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NUR 425 EXAM 3 QUESTIONS AND ANSWERS 2024
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NUR 425 EXAM 3 QUESTIONS AND ANSWERS 2024
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NUR 425 EXAM 3A patient with an acid-base imbalance has an altered potassium level. The nurse
recognizes that the potassium level is altered because
A. Potassium is returned to extracellular fluid when metabolic acidosis is
corrected.
B. Hyperkalemia causes an alkalosis that results in potassium being shifted into
the cells.
C. Acidosis causes hydrogen ions in the blood to be exchanged for potassium from
the cells.
D. In alkalosis, potassium is shifted into extracellular fluid to bind excessive
bicarbonate. - ANSWERS-Answer: c
Rationale:
- Changes in pH (hydrogen ion concentration) will affect potassium balance.
- In acidosis, hydrogen ions accumulate in the intracellular fluid (ICF), and
potassium shifts out of the cell to the extracellular fluid to maintain a balance of
cations across the cell membrane.
- In alkalosis, ICF levels of hydrogen diminish, and potassium shifts into the cell.
- If a deficit of H+ occurs in the extracellular fluid, potassium will shift into the cell.
,- Acidosis is associated with hyperkalemia, and alkalosis is associated with
hypokalemia
Jeri is a 22-year-old female who has been on a 3-day party binge.
Her friends bring her to the ED after being unable to awaken her.
Assessment reveals shallow respirations with a rate of 8/min, diminished breath
sounds, and decreased level of consciousness.
1. What type of acid-base imbalance would you expect Jeri to have?
2. What is causing it?
3. What type of compensation would you expect or not expect? Explain
4. What would Jeri's ABGs look like?
5. What is the treatment? - ANSWERS-1. Respiratory acidosis
2. Hypoventilation secondary to alcohol ingestion
3.
,- Compensation might be noted if the respiratory depression has been present for
24 hours or more: - The HCO3− may be elevated as the result of renal
compensation.
- If her respiratory depression has lasted less than 24 hours, there will not yet be
any renal compensation
4.
- Respiratory acidosis reflected by pH <7.35 and PCO2 >45 mm Hg. The HCO3 will
be normal (20-30 mEq/L) if her respiratory depression has lasted less than 24
hours;
- if longer than 24 hours, the HCO3 may be elevated as the result of
compensation.
- The PaO2 may be <80 mm Hg because of respiratory depression leading to
hypoxemia
5.
- Determine the cause of the respiratory depression.
- If induced by opioids or benzodiazepines, treat with appropriate antagonists.
- If induced by alcohol or other CNS depressants, breathing must be stimulated
until the effects of drugs have worn off.
- Mechanical ventilation may be necessary to increase respiratory rate and depth,
increasing oxygenation and promoting excretion of carbon dioxide
Respiratory acidosis (carbonic acid excess) occurs when? - ANSWERS-whenever
there is hypoventilation.
, - Hypoventilation results in a buildup of carbon dioxide, resulting in an
accumulation of carbonic acid in the blood
- Carbonic acid dissociates, liberating hydrogen ions, and there is a decrease in
pH.
- If carbon dioxide is not eliminated from the blood, acidosis results from the
accumulation of carbonic acid.
Which of the following is the body's first line of defense against an acid-base
imbalance? - ANSWERS-Chemical and protein buffers
In regards to acid-base imbalance, what does "compensation" mean? - ANSWERS-
It is the body's attempt to correct the acid-base imbalance
Which of the following places a patient at risk for a state of acidosis? (SELECT ALL
THAT APPLY)
a. A patient with severe anxiety
b. A patient rescued from a drowning
c. A patient who consumed an entire bottle of Tums
d. A patient with severe diarrhea
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