BLACK & HAWKS: MEDICAL-SURGICAL NURSING,
8TH EDITION CHAPTER 13: AND --- ACID-BASE
BALANCE CHAPTER 67: ACUTE RESPIRATORY
FAILURE AND ACUTE RESPIRATORY DISTRESS
SYNDROME HARDING: LEWIS'S MEDICAL-
SURGICAL NURSING, 11TH EDITION
When an individual's serum pH begins to fall below 7.35,
the mechanism that responds instantaneously to return
the serum pH to normal level is
a. Ammonia gas combining with H+
b. Excretion of acid by the lungs
c. Plasma bicarbonate buffering the acid
,d. Secretion of hydrogen ions (H+) by the kidneys -
✔✔ANSWER✔✔->>>>>>>>ANS:C
Blood buffers constitute the body's first line of defense
against acid-base imbalance.
A client in diabetic ketoacidosis has an elevated serum
potassium ion (K+) level. The nurse explains to the client
that this is caused by
a. Bicarbonate loss in the urine instead of K+ loss
b. Binding of H+ to blood proteins
c. Increased reabsorption of K+ in the distal tubule of the
nephron
d.
Secretion by the kidneys of H+ and retention of K+ -
✔✔ANSWER✔✔->>>>>>>>ANS:D
In cases of serum H+ excess, more H+ is secreted by renal
tubular cells, whereas K+ is retained, promoting
,hyperkalemia. Hyperkalemia also occurs because H+ and
K+ exchange places in an attempt to maintain
electroneutrality, with more H+ entering cells and more
K+ leaving cells.
The nurse teaching a 32-year-old man with renal failure
about the pathophysiologic mechanism of acid-base
balance recognizes that the instructions have been
understood when the client says
a. "Acidic foods must be eliminated from my diet"
b. "I lose too much acid through my kidneys"
c. "My breathing increases to correct imbalances"
d. "My urine output will increase when my pH falls" -
✔✔ANSWER✔✔->>>>>>>>ANS:C
When kidney disease impairs excretion of fixed acids, the
respiratory system can increase ventilation to "blow off"
excess acid as carbon dioxide.
, The nurse explains to a concerned family member of a
client who has developed respiratory acidosis that the
kidneys
a. Achieve optimal compensation immediately
b. Are unable to compensate
c. Can achieve optimal compensation in about 3 days
d. Will compensate within 24 hours ANS:C -
✔✔ANSWER✔✔->>>>>>>>ANS:C
The lungs or kidneys alter actual amounts of acid and
base, but regulation by these systems is not
instantaneous. The kidneys may require up to 72 hours to
achieve optimal compensation.
In an assessment of current clients, the nurse recognizes
that the client most likely to develop respiratory acidosis
has
a. Chronic obstructive pulmonary disease
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