The nurse is caring for a patient with metabolic acidosis secondary to renal failure caused by poor glucose regulation. The patient reports a headache, weakness, and nausea
The nurse assesses an elevated blood sugar, Kussmaul breathing, and peripheral vasodilation. What collaborative interventions will the nurse anticipate to restore pH balance? Select all that apply.
a. Insulin to lower blood sugar
b. Tylenol for headache
c. Mechanical ventilation to correct breathing
d. Dialysis to remove toxins
e. Bicarbonate administration
A, D, E
Treatment for metabolic acidosis is aimed at correcting the underlying problem, which includes glucose regulation; that would be achieved by administering insulin. Dialysis for kidney failure is aimed at treating an underlying cause of the metabolic acidosis and would be anticipated. Bicarbonate administration can reduce pH and begin the process of resolving the problem. Tylenol will not resolve the patient's headache unless the metabolic acidosis is also resolved. Mechanical ventilation is not indicated, because while metabolic acidosis exists, the breathing pattern helps to compensate; correction of metabolic acidosis will correct the breathing pattern.
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A client has been diagnosed with prerenal azotemia. What clinical manifestations can the nurse expect this client to exhibit?
A. Tachycardia, decreased urinary output, and hypotension B. Bradycardia, decreased urinary output, and hypotension C. Bradycardia, scanty urine output, and rising serum electrolyte levels D. Tachycardia, large quantities of dilute urine, and normal serum electrolyte levels
The patient is exhibiting Kussmaul's breathing. The nurse knows this is most likely a compensatory effort for which acid-base disturbance?
a. respiratory acidosis c. metabolic acidosis b. respiratory alkalosis d. metabolic alkalosis
The political team for a campaign asks a nurse to help the candidate with the health care issues affecting the city. In preparation for the task of presenting to the team and the candidate, the nurse investigates issues that affect nursing's future
Which of the following issues would the nurse present to the committee to assist in informing the government of the nurse's needs and desires? A) Need for changes in the health care delivery system to meet the needs of the population B) Recognition that positive outcomes of client care are improved when professional nurses provide care C) Determine a means to disseminate nursing research findings to the public D) Support interprofessional learning experiences that result in long-lasting effects
At the time of admission, a patient gave a history of allergy to penicillin that was duly noted in all critical areas of the patient's record. While giving medications, a nurse accidentally adminis-tered penicillin to this patient
The patient had a severe reaction but recovered. What is the im-plication of the nurse's action? a. The nurse cannot be sued for malpractice because the patient did not directly the nurse of the allergy. b. The nurse failed to act in a reasonable and prudent fashion and thus is liable for mal-practice. c. The nurse who gave the medication can bring a countersuit against the nurse who took the history. d. There is no cause for concern because the action did not result in the patient's death.