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Dif cognitive level knowledge ref p 449 obj describe

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DIF:Cognitive Level: KnowledgeREF:p. 449OBJ:Describe the medical management of the patient with acute kidney injury.TOP:Nursing Process Step: AssessmentMSC:NCLEX: Physiological Integrity26.The patient is diagnosed with acute kidney injury and has been getting dialysis 3 days perweek. The patient complains of general malaise and is tachypneic. An arterial blood gas isordered and shows that the patient’s pH is 7.19, with a PCO2of 30 mm Hg and a bicarbonatelevel of 13 mEq/L. The nurse prepares to:a.administer morphine to slow the respiratory rate.b.prepare for intubation and mechanical ventilation.c.administer intravenous sodium bicarbonate.d.cancel tomorrow’s dialysis session.ANS: CMetabolic acidosis is the primary acid-base imbalance seen in acute kidney injury. Treatmentof metabolic acidosis depends on its severity. Patients with a serum bicarbonate level of lessthan 15 mEq/L and a pH of less than 7.20 are usually treated with intravenous sodiumbicarbonate. The goal of treatment is to raise the pH to a value greater than 7.20. Rapidcorrection of the acidosis should be avoided, because tetany may occur as a result ofhypocalcemia. Renal replacement therapies also may correct metabolic acidosis because itremoves excess hydrogen ions and bicarbonate is added to the dialysate and replacementsolutions; therefore, dialysis would not be cancelled. The tachypnea is a compensatorymechanism for the metabolic acidosis, and treatments to decrease the respiratory rate are notindicated. Treatment is aimed at correcting the metabolic acidosis, and this scenario does notprovide data to support the need for intubation.
DIF:Cognitive Level: AnalysisREF:p. 450OBJ:Describe the medical management of the patient with acute kidney injury.TOP:Nursing Process Step: ImplementationMSC:NCLEX: Physiological Integrity27.The removal of plasma water and some low–molecular weight particles by using a pressure orosmotic gradient is known as:

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Term
Fall
Professor
Wishtichusen
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