Advance Med-Surg Exam 2 Evolve |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
review questions exam with correct |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answers
Metabolic alkalosis |||\\\
(Because gastric secretions are rich in HCl acid, the patient who is vomiting will lose a
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
significant amount of gastric acid and be at an increased risk for metabolic alkalosis.) - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔You are admitting a patient with complaints of abdominal pain, nausea, and |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
vomiting. A proximal bowel obstruction is suspected. Which acid-base imbalance do you
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
anticipate in this patient? |||\\\ |||\\\ |||\\\
Metabolic acidosis |||\\\
Metabolic alkalosis |||\\\
Respiratory acidosis |||\\\
Respiratory alkalosis |||\\\
3.1 mEq/L|||\\\
(The normal range for serum potassium is 3.5 to 5.0 mEq/L. This IV order provides a substantial
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
amount of potassium. Thus the patient's potassium level must be low. The only low value
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
shown is 3.1 mEq/L.) - correct answer✔✔Which serum potassium result best supports the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
rationale for administering a stat dose of IV potassium chloride 20 mEq in 200 mL of normal
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
saline over 2 hours? |||\\\ |||\\\ |||\\\
3.1 mEq/L|||\\\
3.9 mEq/L|||\\\
4.6 mEq/L|||\\\
5.3 mEq/L|||\\\
,Sodium, 135 mEq/L; potassium, 4.5 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(The normal range for serum sodium is 135 to 145 mEq/L, and the normal range for potassium
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
is 3.5 to 5.0 mEq/L. The change in the IV order decreases the amount of potassium and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
increases the amount of sodium. Therefore, for this order to be appropriate, the potassium
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
level must be near the high end and the sodium level near the low end of their respective
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
ranges.) - correct answer✔✔You receive a physician's order to change a patient's IV from D5½
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
NS with 40 mEq KCl/L to D5NS with 20 mEq KCl/L. Which serum laboratory values on this same
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
patient best support the rationale for this IV order change?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium, 136 mEq/L; potassium, 3.6 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium, 145 mEq/L; potassium, 4.8 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium, 135 mEq/L; potassium, 4.5 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium, 144 mEq/L; potassium, 3.7 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
within normal limits |||\\\ |||\\\
(The normal pH is 7.35 to 7.45. Normal PaCO2 levels are 35 to 45 mm Hg, and HCO3 is 22 to 26
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
mEq/L. Normal PaO2 is >80 mm Hg. Normal oxygen saturation is >95%. Because the patient's
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
results all fall within these normal ranges, the nurse can conclude that the patient's blood gas
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
results are within normal limits.) - correct answer✔✔You are caring for a patient admitted
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
with an exacerbation of asthma. After several treatments, the ABG results are pH 7.40, PaCO2
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
40 mm Hg, HCO3 24 mEq/L, PaO2 92 mm Hg, and O2 saturation of 99%. You interpret these
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
results as |||\\\
metabolic acidosis. |||\\\
respiratory acidosis. |||\\\
respiratory alkalosis. |||\\\
within normal limits. |||\\\ |||\\\
Partially compensated respiratory acidosis |||\\\ |||\\\ |||\\\
,(A low pH (normal, 7.35-7.45) indicates acidosis. In a patient with respiratory disease such as
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
COPD, the patient retains carbon dioxide (normal, 35-45 mm Hg), which acts as an acid in the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
body. For this reason, the patient has respiratory acidosis. The elevated HCO3 indicates a
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
partial compensation for the elevated CO2.) - correct answer✔✔You are caring for a patient
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
admitted with a diagnosis of chronic obstructive pulmonary disease (COPD) who has the |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
following arterial blood gas results: pH 7.33, PaO2 47 mm Hg, PaCO2 60 mm Hg, HCO3 32 |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
mEq/L, and O2 saturation of 92%. What is the correct interpretation of these results?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Fully compensated respiratory alkalosis
|||\\\ |||\\\ |||\\\
Partially compensated respiratory acidosis |||\\\ |||\\\ |||\\\
Normal acid-base balance with hypoxemia |||\\\ |||\\\ |||\\\ |||\\\
Normal acid-base balance with hypercapnia |||\\\ |||\\\ |||\\\ |||\\\
Phosphorus falling to 2.1 mg/dL |||\\\ |||\\\ |||\\\ |||\\\
(Calcium has an inverse relationship with phosphorus in the body. When phosphorus levels fall,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
calcium rises, and vice versa. Because hypercalcemia rarely occurs as a result of calcium intake,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the patient's phosphorus falling to 2.1 mg/dL (normal, 2.4-4.4 mg/dL) may be a result of the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
phosphate-binding effect of calcium carbonate.) - correct answer✔✔You are caring for a |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
patient receiving calcium carbonate for the treatment of osteopenia. Which serum laboratory
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
result would you identify as an adverse effect related to this therapy?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium falling to 138 mEq/L |||\\\ |||\\\ |||\\\ |||\\\
Potassium rising to 4.1 mEq/L |||\\\ |||\\\ |||\\\ |||\\\
