The patient had diarrhea for 5 days and developed an acid-base ...

[HCHenry]

The patient had diarrhea for 5 days and developed an acid-base imbalance. Which statement would indicate that the nurse's teaching about the acid-base imbalance has been effective?
 
  a. To prevent another problem, I should eat less sodium during diarrhea.
  b. My blood became too acid because I lost some base in the diarrhea fluid.
  c. Diarrhea removes fluid from the body, so I should drink more ice water.
  d. I should try to slow my breathing so my acids and bases will be balanced.

Question 2

The patient has recent bilateral, above-the-knee amputations and has developed C. difficile diarrhea. What assessments should the nurse use to detect ECV deficit in this patient? (Select all that apply.)
 
  a. Test for skin tenting.
  b. Measure rate and character of pulse.
  c. Measure postural blood pressure and heart rate.
  d. Check Trousseau's sign.
  e. Observe for flatness of neck veins when upright.
  f. Observe for flatness of neck veins when supine.

[leannegxo]

Answer to Question 1

ANS: B
Diarrhea causes metabolic acidosis through loss of bicarbonate, which is a base. Eating less sodium during diarrhea increases the risk of ECV deficit. Although diarrhea does remove fluid from the body, it also removes sodium and bicarbonate which need to be replaced. Rapid deep respirations are the compensatory mechanism for metabolic acidosis and should be encouraged rather than stopped.

Answer to Question 2

ANS: A, B, F
ECV deficit is characterized by skin tenting; rapid, thready pulse; and flat neck veins when supine, which can be assessed in this patient. Although ECV deficit also causes postural blood pressure drop with tachycardia, this assessment is not appropriate for a patient with recent bilateral, above-the-knee amputations. Trousseau's sign is a test for increased neuromuscular excitability, which is not characteristic of ECV deficit. Flat neck veins when upright is a normal finding.