A patient's blood gases show a pH of 7.53 and bicarbonate level of 36 mEq/L. The nurse realizes that the patient is demonstrating which acid-base disorder?
Respiratory acidosis.
Metabolic alkalosis.
Respiratory alkalosis.
Metabolic acidosis.
The Correct Answer is B
Metabolic alkalosis.
Choice A rationale:
The given blood gas results show a pH of 7.53, which is alkaline (above the normal range of
7.35 to 7.45), and a high bicarbonate level of 36 mEq/L (normal range is 22 to 26 mEq/L). This combination indicates metabolic alkalosis, a condition where there is an excessive accumulation of bicarbonate in the blood, leading to increased pH.
Choice B rationale:
Metabolic alkalosis is characterized by increased blood bicarbonate levels, which can occur due to conditions like vomiting, diuretic use, or excessive ingestion of bicarbonate-containing substances. It results in symptoms such as muscle twitching, tetany, and respiratory depression.
Choice C rationale:
Respiratory alkalosis is characterized by an elevated blood pH and low carbon dioxide levels (hypocapnia). However, the bicarbonate level is not directly related to respiratory alkalosis, making this choice incorrect based on the given information.
Choice D rationale:
Metabolic acidosis is characterized by a decreased blood pH and low bicarbonate levels. The presented blood gas results show an alkaline pH and high bicarbonate, making this choice incorrect.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Potential Condition.
Based on the provided information, it's challenging to make a definitive diagnosis with the given laboratory results and clinical presentation. The client's symptoms, such as severe abdominal pain, vomiting, dyspnea, yellow sclera, dry mucous membranes, tachycardia, and positive Chvostek and Trousseau signs, suggest a complex clinical picture that requires further investigation and assessment. Action to Take 1: Notify the provider. Rationale: The client's condition appears to be critical and requires immediate medical attention. Notifying the provider will initiate a comprehensive evaluation and potential interventions. Action to Take 2: Withhold medication for diarrhea until the underlying cause is determined. Rationale: Diarrhea can be a symptom of various conditions, and administering medication without a clear diagnosis may mask important clinical information. Parameters to Monitor 1: Serum bicarbonate level.
Rationale:
Monitoring serum bicarbonate levels can help identify potential acid-base imbalances and assess the client's metabolic status, especially given the history of end-stage renal disease. Parameters to Monitor 2: Intake and Output. Rationale: Monitoring intake and output is essential to assess fluid balance and kidney function, especially in a client with end- stage renal disease and potential electrolyte imbalances.
Correct Answer is D
Explanation
Digoxin. Choice A rationale:
Potassium chloride (KCL) is a supplement used to treat or prevent low potassium levels. While it can have side effects, visual disturbances are not typically associated with KCL. Therefore, it is not the medication the nurse suspects to be causing the problem.
Choice B rationale:
Warfarin (Coumadin) is an anticoagulant used to prevent blood clot formation. Visual disturbances are not a known side effect of warfarin. Therefore, it is unlikely to be the cause of the patient's symptoms.
Choice C rationale:
Aspirin (ASA) is a pain reliever and antiplatelet medication, and while it can cause visual disturbances in some cases, it is not a common or significant side effect. Aspirin is also not specifically linked to atrial fibrillation.
Choice D rationale:
Digoxin (Lanoxin) is used to treat atrial fibrillation and heart failure. Visual disturbances are a known side effect of digoxin toxicity. Given the patient's diagnosis of atrial fibrillation and the reported symptoms, the nurse suspects the problem lies with digoxin and should further investigate and report to the provider.
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