NUR 336 Acid-Base Balance Review
Questions and Correct Answers
Respiratory acidosis (hypoventilation) risk factors ✅obesity, tumors, stroke,
neurological diseases, pulmonary embolus, ARDS, pulmonary edema, asthma,
pneumonia, respiratory depression (opioids, poisons, anesthetics), COPD
Respiratory acidosis signs and symptoms ✅muscle weakness, numbness & tingling
(hands and feet), headache, cyanosis, vasodilation (cause of headache), bradycardia
and hypotension as acidosis worsens, ineffective, shallow, rapid breathing, initially low
respiratory rate
Respiratory acidosis electrolyte imbalance ✅hyperkalemia
Respiratory acidosis teaching needs ✅breathing treatments, breathing techniques
(pursed lip), weight management, smoking cessation, fall prevention
Respiratory acidosis treatment ✅oxygen therapy, narcan, enhance gas exchange
(positioning and breathing techniques, ventilatory support, *bronchodilators*,
mucolytics), *IS, BiPAP, CPAP, ventilator, bicarb if needed, cardiac monitor*
Respiratory alkalosis (hyperventilation) risk factors ✅*fear, anxiety, panic attacks,
pain*, intracerebral trauma, asphyxiation, shock, meningitis, irregular breathing patters,
aspirin overdose
Respiratory alkalosis signs and symptoms ✅*SOB, lightheadedness, cramping,
hyperventilation, tetany, numbness in mouth, tingling*, tachypnea, inability to
concentrate, tinnitus, possible loss of consciousness, tachycardia, rapid, deep
respirations
Respiratory alkalosis electrolyte imbalances ✅hypocalcemia and hypokalemia
Respiratory alkalosis teaching needs ✅stress management, proper use of
medications, breathing techniques, anxiety reduction techniques
Respiratory alkalosis treatment ✅*rebreathing with paper bag (rebreathing
techniques), pain medication, fall prevention, decreased stimulation*, anti-anxiety
medications, electrolyte replacement, oxygen therapy
Metabolic acidosis risk factors ✅*obesity, hypothyroidism, ileostomy (loose stools is
bad), DKA, kidney failure, pancreatitis (inadequate production of bicarbonate), diarrhea
, (excessive elimination of bicarbonate)*, liver failure, heavy exercise, starvation, surgery,
dehydration
Metabolic acidosis signs and symptoms ✅*decreased LOC, lethargy, bradycardia,
rapid, deep respirations (Kussmaul respirations)*, headache, drowsiness, confusion, dry
mucous membranes, decreased respiratory rate
Metabolic acidosis electrolyte imbalance ✅hyperkalemia
Metabolic acidosis teaching needs ✅*diabetic management, alcohol cessation,
probiotics to prevent diarrhea*, medication compliance, education on exercise, proper
use of aspirin, diet teaching needs for kidney failure
Metabolic acidosis treatment ✅*if sodium bicarbonate is low, administer PO/IV sodium
bicarbonate (if pH is less than 7.2), insulin if DKA, dialysis*, assess labs (worries about
hyperkalemia), tele monitor, antidiarrheal and provide rehydration, fall prevention,
probiotics
Metabolic alkalosis risk factors ✅*oral ingestion of excess amounts of antacids
(bases), blood transfusions, TPN, excess sodium bicarbonate administration, prolonged
vomiting, NG suctioning, potassium depletion due to thiazide diuretics, laxative
overuse*, Cushing's syndrome, hyperaldosteronsim
Metabolic alkalosis signs and symptoms ✅*changes in LOC, increased respirations,
anxiety, irritability, positive Chvostek's sign, tachycardia, numbness, tingling, tetany,
hyperreflexia*, muscle weakness, confusion, convulsions
Metabolic alkalosis electrolyte imbalances ✅hypocalcemia and hypokalemia
Metabolic alkalosis teaching needs ✅*adhere to diet and dialysis regimen, safe food
handling, fall risk precautions*, education about turns/diuretics
Metabolic alkalosis treatment ✅*antiemetics, fluids, electrolyte replacement, d/c NG
suctioning*, dialysis compliance
A nurse in the emergency department is caring for a client who has pulmonary edema,
reports dyspnea, and appears anxious. The client's blood pressure is 108/79 and his
apical pulse is 112. Which of the following interventions is the nurse's priority?
a) Administer high-flow oxygen at 5 L/min by facemask to the client
b) Place the client in high-Fowler's position with legs dependent
c) Give the client sublingual nitroglycerin
d) Reassure the client ✅Administer high-flow oxygen at 5 L/min by facemask to the
client.
