A nurse assesses a diabetic client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.39, PaCO2 27 mm Hg, and HCO3 19 mEq/L. Which sign or symptom does the nurse identify as an example of the client's compensatory mechanisms?

Increased release of acids from the kidneys.

Increased urinary output.

Increased thirst and hunger.

Increased rate and depth of respirations.

Answer and Explanation

The Correct Answer is D

A.   This is not a compensatory mechanism for metabolic acidosis. In fact, during metabolic acidosis, the kidneys excrete hydrogen ions (acid) and reabsorb bicarbonate (base) to help normalize the pH of the blood.
B.   Increased urinary output (polyuria) is not typically a direct compensatory response to metabolic acidosis. However, metabolic acidosis can lead to osmotic diuresis in certain conditions, which may increase urinary output as the body tries to excrete excess acids and maintain electrolyte balance.
C.   Increased thirst (polydipsia) and hunger (polyphagia) are not typical compensatory responses to metabolic acidosis. These symptoms are more associated with hyperglycemia in diabetes rather than acid-base disturbances.
D.   During metabolic acidosis, the respiratory system compensates by increasing the rate and depth of respirations (hyperventilation). By blowing off more CO2 (carbon dioxide), the body tries to decrease the

amount of carbonic acid in the blood, thereby increasing the pH towards normal. This compensatory mechanism helps to raise the pH back towards the normal range (7.35-7.45).

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Correct Answer is B

Explanation

A. Offering ice chips, might seem like a safe alternative, but it still poses a risk if the gag reflex is not intact.
B. Assessing the gag reflex is crucial before offering food or fluids to ensure the client can protect their airway and swallow safely. This response prioritizes safety and is appropriate to ensure the client does not aspirate.
C. Calling the healthcare provider to request orders for food and water may be necessary if there are specific protocols or if the client's condition requires further assessment or interventions before oral intake can be resumed. However, this response does not address the immediate need for comfort and hydration.
D. This response involves assessing the client's ability to swallow directly. While it addresses the client's request for water, it may not be the safest initial approach without first assessing the client's readiness and ability to swallow safely.

A. Use IV tubing specific for heparin sodium when administering the infusion. B. Administer 50,000 units of heparin by IV bolus every 12 hr. C. Have vitamin K available on the nursing unit. D. Check the activated partial thromboplastin time (aPTT) every 4 hr.

Correct Answer is D

Explanation

A. Heparin should be administered using IV tubing that is specifically labeled for heparin or that has been dedicated for anticoagulant use only. However, this is not the most important action.

B. Heparin is not typically administered as a bolus (large single dose) because of its rapid onset of action and potential for causing bleeding complications. Instead, heparin is usually administered as a continuous IV infusion to achieve and maintain therapeutic anticoagulation.
C. While vitamin K is an antidote for reversing the effects of warfarin (a different type of anticoagulant), it is not used for reversing the effects of heparin. The reversal agent for heparin is protamine sulfate. Therefore, having vitamin K available is not necessary for managing a client receiving heparin.
D. The aPTT is a laboratory test used to monitor the therapeutic effect of heparin therapy. It measures the clotting time of blood and helps ensure that the client's heparin infusion is within the desired therapeutic range. Checking aPTT regularly (usually every 4-6 hours initially, then adjusting based on results) is essential to maintain therapeutic anticoagulation and avoid complications like bleeding or clotting.

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A nurse assesses a diabetic client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.39, PaCO2 27 mm Hg, and HCO3 19 mEq/L. Which sign or symptom does the nurse identify as an example of the client's compensatory mechanisms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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A nurse assesses a diabetic client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.39, PaCO2 27 mm Hg, and HCO3 19 mEq/L. Which sign or symptom does the nurse identify as an example of the client's compensatory mechanisms?

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