A nurse is preparing a client for a hip arthroplasty. For which of the following reasons should the nurse assess the client's vital signs?

To determine how the client will tolerate the procedure

To establish a baseline for postoperative assessment

To prevent postoperative hypotension

To assess the client's pain level

Answer and Explanation

The Correct Answer is B

A.   Vital signs, including blood pressure, heart rate, respiratory rate, and temperature, provide baseline information about the client's cardiovascular and respiratory status. This assessment helps predict how well the client might tolerate the surgical procedure under anesthesia and monitor for any deviations during the procedure.
B.   Establishing baseline vital signs before surgery provides a comparison point for monitoring the client's recovery and identifying any postoperative complications. Changes in vital signs postoperatively can indicate potential issues such as bleeding, fluid imbalance, or respiratory compromise.
C.   Monitoring blood pressure before surgery helps identify clients at risk for intraoperative hypotension, particularly important during induction of anesthesia and throughout the surgical procedure. Establishing baseline blood pressure levels guides intraoperative management to maintain hemodynamic stability.
D.   While vital signs are important for assessing physiological status, they do not directly assess pain. Pain assessment involves asking the client about their pain experience, location, intensity, and factors that alleviate or exacerbate pain. Vital signs can indirectly reflect pain if pain causes changes in heart rate or blood pressure, but they are not specific indicators of pain.

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Correct Answer is D

Explanation

A. PaCO2 (partial pressure of carbon dioxide) reflects the respiratory component of acid-base balance. In metabolic acidosis, the respiratory system compensates by increasing ventilation to decrease PaCO2 (hyperventilation). Therefore, PaCO2 is typically below normal (less than 35-45 mm Hg) in metabolic acidosis, not above 45 mm Hg.
B. HCO3 (bicarbonate) is a buffer that helps regulate pH in the body. In metabolic acidosis, there is a primary decrease in HCO3 due to either increased acid production (e.g., lactic acidosis, ketoacidosis) or decreased acid elimination (e.g., renal failure). Therefore, HCO3 is typically below normal (< 22-26 mEq/L) in metabolic acidosis, not above 26 mEq/L.
C. PaO2 (partial pressure of oxygen) measures the oxygen level in the blood. It is not directly related to the diagnosis of metabolic acidosis. Low PaO2 levels may indicate respiratory dysfunction or impaired gas exchange but are not specific to metabolic acidosis.
D. pH below 7.35 indicates acidosis. In metabolic acidosis, the primary defect is a decrease in blood pH due to an excess of acids or a loss of bases. The pH typically decreases below the normal range of 7.35-7.45 in metabolic acidosis.

A. Hypophosphatemia B. Hypernatremia C. Hypercalcemia D. Hyperkalemia

Correct Answer is D

Explanation

A. Hypophosphatemia refers to low levels of phosphate in the blood. In prerenal AKI, phosphate levels are typically normal or even elevated due to reduced kidney function and impaired phosphate excretion. Therefore, hypophosphatemia is not expected in prerenal AKI.
B. Hypernatremia refers to high levels of sodium in the blood. In prerenal AKI, sodium levels can be elevated due to reduced kidney function and impaired ability to excrete sodium. This occurs because the kidneys play a crucial role in regulating sodium balance. Therefore, hypernatremia is a possible electrolyte imbalance in prerenal AKI.
C. Hypercalcemia refers to high levels of calcium in the blood. In prerenal AKI, calcium levels are usually normal or decreased due to various factors, including reduced renal excretion of calcium. Therefore, hypercalcemia is not typically seen in prerenal AKI.
D. Hyperkalemia refers to high levels of potassium in the blood. In prerenal AKI, hyperkalemia is a common electrolyte imbalance. Normally, the kidneys play a critical role in potassium excretion. Reduced kidney function in prerenal AKI can lead to impaired potassium excretion, resulting in elevated potassium levels in the blood.

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A nurse is preparing a client for a hip arthroplasty. For which of the following reasons should the nurse assess the client's vital signs?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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