A nurse is collecting data from a client who has pneumonia and is experiencing acute respiratory acidosis. Which of the following manifestations should the nurse expect to find?
Circumoral numbness and tingling
Muscle flaccidity
Decreased level of consciousness
Cool, clammy skin
The Correct Answer is C
Acute respiratory acidosis occurs when there is inadequate excretion of carbon dioxide due to respiratory dysfunction, leading to an increase in carbon dioxide levels (hypercapnia) and subsequent acidosis (decrease in pH).
Manifestations of acute respiratory acidosis include:
A. Circumoral numbness and tingling - This is associated with respiratory alkalosis, not acidosis. B. Muscle flaccidity - This is more commonly seen in hyperkalemia or conditions affecting neuromuscular transmission. C. Decreased level of consciousness - This is a key manifestation of acute respiratory acidosis due to the effects of hypercapnia on the central nervous system. D. Cool, clammy skin - This is not typically associated with acute respiratory acidosis; instead, it might be seen in shock or hypoperfusion states.
Therefore, the nurse should expect to find a decreased level of consciousness in a client experiencing acute respiratory acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
(A) Increased bowel sounds
At the end of life, decreased bowel sounds or even absent bowel sounds are more common due to reduced gastrointestinal activity as the body begins to shut down. Increased bowel sounds are not typically expected.
(B) Hypertension
Hypertension is not typically expected at the end of life. Instead, hypotension (low blood pressure) is more common as the heart and other systems begin to fail.
(C) Moist mucous membranes
At the end of life, mucous membranes are often dry due to decreased fluid intake and systemic dehydration. Moist mucous membranes would not be an expected finding.
(D) Mottled skin
Mottled skin is a common and expected finding at the end of life. It occurs as circulation diminishes and the skin takes on a blotchy, purplish appearance, typically starting in the extremities and moving centrally. This is a sign that the body is shutting down and approaching death.
Correct Answer is C
Explanation
A. Hypoglycemia: Hypoglycemia, or low blood sugar, is not typically associated with hypokalemia. Hypokalemia is a condition characterized by low levels of potassium in the blood. While both conditions can occur due to certain diseases or medication use, they are not directly related.
B. Hyperreflexia: Hyperreflexia, a condition characterized by overactive reflexes, is not a common symptom of hypokalemia. Hypokalemia primarily affects muscle function, leading to symptoms such as muscle weakness, cramps, and potentially cardiac dysrhythmias. It does not typically cause an overactive reflex response.
C. Cardiac dysrhythmias: This is correct. Hypokalemia can lead to cardiac dysrhythmias. Potassium plays a crucial role in maintaining normal electrical activity in the heart. When potassium levels are low, it can disrupt this electrical activity, leading to irregular heart rhythms.
D. Increased appetite: Increased appetite is not a typical symptom of hypokalemia. In fact, loss of appetite is more commonly associated with this condition. Severe hypokalemia can affect the functioning of the muscles in the digestive system, leading to symptoms such as bloating, constipation, and abdominal pain.
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