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 B
Explanation
Antihistamines primarily work by blocking the H1 receptors, which are the receptors responsible for mediating the actions of histamine in the body. By blocking these receptors, antihistamines prevent or reduce the effects of histamine, such as itching, sneezing, runny nose, and watery eyes. This is the main mechanism by which antihistamines provide their therapeutic effects. "Antihistamines block release of histamine from mast cells and basophils." This statement is incorrect. Antihistamines do not block the release of histamine; instead, they block the histamine receptors to prevent the effects of histamine.
"H1 antagonists can bind to H1 receptors, H2 receptors, and muscarinic receptors." This statement is incorrect. H1 antagonists, or H1 receptor blockers, specifically bind to H1 receptors and do not have significant affinity for H2 receptors or muscarinic receptors. "First-generation antihistamines are more selective than second-generation antihistamines." This statement is incorrect. First-generation antihistamines are generally less selective and can have more sedating and anticholinergic effects compared to second-generation antihistamines, which are designed to be more selective for H1 receptors and have reduced sedative properties.
Correct Answer is A
Explanation
Albuterol is a short-acting beta-agonist bronchodilator that provides rapid relief of bronchospasm and helps to alleviate the symptoms of respiratory distress in asthma. It acts quickly to relax the smooth muscles in the airways, improving airflow and relieving wheezing, coughing, and shortness of breath. In an acute asthma exacerbation, albuterol is often the first-line medication used to provide immediate relief and improve respiratory function. Prednisone is an oral corticosteroid that has anti-inflammatory effects and is commonly used in the treatment of asthma. However, it is typically administered orally and takes time to exert its effects. In the emergency department setting, the focus is on providing immediate relief of symptoms, and oral medications like prednisone may not have an immediate effect. Ipratropium is an anticholinergic bronchodilator that can be administered via inhalation. While it is effective in relieving bronchospasm, it is generally used as an adjunct to albuterol and not typically the first-line medication for severe respiratory distress in asthma. Fluticasone is an inhaled corticosteroid that has anti-inflammatory effects and is used for long-term management and control of asthma. It is not appropriate for immediate relief of severe respiratory distress and is not typically used as a first-line medication in the emergency department.
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