a nurse evaluates the following arterial blood gas values in a client ph 748 pao2 98 mm hg paco2 28 mm hg and hco3 22 meql which client condition shou

ATI RN

ATI Fluid Electrolyte and Acid-Base Regulation

1. A nurse evaluates the following arterial blood gas values in a client: pH 7.48, PaO2 98 mm Hg, PaCO2 28 mm Hg, and HCO3 22 mEq/L. Which client condition should the nurse correlate with these results?

A. Diarrhea and vomiting for 36 hours
B. . Anxiety-induced hyperventilation
C. Chronic obstructive pulmonary disease (COPD)
D. Diabetic ketoacidosis and emphysema

Correct answer: B

Rationale:

2. A female patient is discharged from the hospital after having an episode of heart failure. She's prescribed daily oral doses of digoxin (Lanoxin) and furosemide (Lasix). Two days later, she tells her community health nurse that she feels weak and her heart 'flutters' frequently. What action should the nurse take?

A. Tell the patient to rest more frequently.
B. Advise the patient to discontinue digoxin and contact the physician.
C. Contact the physician, report the symptoms, and request a blood sample to determine the patient's potassium level.
D. Instruct the patient to avoid caffeine-containing foods.

Correct answer: C

Rationale: The correct action for the nurse to take is to contact the physician, report the patient's symptoms, and request a blood sample to determine the patient's potassium level. Furosemide, a potassium-wasting diuretic, can lead to hypokalemia, causing weakness and palpitations. Therefore, checking the potassium level is crucial in this situation. Simply telling the patient to rest more frequently won't address the underlying issue of potassium depletion. While digoxin can cause adverse effects, in this case, the symptoms are more likely related to furosemide-induced potassium loss. Instructing the patient to avoid caffeine-containing foods may be beneficial in general, but it wouldn't directly address the potassium depletion that needs urgent attention.

3. You are caring for a 65-year-old male patient admitted to your medical unit 72 hours ago with pyloric stenosis. A nasogastric tube placed upon admission has been on low intermittent suction ever since. Upon review of the mornings blood work, you notice that the patients potassium is below reference range. You should recognize that the patient may be at risk for what imbalance?

A. Hypercalcemia
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis

Correct answer: C

Rationale:

4. What happens first in dehydration?

A. Intercellular fluid volume drops first.
B. Plasma volume drops first.
C. Interstitial fluid drops first.
D. Neither interstitial nor intracellular fluid volume are affected.

Correct answer: C

Rationale: In dehydration, the body first draws fluid from the interstitial space to maintain blood volume, leading to a decrease in interstitial fluid volume. This is why choice C is correct. Choice A is incorrect because intracellular fluid is not the first to be affected. Choice B is also incorrect as plasma volume reduction typically occurs after interstitial fluid loss. Choice D is incorrect as dehydration impacts both interstitial and intracellular fluid volumes.