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?
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Root cause analysis:
Root cause analysis is a method used to identify the underlying causes of adverse events or errors. While it is important for quality improvement and risk management, it does not specifically involve using research and scientific data to guide clinical decision-making in client care.
B. Evidence-based practice:
Evidence-based practice (EBP) involves integrating the best available evidence from research studies with clinical expertise and patient preferences to guide decision-making in client care. By utilizing research and scientific data, nurses can identify effective interventions and strategies to improve client outcomes.
C. Benchmarking:
Benchmarking involves comparing performance metrics or outcomes against standards or best practices. While benchmarking can inform quality improvement efforts, it does not directly involve using research and scientific data to guide clinical decision-making.
D. Standardization:
Standardization involves implementing consistent processes or protocols to improve quality and safety. While standardization is important for ensuring consistency in care delivery, it does not necessarily rely on research and scientific data to inform clinical decision-making as evidence-based practice does.
Correct Answer is C
Explanation
(A) Meloxicam 5 mg PO once daily: Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. It does not typically affect potassium levels.
(B) Acyclovir 400 mg PO twice daily: Acyclovir is an antiviral medication used to treat viral infections such as herpes simplex and varicella-zoster. It does not typically affect potassium levels.
(c) Furosemide 80 mg PO daily: Furosemide is a loop diuretic that promotes diuresis by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle and distal renal tubule. This can lead to increased excretion of potassium in the urine, potentially causing hypokalemia.
(D) Cimetidine 300 mg PO four times per day: Cimetidine is a histamine H2 receptor antagonist used to treat and prevent certain types of ulcer, and to treat conditions that cause the stomach to produce too much acid. It does not typically affect potassium levels.
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