Basic Concepts of Pathophysiology > Pathophysiology
Exam Review
Fluid, Electrolyte, and Acid-Base Balance
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a client who has fluid overload due to heart failure. Which of the following clinical manifestations should the nurse expect to find in the client?
Explanation
Choice A reason:
Dry mucous membranes are a sign of dehydration, not fluid overload.
Choice B reason:
Decreased urine output is a sign of renal failure or dehydration, not fluid overload.
Choice C reason:
Crackles in the lungs are a sign of pulmonary edema, which is a common complication of fluid overload due to heart failure. The excess fluid in the alveoli causes crackling sounds when the client breathes.
Choice D reason:
Hypotension is a sign of hypovolemia or shock, not fluid overload. Fluid overload usually causes hypertension due to increased blood volume and cardiac workload.
A nurse is reviewing the laboratory results of a client who has metabolic acidosis. Which of the following electrolyte imbalances should the nurse anticipate? (Select all that apply.)
Explanation
Choice A reason:
Hyperkalemia is a common electrolyte imbalance in metabolic acidosis. The excess hydrogen ions in the blood cause a shift of potassium from the intracellular to the extracellular space, resulting in increased serum potassium levels.
Choice B reason:
Hyponatremia is a possible electrolyte imbalance in metabolic acidosis. The excess hydrogen ions in the blood can cause a dilutional effect on sodium, resulting in decreased serum sodium levels.
Choice C reason:
Hypercalcemia is not an electrolyte imbalance in metabolic acidosis. In fact, metabolic acidosis can cause hypocalcemia due to increased binding of calcium to albumin and decreased ionized calcium levels.
Choice D reason:
Hypophosphatemia is not an electrolyte imbalance in metabolic acidosis. In fact, metabolic acidosis can cause hyperphosphatemia due to increased renal excretion of hydrogen ions and decreased renal excretion of phosphate.
Choice E reason:
Hypochloremia is a common electrolyte imbalance in metabolic acidosis. The excess hydrogen ions in the blood cause a loss of chloride from the kidneys, resulting in decreased serum chloride levels.
A nurse is teaching a client who has respiratory alkalosis about the causes and prevention of this condition. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
Choice A reason:
Aspirin or other salicylates can cause metabolic acidosis, not respiratory alkalosis, by increasing the production of organic acids and interfering with bicarbonate reabsorption in the kidneys.
Choice B reason:
Breathing into a paper bag when feeling anxious can help prevent or treat respiratory alkalosis by increasing the carbon dioxide levels in the blood and lowering the pH. Anxiety can cause respiratory alkalosis by stimulating hyperventilation, which decreases the carbon dioxide levels in the blood and raises the pH.
Choice C reason:
Drinking more fluids to prevent dehydration can help prevent or treat metabolic alkalosis, not respiratory alkalosis, by increasing the renal excretion of bicarbonate and lowering the pH. Dehydration can cause metabolic alkalosis by decreasing the renal excretion of bicarbonate and raising the pH.
Choice D reason:
Monitoring blood sugar levels regularly can help prevent or treat diabetic ketoacidosis, which is a type of metabolic acidosis, not respiratory alkalosis, by increasing the production of ketone bodies and lowering the pH. Diabetic ketoacidosis can occur when there is insufficient insulin to metabolize glucose and the body resorts to fat breakdown for energy.
A nurse is assessing a client who has diabetic ketoacidosis (DKA) and notes that the client has Kussmaul respirations. Which of the following explanations should the nurse give to the client about this type of breathing pattern?
Explanation
Choice A reason:
Kussmaul respirations are not a compensatory mechanism to increase oxygen intake, but rather to decrease carbon dioxide levels in the blood. Oxygen intake is not affected by Kussmaul respirations, which are characterized by deep and rapid breaths.
Choice B reason:
Kussmaul respirations are not a sign of respiratory failure and impending coma, but rather a sign of metabolic acidosis and an attempt to correct it. Respiratory failure and coma can occur in DKA if the condition is not treated promptly and effectively, but they are not indicated by Kussmaul respirations alone.
Choice C reason:
Kussmaul respirations are not an attempt to lower blood pressure by exhaling more air, but rather an attempt to lower blood acidity by exhaling more carbon dioxide. Blood pressure is not affected by Kussmaul respirations, which are caused by increased acidity in the blood due to the accumulation of ketone bodies from fat breakdown.
Choice D reason:
Kussmaul respirations are a response to lower blood acidity by exhaling more carbon dioxide. Carbon dioxide is an acidic gas that can lower the pH of the blood when it accumulates. By exhaling more carbon dioxide, the body tries to raise the pH of the blood and compensate for the metabolic acidosis caused by DKA.
A nurse is planning care for a client who has hypocalcemia. Which of the following interventions should the nurse include in the plan?
Explanation
Choice A reason:
Administering calcium gluconate IV as prescribed is an intervention that the nurse should include in the plan for a client who has hypocalcemia. Calcium gluconate is a calcium supplement that can increase the serum calcium levels and treat hypocalcemia. It should be given slowly and carefully to avoid extravasation and tissue necrosis.
Choice B reason:
Monitoring for Chvostek's sign and Trousseau's sign is an intervention that the nurse should include in the plan for a client who has hypocalcemia. Chvostek's sign is a facial twitching that occurs when the facial nerve is tapped near the ear. Trousseau's sign is a carpal spasm that occurs when a blood pressure cuff is inflated above the systolic pressure for several minutes. Both signs indicate increased neuromuscular excitability due to low calcium levels.
Choice C reason:
Encouraging intake of foods high in calcium and vitamin D is an intervention that the nurse should include in the plan for a client who has hypocalcemia. Calcium and vitamin D are essential nutrients for bone health and calcium metabolism. Foods high in calcium include dairy products, green leafy vegetables, tofu, sardines, and fortified cereals. Foods high in vitamin D include fatty fish, egg yolks, cheese, and fortified milk.
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