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Questions and Answers
Which factor is responsible for respiratory acidosis associated with pulmonary edema?
Which factor is responsible for respiratory acidosis associated with pulmonary edema?
- Hyperventilation
- Impaired gas exchange (correct)
- Hypocapnia
- Hypocapnia
Which patient conditions have the greatest risk for respiratory acidosis?
Select all that apply.
Which patient conditions have the greatest risk for respiratory acidosis? Select all that apply.
- A fractured femur
- Fractured ribs (correct)
- Receiving opioids (correct)
- Pain
Which changes in laboratory values would the nurse anticipate as a result of renal compensation in a patient with a pH of 7.48 and a PaCO2 of 32 mm Hg?
Select all that apply.
Which changes in laboratory values would the nurse anticipate as a result of renal compensation in a patient with a pH of 7.48 and a PaCO2 of 32 mm Hg? Select all that apply.
- pH decreases to 7.40 (correct)
- Bicarbonate value decreases (correct)
- pH decreases to 7.29
- Bicarbonate value increases
Which physiologic process would the nurse recognize as causing respiratory alkalosis when caring for a patient with a temperature of 104.2°F (40.1°C) who is alone, scared, in pain, and hyperventilating?
Which physiologic process would the nurse recognize as causing respiratory alkalosis when caring for a patient with a temperature of 104.2°F (40.1°C) who is alone, scared, in pain, and hyperventilating?
Which alteration would the nurse anticipate when caring for a patient who states, “I rinse my mouth after meals with baking soda and take antacids before bed each night”?
Which alteration would the nurse anticipate when caring for a patient who states, “I rinse my mouth after meals with baking soda and take antacids before bed each night”?
Which patient condition may have caused metabolic alkalosis and a pH of 7.48?
Select all that apply
Which patient condition may have caused metabolic alkalosis and a pH of 7.48? Select all that apply
Which change in respiratory pattern is associated with metabolic acidosis?
Which change in respiratory pattern is associated with metabolic acidosis?
Which laboratory value would specifically indicate metabolic acidosis in a patient with a pH of 7.3, PaCO2 of 39 mm Hg, PaO2 of 92 mm Hg, and HCO3– level of 17.6 mEq/L?
Which laboratory value would specifically indicate metabolic acidosis in a patient with a pH of 7.3, PaCO2 of 39 mm Hg, PaO2 of 92 mm Hg, and HCO3– level of 17.6 mEq/L?
Which acid-base imbalance would the nurse anticipate in a patient after a motor vehicle accident in which the steering wheel hit the patient’s chest and trapped the patient in the car until rescue workers arrived?
Which acid-base imbalance would the nurse anticipate in a patient after a motor vehicle accident in which the steering wheel hit the patient’s chest and trapped the patient in the car until rescue workers arrived?
The nurse is caring for a patient who fell and is receiving treatment for a fractured arm. The nurse reviews the patient’s laboratory results, which indicate an elevated pH and a decreased PaCO2. Which condition is the patient experiencing based on the current data?
The nurse is caring for a patient who fell and is receiving treatment for a fractured arm. The nurse reviews the patient’s laboratory results, which indicate an elevated pH and a decreased PaCO2. Which condition is the patient experiencing based on the current data?
Which conditions in the medical history would the nurse identify as a risk factor for metabolic acidosis?
Which conditions in the medical history would the nurse identify as a risk factor for metabolic acidosis?
Which ABG data would the nurse identify as supporting the diagnosis of metabolic alkalosis in a patient admitted with dehydration and lethargy?
Which ABG data would the nurse identify as supporting the diagnosis of metabolic alkalosis in a patient admitted with dehydration and lethargy?
Which change in respiratory pattern observed in a type I diabetic patient with metabolic acidosis indicates to the nurse that compensation is occurring?
Which change in respiratory pattern observed in a type I diabetic patient with metabolic acidosis indicates to the nurse that compensation is occurring?
