Acid-Base Balance Exam 2 with Questions and Answers

Acid-Base Balance Exam 2 with Questions and Answers 10) The nurse is reviewing orders written by the healthcare provider for a client with metabolic acidosis. Which order should the nurse question before implementing it for the client? A) Begin intravenous infusion of 0.9% normal saline. B) Draw serum potassium levels every 2 hours. C) Draw arterial blood gas samples every 2 hours. D) Administer 1 ampule of sodium bicarbonate now. ANSWER Answer: D Explanation: Administering bicarbonate to correct acidosis increases the risk for hypernatremia, hyperosmolality, and fluid volume excess. This is the order that the nurse should question before providing. Treatment of metabolic acidosis includes correction of fluid balance. An infusion of normal saline would be appropriate for this client. As metabolic acidosis is corrected, potassium shifts back into the intracellular space. This shift can lead to hypokalemia and cardiac dysrhythmias. Serum potassium levels should be carefully monitored during treatment. Arterial blood gases are used to evaluate treatment and guide additional therapies. 11) The nurse identifies the diagnosis Risk for Injury as appropriate for a client with metabolic acidosis. Which strategies should the nurse use to support this diagnosis? Select all that apply. A) Apply wrist restraints and secure to the bed frame. B) Discuss chemical restraint use with the healthcare provider. C) Keep the bed in the lowest position. D) Keep bed side rails raised. E) Place a clock and calendar at the bedside. ANSWER Answer: C, D, E