Jo is a client with Type 1 Diabetes. Jo has a blood glucose level of 644 mg/dL. The nurse interprets that this client is most at risk of developing which type of acid-base imbalance?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
The Correct Answer is A
Choice A reason: Metabolic acidosis is a condition where the blood pH is lower than normal, due to an excess of acids or a loss of bases in the body. Jo is most at risk of developing metabolic acidosis, because of the high blood glucose level. High blood glucose can cause diabetic ketoacidosis, a complication of Type 1 Diabetes, where the body breaks down fat for energy and produces ketones, which are acidic substances. Ketones can accumulate in the blood and lower the pH, causing symptoms such as nausea, vomiting, abdominal pain, fruity breath, and confusion.
Choice B reason: Metabolic alkalosis is a condition where the blood pH is higher than normal, due to an excess of bases or a loss of acids in the body. Jo is not likely to develop metabolic alkalosis, because of the high blood glucose level. Metabolic alkalosis can be caused by conditions such as vomiting, diuretic use, or excessive antacid intake, which can increase the bicarbonate level or decrease the chloride level in the blood. These conditions are not related to Jo's diabetes.
Choice C reason: Respiratory acidosis is a condition where the blood pH is lower than normal, due to an accumulation of carbon dioxide in the body. Jo is not prone to developing respiratory acidosis, because of the high blood glucose level. Respiratory acidosis can be caused by conditions that impair the lung function, such as asthma, chronic obstructive pulmonary disease (COPD), or pneumonia, which can reduce the ventilation and increase the carbon dioxide level in the blood. These conditions are not related to Jo's diabetes.
Choice D reason: Respiratory alkalosis is a condition where the blood pH is higher than normal, due to a loss of carbon dioxide in the body. Jo is not susceptible to developing respiratory alkalosis, because of the high blood glucose level. Respiratory alkalosis can be caused by conditions that increase the breathing rate, such as anxiety, fever, or hyperventilation, which can reduce the carbon dioxide level in the blood. These conditions are not related to Jo's diabetes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This statement is false. A serum potassium level of 5.6 mEq/L is not a common side effect of furosemide. This value indicates hyperkalemia, or high blood potassium level, which can cause cardiac arrhythmias and muscle weakness. Furosemide is a loop diuretic that causes potassium loss, not retention.
Choice B reason: This statement is false. A serum sodium level of 142 mEq/L is not a common side effect of furosemide. This value is within the normal range of 135-145 mEq/L and does not indicate any problem with sodium balance. Furosemide is a loop diuretic that causes sodium loss, but it is usually compensated by the renin-angiotensin-aldosterone system.
Choice C reason: This statement is false. A serum sodium level of 138 mEq/L is not a common side effect of furosemide. This value is within the normal range of 135-145 mEq/L and does not indicate any problem with sodium balance. Furosemide is a loop diuretic that causes sodium loss, but it is usually compensated by the renin-angiotensin-aldosterone system.
Choice D reason: This statement is true. A serum potassium level of 2.8 mEq/L is a common side effect of furosemide. This value indicates hypokalemia, or low blood potassium level, which can cause cardiac arrhythmias, muscle weakness, and metabolic alkalosis. Furosemide is a loop diuretic that inhibits the reabsorption of sodium and potassium in the ascending loop of Henle, leading to potassium loss in the urine.
Correct Answer is ["A","E","F"]
Explanation
Choice A reason: This statement is true. Distended neck veins are a sign of fluid volume overload, as they indicate increased central venous pressure and right-sided heart failure.
Choice B reason: This statement is false. Hypotension is a sign of fluid volume deficit, not fluid volume overload. Hypotension occurs when the blood pressure is too low to perfuse the vital organs.
Choice C reason: This statement is false. Increased serum osmolality is a sign of fluid volume deficit, not fluid volume overload. Increased serum osmolality occurs when the blood concentration of solutes, such as sodium and glucose, is too high due to fluid loss.
Choice D reason: This statement is false. Dry oral mucosa is a sign of fluid volume deficit, not fluid volume overload. Dry oral mucosa occurs when the oral cavity is dehydrated due to fluid loss.
Choice E reason: This statement is true. Decreased urine specific gravity is a sign of fluid volume overload, as it indicates diluted urine and impaired kidney function.
Choice F reason: This statement is true. Weight gain is a sign of fluid volume overload, as it indicates fluid retention and edema.
Choice G reason: This statement is false. Sunken anterior fontanelle is a sign of fluid volume deficit, not fluid volume overload. Sunken anterior fontanelle occurs when the soft spot on the baby's head is depressed due to fluid loss.
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