A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for respiratory alkalosis?
A client who is taking a thiazide diuretic.
A client who is vomiting.
A client who has salicylate intoxication.
A client who has hypoventilation.
None
None
The Correct Answer is C
The correct answer is Choice C.
Choice A rationale: Thiazide diuretics cause potassium and chloride loss, leading to metabolic alkalosis, not respiratory alkalosis. Hypokalemia decreases hydrogen ion excretion, increasing bicarbonate levels. Metabolic alkalosis is characterized by pH >7.45 and HCO₃⁻ >26 mEq/L rather than decreased PaCO₂.
Choice B rationale: Vomiting leads to metabolic alkalosis due to gastric acid loss. Hydrogen ion depletion increases bicarbonate concentration, shifting pH above normal. Arterial blood gases typically show increased HCO₃⁻ (>26 mEq/L) with a compensatory increase in PaCO₂ (>45 mmHg), not respiratory alkalosis.
Choice C rationale: Salicylate intoxication initially induces hyperventilation, reducing PaCO₂ levels below 35 mmHg and increasing pH above 7.45, leading to respiratory alkalosis. As toxicity progresses, metabolic acidosis may develop due to lactic acid accumulation, but early stages primarily present with respiratory alkalosis.
Choice D rationale: Hypoventilation leads to CO₂ retention, increasing PaCO₂ above 45 mmHg, forming carbonic acid (H₂CO₃) and causing respiratory acidosis. Blood gases show pH <7.35 with elevated PaCO₂, not respiratory alkalosis, which is caused by excessive CO₂ elimination through hyperventilation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
This statement is incorrect. An indirect Coombs' test is not used to determine the risk of hypoglycemia in a baby after birth. It is used to detect antibodies against red blood cells, particularly in the context of blood incompatibility between a pregnant woman and her fetus.
Choice B rationale:
This statement is incorrect. An indirect Coombs' test is not related to determining the amount of amniotic fluid around the fetus. It is used primarily to assess for Rh incompatibility between the mother and fetus.
Choice C rationale:
This statement is incorrect. The test described here is a Doppler ultrasound, not an indirect Coombs' test. Doppler ultrasound is used to study blood flow in the fetus and placenta using ultrasound waves.
Correct Answer is D
Explanation
Choice A rationale:
Abdominal distention is not a typical manifestation of hypoglycemia in a newborn. Instead, it can be associated with gastrointestinal issues or other conditions affecting the abdominal organs.
Choice B rationale:
Petechiae are small, pinpoint purple or red spots that appear on the skin due to broken capillaries. They are not related to hypoglycemia and can be caused by various factors such as blood clotting disorders or infections.
Choice C rationale:
Increased muscle tone is not typically associated with hypoglycemia in a newborn. Instead, hypoglycemic babies may exhibit decreased muscle tone, lethargy, and poor feeding.
Choice D rationale:
Jitteriness is a common manifestation of hypoglycemia in newborns. It is characterized by rhythmic tremors, often involving the face and extremities. This occurs because the brain relies heavily on glucose for energy, and low blood sugar levels can affect neurological function, leading to jitteriness. Prompt intervention is necessary to prevent further complications.
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