Question

48.a nurse is collecting data from a client who reports persistent vomiting, dizziness, palpitations, and numbness and tingling in his fingers and toes and around his mouth. the nurse notes the clients respirations are slow and shallow. the nurse should suspect that the client has developed which of the following acid - base imbalances?
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis

49.a nurse is caring for a client whose arterial blood gases include a ph of 7.30, an hco3 - of 18 meq/l and a paco2 of 28 mm hg. the nurse should suspect that the client has developed which of the following acid - base imbalances?
a. metabolic acidosis
b. respiratory acidosis
c. metabolic alkalosis
d. respiratory alkalosis

50.a nurse is collecting data about an iv infusion site on an infants left hand. which of the following findings should the nurse identify as an indication of an infiltration?
a. blood in the iv tubing
b. absence of blanching at the insertion site
c. edema in the palm of the hand
d. warmth around the insertion site

51.a nurse is caring for a client who is receiving oxygen at 2 l/min via a nasal cannula. from this information, the nurse should identify that the client is receiving which of the following oxygen concentrations?
a. 28%
b. 36%
c. 50%
d. 70%

Explanation:

For question 48: Persistent vomiting leads to loss of gastric acid (HCl), which causes an increase in bicarbonate (HCO₃⁻) relative to carbonic acid (\(H_2CO_3\)). This is metabolic alkalosis. Symptoms like dizziness, palpitations, numbness, and slow - shallow respirations (compensatory mechanism) support this.
For question 49: A pH of 7.30 (acidic), HCO₃⁻ of 18 mEq/L (low, indicating metabolic component), and PaCO₂ of 28 mm Hg (low, compensatory respiratory response). This is metabolic acidosis.
For question 50: Edema in the palm of the hand at the IV infusion site is a sign of infiltration (IV fluid leaking into surrounding tissue). Blood in tubing is related to other issues (e.g., dislodged needle), absence of blanching is not a sign of infiltration, and warmth may indicate infection or other problems.
For question 51: The formula for calculating oxygen concentration (\(FiO_2\)) with a nasal cannula is \(FiO_2=21 + 4\times flow\ rate\). Given a flow rate of 2 L/min, \(FiO_2=21+4\times2 = 29\%\approx28\%\) (due to rounding and normal approximations in clinical settings).

Answer:

1. B. Metabolic alkalosis
2. A. Metabolic acidosis
3. C. Edema in the palm of the hand
4. A. 28%