Sherpath: Acid-Base Regulation: Assess and Recognize Cues

Question 1 of 8

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Which conclusion would the nurse make when the ABG results for a patient suspected of having an acid-base imbalance reveal a decreased pH, increased PaCO₂, and normal HCO₃^–?

• Correct
  • Respiratory acidosisA decreased pH, an increased PaCO₂, and a normal HCO₃^– indicate that the patient is experiencing respiratory acidosis.
• • Respiratory alkalosisA decreased pH, an increased PaCO₂, and a normal HCO₃^– would not indicate respiratory alkalosis. Respiratory alkalosis would be associated with an increased pH, a decreased PaCO₂, and a normal HCO₃^–.
• • Metabolic acidosisA decreased pH, an increased PaCO₂, and a normal HCO₃^– would not indicate metabolic acidosis. Metabolic acidosis would be associated with a decreased pH, a normal PaCO₂, and a decreased HCO₃^–.
• • Metabolic alkalosisA decreased pH, an increased PaCO₂, and a normal HCO₃^– would not indicate metabolic alkalosis. Metabolic alkalosis would be associated with an increased pH, a normal PaCO₂, and an increased HCO₃^–.

Question 2 of 8

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Which actions would the nurse perform when analyzing ABG values for a patient suspected of having an acid-base imbalance?

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  • Examining oxygenation statusThe first step the nurse performs when analyzing ABG values is to examine the oxygenation status to determine if the patient is experiencing hypoxemia.
• Correct
  • Evaluating the pHThe second step the nurse performs when analyzing ABG values is to evaluate the pH to determine if the patient is acidotic or alkalotic.
• Correct
  • Assessing PaCO₂ and HCO₃^–The third step the nurse performs when analyzing ABG values is to assess PaCO₂ and HCO₃^– values. This allows the nurse to determine whether the underlying issue is metabolic or respiratory in nature.
• • Monitoring potassiumPotassium level is not a criterion that is used to analyze ABG values.
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  • Determining compensationThe final step the nurse performs when analyzing ABG values is to determine compensation.

Question 3 of 8

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Which acid-base imbalance would the nurse suspect when providing care to a patient with the following ABG values: pH 7.30, PaCO₂ 40 mm Hg, and HCO₃^– 20 mEq/L?

• • Respiratory acidosisThe nurse would not suspect respiratory acidosis based on these ABG values. Respiratory acidosis would be associated with a decreased pH, an increased PaCO₂, and a normal HCO₃^–.
• • Respiratory alkalosisThe nurse would not suspect respiratory alkalosis based on these ABG values. Respiratory alkalosis would be associated with an increased pH, a decreased PaCO₂, and a normal HCO₃^–.
• Correct
  • Metabolic acidosisMetabolic acidosis is characterized by a decreased pH, a normal PaCO₂, and a decreased HCO₃^–. This is appropriate for the nurse to suspect based on the ABG analysis.
• • Metabolic alkalosisThe nurse would not suspect metabolic alkalosis based on these ABG values. Metabolic alkalosis would be associated with an increased pH, a normal PaCO₂, and an increased HCO₃^–.

Question 4 of 8

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Which assessments would the nurse perform in all patients experiencing an acid-base imbalance?

• • Skin turgorSkin turgor is not an assessment parameter for all patients who are suspected of having an acid-base imbalance.
• • Urine outputUrine output is not an assessment parameter for all patients who are suspected of having an acid-base imbalance.
• • Bowel soundsAuscultating bowel sounds is not an assessment parameter for all patients who are suspected of having an acid-base imbalance.
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  • ABG analysisAll patients who are suspected of having an acid-base imbalance will require an ABG analysis.
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  • Vital signsAll patients who are suspected of having an acid-base imbalance will require a vital signs assessment.

Question 5 of 8

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Which cardiovascular findings would the nurse anticipate in a patient with respiratory acidosis?

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  • TachycardiaTachycardia is an expected cardiovascular assessment finding for a patient who is experiencing respiratory acidosis.
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  • DysrhythmiaDysrhythmia is an expected cardiovascular assessment finding for a patient who is experiencing respiratory acidosis.
• • HypotensionHypotension is not an expected cardiovascular assessment finding for a patient who is experiencing respiratory acidosis. Hypotension is associated with metabolic alkalosis.
• • DyspneaDyspnea is a respiratory, not cardiovascular, assessment finding that is expected for a patient who is experiencing respiratory acidosis. Dyspnea a respiratory finding and is not associated with the cardiovascular system.
• • ConfusionConfusion is a neurologic, not cardiovascular, assessment finding that is expected for a patient who is experiencing respiratory acidosis. Confusion is associated with metabolic acidosis.

Question 6 of 8

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Which clinical manifestation would the nurse anticipate when assessing a patient who is experiencing respiratory alkalosis?

• • DyspneaDyspnea is a clinical manifestation the nurse would anticipate for a patient who is experiencing respiratory acidosis, not alkalosis.
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  • TachypneaTachypnea is a clinical manifestation the nurse would anticipate for a patient who is experiencing respiratory alkalosis.
• • HypertensionHypertension is not a clinical manifestation the nurse would anticipate for a patient who is experiencing respiratory alkalosis.
• • HypotensionHypotension is not a clinical manifestation the nurse would anticipate for a patient who is experiencing respiratory alkalosis. Hypotension is associated with metabolic alkalosis.

Question 7 of 8

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Which assessment finding would cause the nurse to suspect that a patient is experiencing metabolic acidosis?

• • DyspneaDyspnea is an assessment finding that would cause the nurse to suspect respiratory, not metabolic, acidosis.
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  • Kussmaul respirationsKussmaul respirations are frequent, deep breaths that constitute a compensatory mechanism to exhale more carbon dioxide. This is an assessment finding that would cause the nurse to suspect that the patient is experiencing metabolic acidosis.
• • PolyuriaPolyuria is an assessment finding that would cause the nurse to suspect metabolic alkalosis, not acidosis.
• • Muscle twitchingMuscle twitching is an assessment finding that would cause the nurse to suspect metabolic alkalosis, not acidosis.

Question 8 of 8

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Which acid-base imbalance would the nurse suspect in a patient presenting with muscle twitching and tetany who experiences a seizure 10 minutes after hospital admission?

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  • Metabolic alkalosisClinical manifestations associated with metabolic alkalosis include muscle twitching and tetany that may progress to seizure.
• • Metabolic acidosisMuscle twitching, tetany, and seizure are not clinical manifestations associated with metabolic acidosis.
• • Respiratory alkalosisMuscle twitching, tetany, and seizure are not clinical manifestations associated with respiratory alkalosis.
• • Respiratory acidosisMuscle twitching, tetany, and seizure are not clinical manifestations associated with respiratory acidosis.