Magnesium rising to 2.9 mg/dL |||\\\ |||\\\ |||\\\ |||\\\
Phosphorus falling to 2.1 mg/dL |||\\\ |||\\\ |||\\\ |||\\\
Loop diuretics |||\\\
, (Loop diuretics are contraindicated during episodes of hypokalemia because these medications
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
cause the kidneys to excrete sodium and potassium. Thus administration of this type of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
medication at this time would worsen the hypokalemia, putting the patient at risk for |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dysrhythmias. The prescribing physician should be consulted for potassium replacement |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
therapy, and the drug should be withheld until the potassium has returned to normal range.) -
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answer✔✔You are caring for a patient admitted with heart failure. The morning
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
laboratory results reveal a serum potassium level of 2.9 mEq/L. Which classification of |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
medications should you withhold until consulting with the health care provider? |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Antibiotics
Loop diuretics |||\\\
Bronchodilators
Antihypertensives
Listen to the patient's lung sounds and assess respiratory status.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(After 4 hours of infusion time, 500 mL of IV solution should have infused, not 950 mL. This
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
patient is at risk for fluid volume excess, and you should assess the patient's respiratory status
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
and lung sounds as the priority action and then notify the health care provider for further
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
orders.) - correct answer✔✔You are caring for an older patient who is receiving IV fluids
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
postoperatively. During the 8:00 AM assessment of this patient, you note that the IV solution, |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
which was ordered to infuse at 125 mL/hr, has infused 950 mL since it was hung at 4:00 AM.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What is the priority nursing intervention?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Slow the rate to keep vein open until next bag is due at noon.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Notify the health care provider and complete an incident report.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Listen to the patient's lung sounds and assess respiratory status.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Asses the patient's cardiovascular status by checking pulse and blood pressure.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Restlessness
(Restlessness is an early cerebral sign that dehydration has progressed to the point where an |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
intracellular fluid shift is occurring. If the dehydration is left untreated, cerebral signs could |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
review questions exam with correct |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answers
Metabolic alkalosis |||\\\
(Because gastric secretions are rich in HCl acid, the patient who is vomiting will lose a
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
significant amount of gastric acid and be at an increased risk for metabolic alkalosis.) - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔You are admitting a patient with complaints of abdominal pain, nausea, and |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
vomiting. A proximal bowel obstruction is suspected. Which acid-base imbalance do you
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
anticipate in this patient? |||\\\ |||\\\ |||\\\
Metabolic acidosis |||\\\
Metabolic alkalosis |||\\\
Respiratory acidosis |||\\\
Respiratory alkalosis |||\\\
3.1 mEq/L|||\\\
(The normal range for serum potassium is 3.5 to 5.0 mEq/L. This IV order provides a substantial
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
amount of potassium. Thus the patient's potassium level must be low. The only low value
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
shown is 3.1 mEq/L.) - correct answer✔✔Which serum potassium result best supports the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
rationale for administering a stat dose of IV potassium chloride 20 mEq in 200 mL of normal
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
saline over 2 hours? |||\\\ |||\\\ |||\\\
3.1 mEq/L|||\\\
3.9 mEq/L|||\\\
4.6 mEq/L|||\\\
5.3 mEq/L|||\\\
,Sodium, 135 mEq/L; potassium, 4.5 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(The normal range for serum sodium is 135 to 145 mEq/L, and the normal range for potassium
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
is 3.5 to 5.0 mEq/L. The change in the IV order decreases the amount of potassium and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
increases the amount of sodium. Therefore, for this order to be appropriate, the potassium
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
level must be near the high end and the sodium level near the low end of their respective
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
ranges.) - correct answer✔✔You receive a physician's order to change a patient's IV from D5½
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
NS with 40 mEq KCl/L to D5NS with 20 mEq KCl/L. Which serum laboratory values on this same
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
patient best support the rationale for this IV order change?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium, 136 mEq/L; potassium, 3.6 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium, 145 mEq/L; potassium, 4.8 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium, 135 mEq/L; potassium, 4.5 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium, 144 mEq/L; potassium, 3.7 mEq/L |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
within normal limits |||\\\ |||\\\
(The normal pH is 7.35 to 7.45. Normal PaCO2 levels are 35 to 45 mm Hg, and HCO3 is 22 to 26
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
