A nurse is assessing clients who are at risk for acid-base imbalance. Which clients are correctly paired with the acid-base imbalance? (Select all that apply.)

Question

a. Metabolic alkalosis - Young adult who is prescribed intravenous morphine sulfate for pain
b. Metabolic acidosis - Older adult who is following a carbohydrate-free diet
c. Respiratory alkalosis - Client on mechanical ventilation at a rate of 28 breaths/min
d. Respiratory acidosis - Postoperative client who received 6 units of packed red blood cells
e. Metabolic alkalosis - Older client prescribed antacids for gastroesophageal reflux disease

Answer 1

ANS: B, C, E
Respiratory acidosis often occurs as the result of underventilation. The client who is taking opioids, especially IV opioids, is at risk for respiratory depression and respiratory acidosis. One cause of metabolic acidosis is a strict low-calorie diet or one that is low in carbohydrate content. Such a diet increases the rate of fat catabolism and results in the formation of excessive ketoacids. A ventilator set at a high respiratory rate or tidal volume will cause the client to lose too much carbon dioxide, leading to an acid deficit and respiratory alkalosis. Citrate is a substance used as a preservative in blood products. It is not only a base, it is also a precursor for bicarbonate. Multiple units of packed red blood cells could cause metabolic alkalosis. Sodium bicarbonate antacids may increase the risk of metabolic alkalosis.