Mrs. Kalen is a 70-year-old female who has arrived at the ER due to persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. Based on the acid-base interruption from Mrs. Kalen, what can the nurse anticipate the treatment will be for correcting this imbalance?
administration of antiemetics
administration of diuretics
Possible Electrolyte replacement if warranted
Administration of IV 0.9 Saline Solution infusion
Have the patient go home and rest. It will resolve itself shortly.
The Correct Answer is D
Mrs. Kalen is diagnosed with gastroenteritis and dehydration, and the arterial blood gas results indicate metabolic alkalosis (elevated pH and HCO3-). This suggests that there is an excessive loss of gastric acid and chloride ions from vomiting, leading to an imbalance of electrolytes and an increase in bicarbonate levels.
To correct the imbalance and treat dehydration, the primary intervention is fluid replacement. Administration of IV 0.9 Saline Solution, also known as normal saline, is commonly used for fluid resuscitation and rehydration. This isotonic solution helps restore fluid balance and electrolyte levels in the body.
Administration of antiemetics may help control vomiting, but the primary treatment focus in this case is fluid and electrolyte replacement to correct dehydration and the associated metabolic alkalosis.
Administration of diuretics, which increase urine output, would not be appropriate in this case as the patient is already experiencing dehydration.
Electrolyte replacement may be necessary if there are specific electrolyte imbalances identified, but the primary treatment is fluid replacement with IV saline solution.
Having the patient go home and rest without addressing the underlying dehydration and metabolic alkalosis would not be appropriate as it can lead to further complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
The teaching that the nurse will provide to the Patient Care Technician (PCT) when delegating ambulation for a client includes:
● "Please let me know how the client does after each ambulation": This instruction ensures that the PCT communicates any relevant information or changes observed during or after the ambulation, allowing the nurse to stay informed about the client's condition.
● "Be certain to use a gait belt when performing this activity": Using a gait belt is an important safety measure during ambulation. It helps provide support and stability for the client and allows the PCT to maintain control and assist in case the client becomes unsteady or falls.
● "Each ambulation should last 10 minutes": Providing a specific time frame for the ambulation helps guide the PCT in determining the duration of the activity. This ensures consistency in the care provided and allows for proper scheduling of ambulation throughout the day.
The other options provided ("Ambulate the client every four hours," "Come and get me for lunch") do not pertain to specific instructions or teaching related to the delegated ambulation task. The frequency of ambulation and the PCT's lunch break are not relevant to the teaching for this specific task.
Correct Answer is A
Explanation
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