mEq/L. Normal PaO2 is >80 mm Hg. Normal oxygen saturation is >95%. Because the patient's
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
results all fall within these normal ranges, the nurse can conclude that the patient's blood gas
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
results are within normal limits.) - correct answer✔✔You are caring for a patient admitted
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
with an exacerbation of asthma. After several treatments, the ABG results are pH 7.40, PaCO2
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
40 mm Hg, HCO3 24 mEq/L, PaO2 92 mm Hg, and O2 saturation of 99%. You interpret these
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
results as |||\\\
metabolic acidosis. |||\\\
respiratory acidosis. |||\\\
respiratory alkalosis. |||\\\
within normal limits. |||\\\ |||\\\
Partially compensated respiratory acidosis |||\\\ |||\\\ |||\\\
,(A low pH (normal, 7.35-7.45) indicates acidosis. In a patient with respiratory disease such as
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
COPD, the patient retains carbon dioxide (normal, 35-45 mm Hg), which acts as an acid in the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
body. For this reason, the patient has respiratory acidosis. The elevated HCO3 indicates a
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
partial compensation for the elevated CO2.) - correct answer✔✔You are caring for a patient
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
admitted with a diagnosis of chronic obstructive pulmonary disease (COPD) who has the |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
following arterial blood gas results: pH 7.33, PaO2 47 mm Hg, PaCO2 60 mm Hg, HCO3 32 |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
mEq/L, and O2 saturation of 92%. What is the correct interpretation of these results?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Fully compensated respiratory alkalosis
|||\\\ |||\\\ |||\\\
Partially compensated respiratory acidosis |||\\\ |||\\\ |||\\\
Normal acid-base balance with hypoxemia |||\\\ |||\\\ |||\\\ |||\\\
Normal acid-base balance with hypercapnia |||\\\ |||\\\ |||\\\ |||\\\
Phosphorus falling to 2.1 mg/dL |||\\\ |||\\\ |||\\\ |||\\\
(Calcium has an inverse relationship with phosphorus in the body. When phosphorus levels fall,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
calcium rises, and vice versa. Because hypercalcemia rarely occurs as a result of calcium intake,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the patient's phosphorus falling to 2.1 mg/dL (normal, 2.4-4.4 mg/dL) may be a result of the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
phosphate-binding effect of calcium carbonate.) - correct answer✔✔You are caring for a |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
patient receiving calcium carbonate for the treatment of osteopenia. Which serum laboratory
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
result would you identify as an adverse effect related to this therapy?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Sodium falling to 138 mEq/L |||\\\ |||\\\ |||\\\ |||\\\
Potassium rising to 4.1 mEq/L |||\\\ |||\\\ |||\\\ |||\\\
Magnesium rising to 2.9 mg/dL |||\\\ |||\\\ |||\\\ |||\\\
Phosphorus falling to 2.1 mg/dL |||\\\ |||\\\ |||\\\ |||\\\
Loop diuretics |||\\\
, (Loop diuretics are contraindicated during episodes of hypokalemia because these medications
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
cause the kidneys to excrete sodium and potassium. Thus administration of this type of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
medication at this time would worsen the hypokalemia, putting the patient at risk for |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dysrhythmias. The prescribing physician should be consulted for potassium replacement |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
therapy, and the drug should be withheld until the potassium has returned to normal range.) -
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answer✔✔You are caring for a patient admitted with heart failure. The morning
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
laboratory results reveal a serum potassium level of 2.9 mEq/L. Which classification of |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
medications should you withhold until consulting with the health care provider? |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Antibiotics
Loop diuretics |||\\\
Bronchodilators
Antihypertensives
Listen to the patient's lung sounds and assess respiratory status.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(After 4 hours of infusion time, 500 mL of IV solution should have infused, not 950 mL. This
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
patient is at risk for fluid volume excess, and you should assess the patient's respiratory status
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
and lung sounds as the priority action and then notify the health care provider for further
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orders.) - correct answer✔✔You are caring for an older patient who is receiving IV fluids
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postoperatively. During the 8:00 AM assessment of this patient, you note that the IV solution, |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
which was ordered to infuse at 125 mL/hr, has infused 950 mL since it was hung at 4:00 AM.
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What is the priority nursing intervention?
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Slow the rate to keep vein open until next bag is due at noon.
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Notify the health care provider and complete an incident report.
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Listen to the patient's lung sounds and assess respiratory status.
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Asses the patient's cardiovascular status by checking pulse and blood pressure.
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Restlessness
(Restlessness is an early cerebral sign that dehydration has progressed to the point where an |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
intracellular fluid shift is occurring. If the dehydration is left untreated, cerebral signs could |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
