Acid-Base Balance Flashcards
The patient had diarrhea for 5 days and developed an acid-base imbalance. Which statement would indicate that the nurse’s teaching about the acid-base imbalance has been effective
“My blood became too acid because I lost some base in the diarrhea fluid.”
Diarrhea causes metabolic acidosis through loss of bicarbonate, which is a base. Eating less sodium during diarrhea increases the risk of ECV deficit. Although diarrhea does remove fluid from the body, it also removes sodium and bicarbonate which need to be replaced. Rapid deep respirations are the compensatory mechanism for metabolic acidosis and should be encouraged rather than stopped.
The patient has type B chronic obstructive pulmonary disease (COPD) exacerbated by an
acute upper respiratory infection. Which blood gas values should the nurse expect to see?
pH low, PaCO2 high, HCO3 high
Type B COPD is a chronic disease that causes impaired excretion of carbonic acid, thus
causing respiratory acidosis, with PaCO2 high and pH low. This chronic disease exists long
enough for some renal compensation to occur, manifested by high HCO3
−.
The patient has severe hyperthyroidism and will have surgery tomorrow. What assessment is most important for the nurse to assess in order to detect development of the acid-base
imbalance for which the patient has highest risk?
Level of consciousness
Thyroid hormone increases metabolic rate, causing a patient with severe hyperthyroidism to
have high risk of metabolic acidosis from increased production of metabolic acids. Metabolic
acidosis decreases level of consciousness.
The nurse is making a home visit to a child who has a chronic disease. Which finding has the greatest implication for acid-base aspects of this patient’s care?
Urine output is very small today
Oliguria decreases the excretion of metabolic acids and is a risk factor for metabolic acidosis
The nurse has telephone messages from four patients who requested information and assistance. Which one should the nurse refer to a social worker or community agency first?
“I ran out of money and am cutting my insulin dose in half.”
Decreasing an insulin dose by half creates high risk of diabetic ketoacidosis, and this patient
has the highest priority
The patient is hyperventilating from anxiety and abdominal pain. Which assessment findings
should the nurse attribute to respiratory alkalosis? (Multiple Response)
Tingling of fingertips
Numbness around mouth
Cramping in feet
Hyperventilation is a risk factor for respiratory alkalosis. Respiratory alkalosis can cause perioral and digital paresthesias and pedal spasms
Which statements said by patients indicate that the nurse’s teaching regarding prevention of
acid-base imbalances is successful? (Multiple Response)
“I should take my insulin on time every day.”
“My aspirin is on a high shelf away from children.”
“I have reliable transportation to dialysis sessions.”
Taking insulin as prescribed helps prevent diabetic ketoacidosis. Safeguarding aspirin from
children prevents metabolic acidosis from increased acid intake. Regular dialysis reduces the
risk of metabolic acidosis from decreased renal excretion of metabolic acid. Baking soda is
sodium bicarbonate and should not be used as an antacid due to the risk of metabolic alkalosis. Fasting without carbohydrate intake is a risk factor for starvation ketoacidosis.
