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NUR 425 EXAM 3 (ACTUAL ) QUESTIONS WITH ANSWERS.
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NUR 425 EXAM 3 (ACTUAL 2024-2025)QUESTIONS WITH ANSWERS.
A 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.
, NUR 425 EXAM 3 (ACTUAL 2024-2025)
QUESTIONS WITH ANSWERS.
- 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
, NUR 425 EXAM 3 (ACTUAL 2024-2025)
QUESTIONS WITH ANSWERS.
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.
, NUR 425 EXAM 3 (ACTUAL 2024-2025)
QUESTIONS WITH ANSWERS.
- 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.
Respiratory acidosis compensation: - Answers___- To
compensate, the kidneys conserve bicarbonate and secrete
increased concentrations of hydrogen ion into the urine
- During acute respiratory acidosis, the renal compensatory
mechanisms begin to operate within 24 hours
- Until the renal mechanisms have an effect, the serum
bicarbonate level will usually be normal
Hypoventilation (too slow/shallow) often caused by -
Answers___CNS depression
- Drugs (sedatives, opioids), alcohol, brainstem injury
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