Which patients would the nurse identify as being at risk for respiratory acidosis secondary to impaired gas exchange?
Which patients would the nurse identify as being at risk for respiratory acidosis secondary to impaired gas exchange?
Which data in the medical history of a patient who is awake, but lethargic, and taking rapid, deep breaths would the nurse suspect as the cause of the following laboratory values: pH 7.31, PaO2 59.2 mm Hg, PaCO2 38.6 mm Hg, HCO3– 17.5 mEq/L, and oxygen saturation 88%?
Which data in the medical history of a patient who is awake, but lethargic, and taking rapid, deep breaths would the nurse suspect as the cause of the following laboratory values: pH 7.31, PaO2 59.2 mm Hg, PaCO2 38.6 mm Hg, HCO3– 17.5 mEq/L, and oxygen saturation 88%?
Which intervention would the nurse independently implement for a patient experiencing respiratory acidosis?
Which intervention would the nurse independently implement for a patient experiencing respiratory acidosis?
Which nursing intervention is appropriate for all patients experiencing an acid-base imbalance?
Which nursing intervention is appropriate for all patients experiencing an acid-base imbalance?
Which nursing intervention would the nurse anticipate for a patient experiencing respiratory acidosis with chronic obstructive pulmonary disease (COPD)?
Which nursing intervention would the nurse anticipate for a patient experiencing respiratory acidosis with chronic obstructive pulmonary disease (COPD)?
Which interventions would the nurse anticipate when caring for a patient experiencing metabolic acidosis?
Select all that apply.
Which interventions would the nurse anticipate when caring for a patient experiencing metabolic acidosis? Select all that apply.
Which intervention would the nurse anticipate when caring for a patient experiencing metabolic alkalosis?
Which intervention would the nurse anticipate when caring for a patient experiencing metabolic alkalosis?
Which intervention is appropriate for a patient experiencing metabolic acidosis?
Which intervention is appropriate for a patient experiencing metabolic acidosis?
Which intervention would the nurse include in the plan of care for a patient experiencing respiratory alkalosis?
Which intervention would the nurse include in the plan of care for a patient experiencing respiratory alkalosis?
Which members of the health care team would the nurse include when planning a collaborative care conference about the acute phase of any acid-base imbalance?
Select all that apply.
Which members of the health care team would the nurse include when planning a collaborative care conference about the acute phase of any acid-base imbalance? Select all that apply.
Which interventions would the nurse independently implement for a patient experiencing respiratory acidosis?
Which interventions would the nurse independently implement for a patient experiencing respiratory acidosis?
Which intervention would the nurse anticipate when caring for a patient experiencing metabolic acidosis?
Which intervention would the nurse anticipate when caring for a patient experiencing metabolic acidosis?
Which intervention would the nurse anticipate when caring for a patient experiencing metabolic acidosis?
Which intervention would the nurse anticipate when caring for a patient experiencing metabolic acidosis?
Study Notes
Respiratory Acidosis
- Pulmonary edema is a factor that can cause respiratory acidosis because fluid in the alveoli impedes gas exchange, reducing O2 levels in the blood and increasing CO2.
- Patient conditions at greatest risk for respiratory acidosis include:
- COPD
- Pneumonia
- Asthma
- Spinal cord injuries
- Obesity
- Drug overdose
- Trauma
- Atelectasis
Renal Compensation
- Renal compensation for respiratory acidosis would be expected to cause an increase in serum bicarbonate, leading to increased urine pH and increased potassium levels.
- Renal compensation for respiratory alkalosis would be expected to cause a decrease in serum bicarbonate, leading to decreased urine pH and decreased potassium levels.
Respiratory Alkalosis
- Hyperventilation, a common symptom of anxiety, pain, and fever, causes respiratory alkalosis by expelling too much CO2 from the body.
- Hyperventilation is a physiologic process causing respiratory alkalosis due to the reduced CO2 in the blood.
