A client w/ a 3 day hx of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a RR of 6 breaths/min. The ECG monitor displays tachycardia, with a heart rate of 120 beats/min. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which of the following?
D. An increased pH with an increased HCO3
A client who is found unresponsive has ABG's drawn and the results indicate the following; pH is 7.12, Pco2 is 90 mm Hg, and HCO3 is 22 mEq/L. The nurse interprets the results as indicating which condition?
A. Respiratory acidosis without compensation
A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that the client is most likely to experience what type of acid-base imbalance?
C. Respiratory acidosis
A nurse reviews the blood gas results of a client with Guillain-Barre syndrome. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which of the following validates the nurse's findings?
A. pH 7.25, Pco2 50 mm Hg
A nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a Pco2 of 30 mm Hg. The nurse has determined that the client is experienceing respiratory alkalosis. Which laboratory value would most likely be noted in this condition?
A. Potassium level of 3.0 mEq/L
A nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Pco2 of 30 mm Hg, and HCO3 of 22 mEq/L. The nurse analyzes these results as indicating which condition?
D. Respiratory alkalosis, compensated
A client is scheduled for blood to be drawn from the radial artery for an arterial blood gas determination. Before the blood is drawn, an Allen's test is performed to determine the adequacy of the:
C. Ulnar circulation
A 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?
C. Metabolic alkalosis
A nurse is caring for a client with an ileostomy understands that the client is most at risk for developing which acid-base disorder?
C. Metabolic acidosis
A nurse is caring for a client with diabetic ketoacidosis and documenta that the client is experienceing Kussmaul's respirations. Based on this documentation, which of the following did the nurse observe?
A. Respirations that are abnormally deep, regular, and increased in rate
Neurological Clinical Manifestations of Acidosis
Respiratory
Drowsiness
Disorientation
Dizziness
Headache
Coma
MetabolicDrowsiness
Confusion
Headache
Coma
Cardiovascular Clinical Manifestations of Acidosis
RespiratoryDecrease BP
Ventricular fibrillation (r/t hyperkalemia from compensation)
Warm, flushed skin (r/t peripheral vasodilation)
MetabolicDecreased BP
Dysrhythmias (r/t hyperkalemia from compensation)
Warm, flushed skin (r/t peripheral vasodilation)
Gastrointestinal Clinical Manifestations of Acidosis
Respiratory No significant findings
MetabolicNausea
Vomiting
Diarrhea
Abdominal pain
Neuromuscular Clinical Manifestations of Acidosis
RespiratorySeizures
MetabolicNo significant findings
Respiratory Clinical Manifestations of Acidosis
RespiratoryHypoventilation with hypoxia (lungs are unable to compensate when there is a respiratory problem)
MetabolicDeep, rapid respirations (compensatory action by the lungs)
Neuroloogical Clinical Manifestations of Alkalosis
Respiratory
Lethargy
Light-headedness
Confusion
Metabolic
Drowsiness
Dizziness
Nervousness
Confusion
Cardiovascular Clinical Manifestations of Alkalosis
Respiratory
Tachycardia
Dysrhythmias (r/t hypokalemia from compensation)
Metabolic
Tachycardia
Dysrthythmias (r/t hypokalemia from compensation)
Gastrointestinal Clinical Manifestations of Alkalosis
Respiratory
Nausea
Vomiting
Epigastric pain
Metabolic
Anorexia
Nausea
Vomiting
Neuromuscular Clinical Manifestations of Alkalosis
Respiratory
Tetany
Numbness
Tingling of extremities
Hyperreflexia
Seizures
Metabolic
Tremors
Hypertonic muscles
Muscle cramps
Tetany
Tingling of fingers and toes
Seizures
Respiratory Clinical Manifestations of Alkalosis
Respiratory
Hyperventilation (lungs are unable to compensate when there is a respiratory problem)
Metabolic
Hypoventilation (compenstatory action by the lungs)
Causes of Respiratory Acidosis
Asthma
Atelectasis
Brain trauma
Bronchiectasis
Bronchitis
Central nervous system depressants
Emphysema
Hypoventilation
Pulmonary edema
Pneumonia
Pulmonary emboli
Causes of Respiratory Alkalosis
Fever
Hyperventilation
Hypoxia
Hysteria
Overventilation by mechanical ventilators
Pain
Causes of Metabolic Acidosis
Diabetes mellitus or diabetic ketoacidosis
Excessive ingestion of acetylsalicylic acid (asprin)
High fat diet
Insufficient metabolism of carbohydrates
Malnutrition
Renal insufficiency or renal failure
Severe diarrhea
Causes of Metabolic Alkalosis
Diuretics
Excessive vomiting or gastrointestinal suctioning
Hyperaldosteronism
Ingestion of and/or infusion of excess sodium bicarbonate (baking soda)