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A nurse is caring for a 78-year-old client who was recently admitted from the emergency room and is reporting weakness.

Exhibits

Select words from the choices below to fill in each blank in the following sentence.

The nurse has reviewed the client's medical record.

The client is at risk for developing metabolic acidosis hypernatremia

and

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"E"}

Correct choices are; Metabolic acidosis:

This can occur due to the client's diarrhea, leading to loss of bicarbonate (HCO3-) through the gastrointestinal tract. The ABG results show a pH slightly below normal (7.33) and a decreased bicarbonate level (19 mEq/L), indicative of metabolic acidosis.

Hypernatremia:

The client's sodium level is elevated at 149 mEq/L (normal range is 136-145 mEq/L). This indicates hypernatremia, which could be due to dehydration from diarrhea and possibly inadequate fluid intake.


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Related Questions

Correct Answer is A

Explanation

A. Metabolic acidosis is characterized by a low pH (<7.35) and a decreased bicarbonate (HCO3) level (<22 mEq/L). The ABG results show a pH of 7.30 and HCO3 of 18 mEq/L, which are consistent with metabolic acidosis. The low HCO3 indicates that there is an accumulation of acids or loss of bicarbonate in the blood.
B. Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate level (>26 mEq/L). The ABG results show a low pH and low HCO3, which do not support metabolic alkalosis.
C. Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). The pH in this scenario is low (7.30), which does not align with respiratory alkalosis.
D. Respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2 (>45 mm Hg). While the pH is low, indicating acidosis, the PaCO2 in this case is low (28 mm Hg), which does not support respiratory acidosis.

Correct Answer is D

Explanation

A. Metolazone is a thiazide-like diuretic that works primarily in the distal convoluted tubule of the nephron. It can lead to hyponatremia due to its mechanism of increasing sodium and water excretion. However, it is not typically associated with hyperkalemia.
B. Furosemide is a loop diuretic that acts on the ascending loop of Henle. It primarily causes loss of sodium, potassium, and chloride ions. While it can lead to hypokalemia (low potassium levels) due to increased potassium excretion, it does not typically cause hyperkalemia or hyponatremia.
C. Hydrochlorothiazide is a thiazide diuretic that acts on the distal convoluted tubule. It can cause hyponatremia due to increased sodium and water excretion. It may also lead to hypokalemia but is not typically associated with hyperkalemia.
D. Spironolactone is a potassium-sparing diuretic that works by antagonizing aldosterone receptors in the distal nephron, leading to retention of potassium and excretion of sodium. It can cause hyperkalemia due to its potassium-sparing effects. Additionally, it may also lead to hyponatremia, although less commonly than thiazide diuretics.

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