The nurse is caring for a diabetic patient in renal failure who is in metabolic acidosis. Which laboratory findings are consistent with metabolic acidosis?

pH 7.35, PaCO2 40 mm Hg, HCO3-25 mEq/L

pH 7.32, PaCO2 47 mm Hg. HCO3-23 mEq/L

pH 7.3, PaCO2 36 mm Hg. HCO3- 19 mEq/L

pH 7.5, PaCO2 35 mm Hg, HCO3- 35 mEq/L

Answer and Explanation

The Correct Answer is C

A.   pH 7.35, PaCO2 40 mm Hg, HCO3-25 mEq/L: This is within normal ranges and does not indicate acidosis.
B.   pH 7.32, PaCO2 47 mm Hg. HCO3-23 mEq/L: This indicates respiratory acidosis, not metabolic.
C.   pH 7.3, PaCO2 36 mm Hg. HCO3- 19 mEq/L: This indicates metabolic acidosis. The pH is low (acidic), and the HCO3- (bicarbonate) is decreased. The PaCO2 is within normal limits, indicating the respiratory system is compensating for the metabolic acidosis.
D.   pH 7.5, PaCO2 35 mm Hg, HCO3- 35 mEq/L: This indicates alkalosis, not acidosis.

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Correct Answer is B

Explanation

According to the recommended dosage range of 20 to 25 mg/kg/day for a toddler weighing 20 kg, the daily dosage should be between 400 mg (20 kg x 20 mg) and 500 mg (20 kg x 25 mg).

Therefore, the prescribed dosage of 300 mg per day is below the recommended range.

A. Use petroleum-based ointments to moisturize lips. B. Choose a wool blanket when using oxygen. C. Store oxygen tanks upright. D. Keep oxygen tanks 4 feet away from an elect E. Peak T Wave on EKG

Correct Answer is C

Explanation

A. Petroleum-based products should not be used in conjunction with oxygen therapy. They are flammable and can pose a fire hazard when used near oxygen. Instead, use water-based moisturizers to prevent dryness of the lips and skin.
B. Wool and other synthetic fabrics can generate static electricity, which is a fire hazard when using oxygen
therapy. It’s safer to use cotton blankets, as they are less likely to cause static buildup.
C. Oxygen tanks should be stored upright to prevent them from falling over and to ensure the regulator and valves are properly aligned. Storing tanks upright helps maintain stability and prevents accidental damage to the equipment.
D. While the recommendation to keep oxygen tanks away from electrical sources is important, the distance may vary based on specific guidelines. It is generally advised to keep oxygen tanks at least 5-10 feet away from electrical sources and heat sources to avoid any risk of ignition or fire.

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The nurse is caring for a diabetic patient in renal failure who is in metabolic acidosis. Which laboratory findings are consistent with metabolic acidosis?

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