A nurse is caring for a client who has the following arterial blood gas results: HCO3-, 18 mEq, PaCO, 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?

Respiratory acidosis

Metabolic alkalosis

Respiratory alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is D

A.   Respiratory acidosis would typically involve an elevated PaCO2, which is not seen in this case.
B.   Metabolic alkalosis is characterized by an elevated bicarbonate level, which is not present in this scenario.
C.   Respiratory alkalosis would present with a low PaCO2 and an elevated pH, which is not the case here.
D.   The low bicarbonate level (HCO3) 18mEq/L (normal range of 22-26 mEq/L), and low pH 7.30 (normal range of 7.35-7.45), indicate metabolic acidosis. suggesting acidemia. The PaCO2 is also low at 28 mm Hg, indicating a respiratory compensation for the metabolic acidosis.

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Correct Answer is B

Explanation

A. Normal calcium levels are not indicative of hypoparathyroidism.
B. A manifestation of hypoparathyroidism would be a high phosphate level due to the low production of parathyroid hormone, which is responsible for regulating calcium and phosphate levels. It leads to reduced phosphate excretion.
C. Low magnesium levels are not indicative of hypoparathyroidism.
D. Normal vitamin D levels are not indicative of hypoparathyroidism.

A. Administer oral corticosteroids. B. Weigh the client daily. C. Provide a low-carbohydrate diet. D. Restrict fluid intake

Correct Answer is B

Explanation

A. Administering corticosteroids is crucial during an Addisonian crisis but typically involves intravenous corticosteroids (not oral) during the crisis to quickly restore hormone levels. Oral corticosteroids are part of regular maintenance therapy but not an immediate intervention in the crisis.

B. Weighing the client daily is important to monitor for potential fluid loss, dehydration, or weight changes related to Addison's disease and Addisonian crisis. Clients with Addison’s disease may experience fluid and electrolyte imbalances, so daily weight tracking helps detect early signs of fluid shifts, which are critical in crisis prevention and management.

C. A low-carbohydrate diet is not recommended for clients with Addison’s disease, as they may need a balanced diet with sufficient carbohydrates to prevent hypoglycemia.

D. Fluid intake should not be restricted; rather, maintaining adequate hydration is vital. Clients in Addisonian crisis are often at risk for dehydration due to fluid losses and low aldosterone levels, making fluid replacement essential.

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A nurse is caring for a client who has the following arterial blood gas results: HCO3-, 18 mEq, PaCO, 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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