The nurse is making a home visit to a child who has a chronic ...

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The nurse is making a home visit to a child who has a chronic disease. Which finding has the greatest implication for acid-base aspects of this patient's care?
 
  a. Urine output is very small today.
  b. Whites of the eyes appear more yellow.
  c. Skin around the mouth is very chapped.
  d. Skin is sweaty under three blankets.

Question 2

The patient has severe hyperthyroidism and will have surgery tomorrow. What assessment is most important for the nurse to assess in order to detect development of the acid-base imbalance for which the patient has highest risk?
 
  a. Urine output and color
  b. Level of consciousness
  c. Heart rate and blood pressure
  d. Lung sounds in lung bases

[tuate]

Answer to Question 1

ANS: A
Oliguria decreases the excretion of metabolic acids and is a risk factor for metabolic acidosis. Jaundice requires follow-up but is not an acid-base problem. Perioral chapped skin needs intervention but is not an acid-base issue. With three blankets, diaphoresis is not unusual.

Answer to Question 2

ANS: B
Thyroid hormone increases metabolic rate, causing a patient with severe hyperthyroidism to have high risk of metabolic acidosis from increased production of metabolic acids. Metabolic acidosis decreases level of consciousness. Changes in urine output, urine color, and lung sounds are not signs of metabolic acidosis. Although metabolic acidosis often causes tachycardia, many other factors influence heart rate and blood pressure, including thyroid hormone.

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TYSM

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