Nursing A Concept-Based Approach to Learning Volumes I II & III 3rd Edition

Nursing A Concept-Based Approach to Learning Volumes I II & III 3rd Edition 

Module 1 Acid-Base Balance
The Concept of Acid-Base Balance
1) A client is brought to the emergency department (ED) after passing out in a local department
store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would the
nurse expect to assess in this client?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratory acidosis Answer: A
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The body
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
B) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
C) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
D) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
Page Ref: 6
Cognitive Level: Analyzing
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects
an understanding of human growth and development, pathophysiology, pharmacology, medical
management and nursing management across the health-illness continuum, across lifespan, and in all
healthcare settings. | NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing Process: Assessment
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
2) Which risk factors exhibited by the client presenting in the emergency department (ED) would
place the client at risk for metabolic acidosis? Select all that apply.
A) Abdominal fistulas
B) Chronic obstructive pulmonary disease
C) Pneumonia
D) Acute renal failure
E) Hypovolemic shock Answer: A, D, E
Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client
at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure;
and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk
for respiratory acidosis with the increased retention of carbon dioxide in the blood.
C) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure;
and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk
for respiratory acidosis with the increased retention of carbon dioxide in the blood.
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure;
and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk
for respiratory acidosis with the increased retention of carbon dioxide in the blood.
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure;
and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk
for respiratory acidosis with the increased retention of carbon dioxide in the blood.
Page Ref: 6, 14
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects
an understanding of human growth and development, pathophysiology, pharmacology, medical
management and nursing management across the health-illness continuum, across lifespan, and in all
healthcare settings. | NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing Process: Assessment
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
MNL LO: Analyze the concept of acid-base balance and its application to nursing care

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