Metabolic Alkalosis
- Altering body pH by rinsing the mouth with baking soda and taking antacids frequently can cause metabolic alkalosis.
- Conditions in the medical history that may cause metabolic alkalosis include:
- Prolonged vomiting
- Excessive use of diuretics
- Hypokalemia
- Hyperaldosteronism
Metabolic Acidosis
- A deep, rapid respiratory pattern known as Kussmaul breathing is often present in patients with metabolic acidosis.
- Metabolic acidosis, as shown by a low HCO3– level, is indicated by a pH of 7.3, PaCO2 of 39 mm Hg, PaO2 of 92 mm Hg, and HCO3– level of 17.6 mEq/L.
- Metabolic acidosis would be anticipated in a patient after a motor vehicle accident with chest trauma that caused tissue hypoxia, compromising the body's ability to metabolize glucose and produce energy.
- Conditions in the medical history that would be a risk factor for metabolic acidosis include:
- Diabetes
- Renal failure
- Severe diarrhea
- Sepsis
- Starvation
- Alcohol or drug overdose
- Salicylate poisoning
- Lactic acidosis
Other Conditions
- Metabolic alkalosis in a patient with dehydration and lethargy would be supported by elevated pH (above 7.45), low PaCO2 (below 35 mm Hg), and elevated HCO3– (above 26 mEq/L).
- Respiratory alkalosis, characterized by a low PaCO2 and high pH (above 7.45), can occur in a patient with a fractured arm, possibly due to anxiety and pain.
- Kussmaul breathing, characterized by rapid, deep breaths, is a classic compensatory mechanism for metabolic acidosis in a type I diabetic patient.
- Respiratory acidosis is a risk for patients with impaired gas exchange, such as those with COPD, pneumonia, or asthma.
- Respiratory acidosis, indicated by a low pH (below 7.35) and high PaCO2 (above 45 mm Hg), is suggested in a patient with altered mental status, rapid deep breaths, and oxygen saturation of 88%, which may be caused by hypoventilation due to respiratory insufficiency.
- Respiratory acidosis often requires intervention with mechanical ventilation to increase alveolar ventilation and promote CO2 elimination.
Nursing Interventions
- Nursing interventions for all patients experiencing an acid-base imbalance include:
- Monitoring vital signs
- Assessing respiratory status
- Monitoring acid-base balance
- Providing patient education
- Nursing interventions for patients experiencing respiratory acidosis with COPD include:
- Promoting airway clearance
- Administering bronchodilators
- Teaching about oxygen therapy
- Providing emotional support
- Nursing interventions for patients experiencing metabolic acidosis include:
- Monitoring for signs of hypoglycemia
- Administering insulin
- Administering bicarbonate-containing solutions
- Ensuring adequate hydration
- Nursing interventions for patients experiencing metabolic alkalosis include:
- Administering potassium or chloride as needed
- Monitoring for signs of hypokalemia
- Encouraging fluid intake
- Nursing interventions for patients experiencing respiratory alkalosis include:
- Reducing anxiety
- Providing paper bag for breathing
- Encouraging slow, deep breaths
- Encouraging relaxation techniques
Team Collaboration
- Members of the health care team who should be included in the collaborative care conference for the acute phase of any acid-base imbalance include:
- Physician
- Nurse
- Respiratory therapist
- Pharmacist
- Nutritionist
- Social worker
Additional Nursing Interventions
- Nursing interventions for patients experiencing respiratory acidosis include:
- Supporting respiratory status
- Promoting oxygenation
- Administering prescribed medications
- Nursing interventions for patients experiencing metabolic acidosis include:
- Ensuring adequate hydration
- Administering prescribed medications
- Monitoring for signs of hypoglycemia
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Description
Test your knowledge on the factors leading to respiratory acidosis, particularly in relation to pulmonary edema. Understand the physiological mechanisms involved and impact on respiratory function. This quiz is essential for students studying respiratory physiology or medicine.
