1. Acid base imbalance
While checking arterial blood gas results, a nurse finds respiratory acidosis. What does the nurse suspect is occurring
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the patient?
reduced tidal volumes
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2 ) levels. Which of the
following does the nurse suspect is the most likely cause?
Hyperventilation
The nurse is assessing a client with suspected respiratory acidosis. Which assessment items are priority for the nurse
to collect?
Rate and depth of respirations, Skin color and temperature, Appearance of the optic nerve
o The nurse is administering sodium bicarbonate to the client with respiratory acidosis. The nurse understands
that which is the primary goal of treatment for this client?
Removing excess acids in blood
The student nurse is assisting in the care for a client with acute respiratory acidosis. The nurse explains to the student
nurse that the client's blood pH initially falls in the development of acute respiratory acidosis because of which
process?
Hypoventilation
2. ACTH
The nurse is preparing a client for testing to determine if the client has Cushing syndrome. What tests are included in
the screening process
24-hour urine secretion of cortisol
Dexamethasone suppression test
Plasma levels of ACTH
A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The
nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun
exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client,
what does the nurse anticipate seeing?
Increased levels of ACTH
A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy.
Regarding which type of replacement will the nurse educate the client?
Cortisol replacement therapy
Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands,
the adrenals' production of cortisol drops. This is an example of which type of endocrine disorder?
Secondary
The nurse is preparing a client for a test that will measure negative feedback suppression of ACTH. Which medication
will the nurse administer in conjunction for this test?
Dexamethasone
ACTH deficiency results in secondary hypocortisolism
ACTH deficiency is most commonly caused by?
glucocorticoid withdrawal
6 symptoms of an ACTH deficiency
tiredness
weakness
anorexia
N/V
hypoglycemia
orthostatic hypotension
interpretation of ACTH levels requires simultaneous assessment of plasma cortisol levels
ACTH levels are normal to high in primary adrenal insufficiency
ACTH levels are low to absent in secondary adrenal insufficiency
The client has been taking an oral cortisol preparation for 2 years to manage an autoimmune disease. What effects does
the nurse expect this therapy to have on this client's circulating levels of ACTH and aldosterone?
Decreased ACTH, decreased aldosterone
A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with elevated levels of:
Adrenocorticotropic hormone (ACTH)
3. Acute epiglottitis
A caregiver calls the pediatrician's office and reports to the nurse that her 4-year-old, who was fine the previous day,
complained of a sore throat early in the morning and now has a temperature of 102.6° F (39.2° C). The caregiver has [Show Less]