indicates |__ |- |correct |answersmetabolic |acidosis
