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A nurse is caring for a client who has acute kidney injury. The client's ABGS are:

PH:7.26

PaCO2: 30 mm Hg

HCO3: 14 mEq/L

Which of the following acid-imbalances should the nurse identify the client is experiencing?

A.

Metabolic alkalosis

B.

Respiratory acidosis

C.

Respiratory alkalosis

D.

Metabolic acidosis

Answer and Explanation

The Correct Answer is D

(A) Metabolic alkalosis: This condition is characterized by a high blood pH (>7.45) and a high bicarbonate level (>26 mEq/L). The client’s pH and bicarbonate levels are both lower than normal, which rules out metabolic alkalosis.

(B) Respiratory acidosis: This condition is characterized by a low blood pH (<7.35) and a high PaCO2 level (>45 mm Hg). Although the client’s pH is low, the PaCO2 level is also low, which rules out respiratory acidosis.

 (c) Respiratory alkalosis: This condition is characterized by a high blood pH (>7.45) and a low PaCO2 level (<35 mm Hg). The client’s pH is low, which rules out respiratory alkalosis.

(D) Metabolic acidosis: This condition is characterized by a low blood pH (<7.35) and a low bicarbonate level (<22 mEq/L). The client’s pH is 7.26 and bicarbonate level is 14 mEq/L, both of which are lower than normal. This indicates metabolic acidosis, which is common in clients with acute kidney injury as the kidneys are unable to excrete hydrogen ions and reabsorb bicarbonate. Therefore, the nurse should identify that the client is experiencing metabolic acidosis.


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Related Questions

Correct Answer is A

Explanation

A. "I will take my warfarin with a glass of water the night before my surgery":

This statement indicates a need for further teaching. Warfarin is an anticoagulant medication, and it should typically be discontinued or adjusted before surgery to reduce the risk of excessive bleeding. Taking it the night before surgery could increase the risk of bleeding during the procedure.

B. "I understand what risks I can expect with this surgery":

This statement suggests that the client has received information about the risks associated with the surgery, which is an essential component of preoperative education. There is no indication for further teaching based on this statement.

C. "I will take time to relax if I get nervous the night before surgery":

This statement demonstrates the client's awareness of the importance of managing stress and anxiety before surgery, which is a positive coping strategy. There is no need for further teaching based on this statement.

D. "I will have a glass of water the morning of my surgery":

This statement is generally acceptable. Clear fluids may be allowed up to a certain time before surgery, depending on the facility's protocol. However, specific instructions regarding fasting before surgery should be clarified with the healthcare provider or surgical team to ensure adherence to preoperative guidelines.

Correct Answer is C

Explanation

(A) Swallow the tablet whole with an 8 oz glass of water.
Sublingual nitroglycerin tablets should not be swallowed. They need to be placed under the tongue where they can dissolve and be absorbed quickly to provide rapid relief from angina.

(B) Store the medication in a pill box at the bedside.
Nitroglycerin sublingual tablets should be stored in their original container and kept tightly closed to protect them from light and moisture. Storing them in a pill box at the bedside could lead to degradation of the medication.

(C) Take the medication at the first indication of chest pain.
This is the correct instruction. Nitroglycerin sublingual tablets should be taken at the first sign of chest pain to provide prompt relief. The rapid onset of action helps to alleviate angina symptoms quickly.

(D) Remove the nitroglycerine patch before taking the sublingual tablet.
It is not necessary to remove the nitroglycerin patch before taking a sublingual tablet. The two forms of nitroglycerin can be used together, as the patch provides a continuous dose while the sublingual tablet offers rapid relief of acute symptoms.

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