A client is in a motor vehicle accident with a severe kidney injury and develops acute renal failure. Which acid-base imbalance is most likely to develop?

Respiratory Acidosis

Metabolic Alkalosis

Respiratory Alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is D

A. Respiratory Acidosis: Respiratory acidosis results from inadequate ventilation leading to CO₂ retention, which is unrelated to kidney failure.

B. Metabolic Alkalosis: Metabolic alkalosis occurs due to excessive loss of acids (e.g., vomiting) or excess bicarbonate intake. Acute renal failure causes acid retention, not loss.

C. Respiratory Alkalosis: Respiratory alkalosis is caused by hyperventilation and excessive CO₂ loss, not renal dysfunction.

D. Metabolic acidosis: The kidneys play a vital role in acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. Acute renal failure impairs these functions, leading to acid retention and metabolic acidosis.

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Correct Answer is A

Explanation

A. The development of malignant hyperthermia: Malignant hyperthermia (MH) is a life-threatening reaction to certain anesthetics (e.g., succinylcholine, halothane). It causes rapid muscle breakdown, severe hyperthermia, tachycardia, muscle rigidity, and metabolic acidosis. Immediate treatment with IV dantrolene and cooling measures is required.

B. The development of fluid volume excess: Fluid overload may cause hypertension and pulmonary edema but does not cause sudden high fever.

C. The development of an allergic response to the pain medication: Drug allergies typically present with rash, itching, or anaphylaxis, not extreme fever.

D. The development of an infection. Post-op infections usually develop over several days, not immediately in PACU.

A. Chloride level would be decreed B. Sodium level would be elevated C. Magnesium level would be elevated. D. Potassium level would be decreased

Correct Answer is A

Explanation

A. Chloride level would be decreased: Metabolic alkalosis is often associated with hypochloremia, especially when caused by vomiting or diuretics. However, hypokalemia is more clinically significant.

B. Sodium level would be elevated: Sodium levels are not directly affected by metabolic alkalosis.

C. Magnesium level would be elevated: Magnesium levels are not significantly altered in metabolic alkalosis.

D. Potassium level would be decreased: A bicarbonate level of 30 mEq/L indicates metabolic alkalosis. In alkalosis, hydrogen ions shift out of the cells, and potassium moves into the cells, leading to hypokalemia.

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A client is in a motor vehicle accident with a severe kidney injury and develops acute renal failure. Which acid-base imbalance is most likely to develop?

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