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.

Answer and Explanation

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

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Correct Answer is B

Explanation

An increased serum potassium level, also known as hyperkalemia, can have adverse effects on the electrical conduction of the heart, potentially leading to life-threatening cardiac dysrhythmias. Therefore, it is crucial to assess the patient's pulse rate and rhythm promptly to identify any abnormal cardiac activity.

Assessing the oxygen saturation (oxygen stats), respiratory rate and depth, and deep tendon reflexes are also important assessments, but they are not the priority in this case. Hyperkalemia primarily affects cardiac function, and prompt identification of any potential cardiac rhythm disturbances is essential to prevent further harm.

A. Alcohol B. Chocolate C. Peppermint D. Citrus fruits E. Cola sodas F. Fatty foods

Correct Answer is ["A","B","C","D","E","F"]

Explanation

1. Alcohol: Alcohol can relax the LES, leading to increased reflux symptoms. 2. Chocolate: Chocolate contains compounds that can relax the LES and contribute to reflux symptoms.

3. Peppermint: Peppermint, including peppermint oil and peppermint-flavored foods, can relax the LES and worsen reflux symptoms.

4. Citrus fruits: Citrus fruits and juices, such as oranges, grapefruits, and lemons, are acidic and can irritate the esophagus, exacerbating GERD symptoms.

5. Cola sodas: Cola sodas, including both regular and diet varieties, can contribute to reflux symptoms due to their carbonation and acidic content.

6. Fatty foods: High-fat foods, such as fried foods, fatty meats, and full-fat dairy products, can delay stomach emptying and increase pressure on the LES, leading to reflux.

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Naxlex Comprehensive Predictor Exams

In reviewing the electrolytes of a patient, the nurse notes the serum potassium level has increased from 4.3 mEq/L to 5.9 mEq/L. Which assessment does the nurse initiate first to prevent further harm?

Correct Answer is B

Explanation

The nurse is planning to teach the patient with gastroesophageal reflux disease (GERD) about foods or beverages that decrease lower esophageal sphincter (LES) pressure. What should be included in this list (select all that apply)?

Correct Answer is ["A","B","C","D","E","F"]

Explanation

A nursing instructor is teaching a group of nursing students about antihistamines. Which statement by a student indicates an understanding of the mechanism of action of the antihistamines?

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