If your patient has a higher than normal pH (alkalosis), you would expect to also see:
Low HCO3- and high PaCO2
Low PaCO2 and low HCO3-
Low PaCO2 and high HCO3-
High PaCO2 and high HCO3-
The Correct Answer is C
Choice A reason: This is incorrect because low HCO3- and high PaCO2 are signs of metabolic acidosis, not alkalosis. Metabolic acidosis is a condition where the blood pH is lower than the normal range of 7.35 to 7.45, due to an excess of acids or a loss of bases in the body.
Choice B reason: This is incorrect because low PaCO2 and low HCO3- are signs of respiratory acidosis, not alkalosis. Respiratory acidosis is a condition where the blood pH is lower than the normal range of 7.35 to 7.45, due to impaired gas exchange or hypoventilation, which causes carbon dioxide to accumulate in the blood.
Choice C reason: This is correct because low PaCO2 and high HCO3- are signs of alkalosis. Alkalosis is a condition where the blood pH is higher than the normal range of 7.35 to 7.45, due to a loss of acids or an excess of bases in the body. There are two types of alkalosis: respiratory and metabolic. Respiratory alkalosis is caused by hyperventilation, which lowers the PaCO2 in the blood. Metabolic alkalosis is caused by vomiting, diuretics, or excessive intake of antacids, which raises the HCO3- in the blood.
Choice D reason: This is incorrect because high PaCO2 and high HCO3- are signs of compensation, not alkalosis. Compensation is a process where the body tries to restore the normal pH by adjusting the levels of PaCO2 and HCO3- in the opposite direction of the primary disorder. For example, if the patient has metabolic alkalosis, the respiratory system will try to compensate by retaining carbon dioxide and lowering the PaCO2. If the patient has respiratory alkalosis, the renal system will try to compensate by excreting bicarbonate and lowering the HCO3-.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Producing phosphate buffers is not the main function of the kidneys in response to acid-base disturbances. Phosphate buffers are mainly found in the intracellular fluid and the urine, where they help to maintain the pH by binding or releasing hydrogen ions.
Choice B reason: Adjusting PaCO2 levels is not the function of the kidneys, but rather the function of the lungs in response to acid-base disturbances. The lungs regulate the PaCO2 levels by increasing or decreasing the rate and depth of respiration, which affects the amount of carbon dioxide exhaled.
Choice C reason: Producing protein buffers is not the function of the kidneys, but rather the function of the cells and the plasma in response to acid-base disturbances. Protein buffers are the most abundant and versatile buffers in the body, as they can act as acids or bases by donating or accepting hydrogen ions.
Choice D reason: Excreting or reabsorbing hydrogen or bicarbonate is the main function of the kidneys in response to acid-base disturbances. The kidneys regulate the HCO3- levels by either reabsorbing it from the filtrate or generating it from carbon dioxide and water. The kidneys also regulate the hydrogen ion levels by either excreting it into the urine or exchanging it for sodium ions.
Correct Answer is A
Explanation
Choice A reason: The client with an ileostomy is at risk for fluid volume deficit because an ileostomy is a surgical opening in the ileum, the last part of the small intestine, that allows the drainage of intestinal contents. This can result in a loss of fluids and electrolytes, especially sodium and potassium, which can lead to dehydration and hypovolemia.
Choice B reason: The client with cirrhosis is not at risk for fluid volume deficit, but rather fluid volume excess. Cirrhosis is a chronic liver disease that causes scarring and impaired liver function. This can lead to portal hypertension, which is an increase in the pressure in the portal vein that carries blood from the digestive organs to the liver. Portal hypertension can cause ascites, which is the accumulation of fluid in the abdominal cavity, and edema, which is the swelling of the tissues due to fluid retention.
Choice C reason: The client with heart failure is not at risk for fluid volume deficit, but rather fluid volume excess. Heart failure is a condition where the heart is unable to pump enough blood to meet the body's needs. This can lead to congestion of the blood vessels, which can cause pulmonary edema, which is the accumulation of fluid in the lungs, and peripheral edema, which is the swelling of the extremities due to fluid retention.
Choice D reason: The client with decreased renal function is not at risk for fluid volume deficit, but rather fluid volume excess. Decreased renal function is a condition where the kidneys are unable to filter the blood and remove excess fluids and wastes. This can lead to oliguria, which is a decrease in urine output, and anuria, which is the absence of urine output. This can cause fluid overload, which can affect the heart and the lungs.
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