Acid-Base Balance

Question 1

caused by an excess of dissolved carbon dioxide, or carbonic acid

Answer 1

Respiratory Acidosis

Question 2

Respiratory Acidosis

Answer 2

pH less than 7.35 and a PaCO2 greater than 45 mmHg

Question 3

Chronic respiratory acidosis

Answer 3

bicarbonate level is higher than 28 mEq/L, as kidneys compensate by retaining bicarbonate

Question 4

Respiratory acidosis

Answer 4

results from carbon dioxide retention caused by alveolar hypoventilation

Question 5

Hypoxemia (decreased oxygen)

Answer 5

frequently accompanies respiratory acidosis

Question 6

Acute respiratory acidosis

Answer 6

results from sudden failure of ventilation

Question 7

Acute respiratory acidosis

Answer 7

Chest trauma, aspiration of foreign body, acute pneumonia, overdoses of narcotic or sedative meds

Question 8

Acute respiratory acidosis

Answer 8

serum bicarbonate level initially unchanged b/c the compensatory response of kidneys continues over hours to days

Question 9

Acute respiratory acidosis

Answer 9

Hypercapnia (increased carbon dioxide levels) affects neurologic function and the cardiovascular system

Question 10

Chronic Respiratory Acidosis

Answer 10

most patients have COPD, with chronic bronchitis and emphysema

Question 11

Primary risk factor for respiratory acidosis

Answer 11

chronic lung diseases: pneumonia, COPD// or trauma

Question 12

Respiratory Acidosis Etiology

Answer 12

Diseases of the airway such as asthma, COPD
Disease of the chest
Drugs that suppress breathing such as opioids or alcohol
Obstructive sleep apnea

Question 13

Acute respiratory acidosis

Answer 13

headache, warm flushed skin, elevated pulse, blurred vision, irritability or AMS, decreasing LOC, cardiac dysrhythmias, cardiac arrest

Question 14

Chronic respiratory acidosis

Answer 14

weakness, dull headache, sleep disturbances with daytime sleepiness, impaired memory, personality changes

Question 15

Respiratory acidosis

Answer 15

use continuous positive airway pressure CPAP

Question 16

Chronic respiratory acidosis

Answer 16

encourage pursed lip breathing

Question 17

Chronic respiratory acidosis

Answer 17

serum electrolytes may show hypochloremia

Question 18

Respiratory acidosis pharmacologic therapies

Answer 18

bronchodilator to open airways, ABT for resp infect

Question 19

Respiratory acidosis

Answer 19

tx focuses on improving alveolar ventilation and gas exchange

Question 20

Respiratory alkalosis

Answer 20

pH greater than 7.45 and PaCO2 of less than 35 mmHg

Question 21

Respiratory alkalosis

Answer 21

always caused by hyperventilation, leading to carbon dioxide deficit

Question 22

Respiratory alkalosis

Answer 22

high fever, hypoxia, gram-negative bacteremia, thyrotoxicosis, early salicylate intoxication, encephalitis, high progesterone levels

Question 23

Respiratory alkalosis

Answer 23

light-headedness, a feeling of panic and difficulty concentrating, circumoral and distal extremity paresthesias, tremors, and postive chvostek sign, and trousseau sign, tinnitus, chest tightness, palpitations

Question 24

Acids

Answer 24

release hydrogen ions in solution

Question 25

Bases

Answer 25

accept hydrogen ions in solution

Question 26

solution = more acidic

Answer 26

as hydrogen ion concentration increases, the pH falls

Question 27

solution = more alkaline

Answer 27

as hydrogen ion concentration falls, pH rises

Question 28

7.35-7.45

Answer 28

normal pH of body fluids

Question 29

acids

Answer 29

metabolic processes produce

Question 30

24-28 mEq/L

Answer 30

normal serum bicarbonate level

Question 31

1.2 mEq/L

Answer 31

normal serum carbonic acid

Question 32

alkalosis

Answer 32

depresses respiratory center, decreasing rate and depth of respirations

Question 33

acidosis

Answer 33

kidneys excrete H+ and retain bicarbonate

Question 34

alkalosis

Answer 34

kidneys retain H+ and excrete bicarbonate

Question 35

metabolic acidosis

Answer 35

n/v, weakness, fatigue, headache, decreased LOC, hyperventalation

Question 36

metabolic alkalosis

Answer 36

confusion, decreased LOC, hypotension, tetany, seizures, respiratory failure

Question 37

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder?

Answer 37

Metabolic alkalosis

Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis as a result of the loss of hydrochloric acid.

Question 38

A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats/minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding?

Answer 38

An increased pH with an increased HCO3

Clients experiencing nausea and vomiting would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH and HCO3 to increase. Symptoms experienced by the client would include hypoventilation and tachycardia.

Question 39

The nurse caring for a client with an ileostomy understands that the client is most at risk for developing which acid-base disorder?

Answer 39

Metabolic acidosis

Question 40

Clinical manifestations of respiratory alkalosis include

Answer 40

lethargy, lightheadedness, confusion, tachycardia, dysrhythmias related to hypokalemia, nausea, vomiting, epigastric pain, and numbness and tingling of the extremities. Hyperventilation (tachypnea) occurs.

Question 41

The nurse plans care for a client with chronic obstructive pulmonary disease (COPD), understanding that the client is most likely to experience what type of acid-base imbalance?

Answer 41

Respiratory acidosis is most often caused by hypoventilation in a client with COPD.

Question 42

A client with a history of lung disease is at risk for developing respiratory acidosis. The nurse should assess the client for which signs and symptoms characteristic of this disorder?

Answer 42

When a client is experiencing respiratory acidosis, the respiratory rate and depth increase in an attempt to compensate. The client also experiences headache; restlessness; mental status changes, such as drowsiness and confusion; visual disturbances; diaphoresis; cyanosis as the hypoxia becomes more acute; hyperkalemia; rapid, irregular pulse; and dysrhythmias.

Question 43

An anxious preoperative client is at risk for developing respiratory alkalosis. The nurse should assess the client for which signs and symptoms characteristic of this disorder?

Answer 43

Clinical manifestations of respiratory alkalosis include a decrease in the respiratory rate and depth, headache, lightheadedness, vertigo, mental status changes, paresthesias such as tingling of the fingers and toes, hypokalemia, hypocalcemia, tetany, and convulsions.

Question 44

A client with diabetes mellitus has a blood glucose level of 644 mg/dL. The nurse should develop a plan of care because the client is at risk for the development of which type of acid-base imbalance?

Answer 44

Metabolic acidosis

Question 45

The client with a history of lung disease is at risk for developing respiratory acidosis. The nurse assesses this client for which signs/symptoms that are characteristic of this disorder?

Answer 45

Headache, restlessness, and confusion

Question 46

A nurse is admitting a client with a diagnosis of Guillain-Barré syndrome to the hospital. The nurse knows that if the disease is severe enough, the client will be at risk for which acid-base imbalance?

Answer 46

Respiratory acidosis

Question 47

A nurse is caring for a client who overdosed on acetylsalicylic acid (aspirin) 24 hours ago. The nurse should expect to note which findings associated with an anticipated acid-base disturbance?

Answer 47

If metabolic acidosis occurs, the client is likely to exhibit drowsiness, headache, and tachypnea.

Question 48

A client has been diagnosed with metabolic alkalosis as a result of excessive antacid use. The nurse should monitor this client, expecting to note which signs/symptoms?

Answer 48

A client with metabolic alkalosis is likely to exhibit decreased respiratory rate and depth as a compensatory mechanism.