rationales for qbank nscbn.docx

rationales for qbank nscbn.docx - Metabolic acidosis can be...

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Metabolic acidosis can be caused by many conditions, including renal failure, shock, severe diarrhea, dehydration, diabetic acidosis, and salicylate poisoning. With metabolic acidosis, you should expect a low pH (less than 7.35) and a low HCO3 (less than 22 mEq/L.) Compensation means the body is trying to get the pH back in balance; therefore, a pure metabolic acidosis should elicit a compensatory decrease in PaCO2 (normal is 35-45 mm Hg.) The hemoglobin is within normal limits (WNL) for both males and females. The chloride and sodium results are also WNL. The incidence of hypertension is greater among African-Americans than other groups in the United States. The incidence among the Hispanic population is rising. The clinic nurse is assisting with medical billing. The nurse uses the DRG (Diagnosis Related Group) manual for which purpose ?- Determine reimbursement for a medical diagnosis --- DRGs are the basis of prospective payment plans for reimbursement for Medicare clients. Other insurance companies often use it as a standard for determining payment. Smoking cessation is the priority for clients at risk for cardiac disease. Smoking’s effects result in reduction of cell oxygenation and constriction of the blood vessels. All of the other factors should be addressed at some point in time. The typical client with HHNS will have a plasma glucose level of 600 mg/dL (33.33 mmol/L) or greater, high serum osmolality, profound dehydration, a serum pH greater than 7.3 and some alteration in consciousness. Unlike diabetic ketoacidosis, however, there is little to no ketosis. HHNS usually presents
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