A client with a history of takes about 15 antacid tablets per day. The nurse understands that this client is at risk for:
metabolic alkalosis.
respiratory alkalosis.
metabolic acidosis.
respiratory acidosis.
The Correct Answer is A
A. Metabolic alkalosis is characterized by an elevation of the bicarbonate (HCO3) levels in the blood, leading to an increase in pH above the normal range (7.35-7.45). Antacid tablets typically contain compounds such as calcium carbonate, magnesium hydroxide, or aluminum hydroxide, which can neutralize stomach acid (hydrochloric acid). Chronic ingestion of large amounts of antacids, as in the case of this client taking approximately 15 tablets per day, can result in excessive bicarbonate intake, leading to metabolic alkalosis.
B. Respiratory alkalosis occurs when there is a decrease in carbon dioxide (CO2) levels in the blood, leading to an increase in pH above the normal range. Antacid tablets do not directly affect respiratory function or CO2 levels, so respiratory alkalosis is unlikely to occur as a result of antacid ingestion.
C. Metabolic acidosis is characterized by a decrease in bicarbonate (HCO3) levels in the blood, leading to a decrease in pH below the normal range. In the context of antacid ingestion, metabolic acidosis is less likely to occur. However, if the antacids contain compounds that are absorbed systemically and excreted by the kidneys (such as aluminum-containing antacids), they may lead to renal dysfunction or electrolyte imbalances, which could potentially contribute to metabolic acidosis.
D. Respiratory acidosis occurs when there is an increase in carbon dioxide (CO2) levels in the blood, leading to a decrease in pH below the normal range. Antacid tablets do not directly affect respiratory function or CO2 levels, so respiratory acidosis is unlikely to occur as a result of antacid ingestion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. In respiratory alkalosis, the pH is elevated (alkalotic), the PaCO2 (partial pressure of carbon dioxide) is decreased (hypocapnia), and the HCO3 (bicarbonate) level may be within normal limits or slightly decreased due to compensatory mechanisms. In this option, the pH is elevated (7.54), the PaCO2 is decreased (25), and the HCO3 level is within normal limits (24). These findings support respiratory alkalosis.
B. pH 7.50, PaCO2 40, HCO3 28: In this option, the pH is elevated (7.50), the PaCO2 is within normal limits (40), and the HCO3 level is elevated (28). These findings are not consistent with respiratory alkalosis. Instead, they suggest metabolic alkalosis, where both the pH and bicarbonate levels are elevated.
C. pH 7.35, PaCO2 35, HCO3 22: In this option, the pH is within normal limits (7.35), the PaCO2 is within normal limits (35), and the HCO3 level is within normal limits (22). These findings are not consistent with respiratory alkalosis.
D. pH 7.32. PaCO2 48, HCO3 24: In respiratory alkalosis, the pH is elevated (alkalotic), the PaCO2 is decreased (hypocapnia), and the HCO3 level may be within normal limits or slightly decreased due to compensatory mechanisms. In this option, the pH is within normal limits (7.32), the PaCO2 is elevated (48), and the HCO3 level is within normal limits (24). These findings are not consistent with respiratory alkalosis.
Correct Answer is C
Explanation
C. Excessive noise in the hospital environment, including alarms, conversations, and equipment noises, can disrupt sleep and negatively impact sleep quality. Therefore, limiting unnecessary noise on the unit is a crucial nursing intervention for improving sleep quality in the acute care setting. This may involve implementing quiet hours, reducing unnecessary conversations and activities during nighttime hours, and using noise-reducing strategies such as earplugs or white noise machines.
A. While providing a bedtime snack may help alleviate hunger and promote comfort, especially if the client is on a restricted diet or experiencing appetite changes, it may not directly address factors affecting sleep quality. Additionally, consuming food close to bedtime may not be suitable for all patients, especially those with dietary restrictions or certain medical conditions. Therefore, while a bedtime snack may be beneficial in some cases, it may not be the most important intervention for improving sleep quality in the acute care setting.
B. Pulling curtains around the bed can help create a sense of privacy and reduce visual distractions, which may contribute to a more conducive sleep environment. Enhanced privacy can also promote relaxation and feelings of security, potentially improving sleep quality. However, while privacy curtains can mitigate some external disturbances, they may not completely eliminate factors that affect sleep, such as noise or light.
D. Providing a backrub can promote relaxation, relieve tension, and enhance comfort, which may contribute to improved sleep quality for some patients. Massage therapy has been shown to reduce stress and promote relaxation, potentially facilitating better sleep. However, while backrubs can be a beneficial adjunct to promoting relaxation and comfort, they may not address all factors that affect sleep quality in the acute care setting.
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