Patho Patho #50
When a client is experiencing acute kidney injury, which acid-base imbalance does the nurse monitor for?
- 1. Respiratory acidosis
This answer choice is not correct as respiratory acidosis occurs when a client is unable to exhale enough CO2, such as clients with COPD who have inelastic alveoli.
- 2. Metabolic acidosis
This answer is correct because clients with acute kidney injury are at increased risk for developing metabolic acidosis as H+ ions build up within the body and the kidneys are unable to produce adequate amounts of HCO3 to maintain acid-base balance.
- 3. Respiratory alkalosis
This answer choice is not correct because respiratory alkalosis occurs when clients exhale excessive amounts of CO2 when they are hyperventilating.
- 4. Metabolic alkalosis
This answer choice is not correct because clients are at risk for developing metabolic alkalosis when HCO3 is present in excess amount or there is a decrease in H+ ions, such as in severe and prolonged vomiting.
The focus of this question is asking the nurse to identify which acid base balance is expected in a client with acute kidney injury.When the kidneys are injured, they are unable to produce HCO3 as readily or excrete H+ in adequate amounts. The buildup of acidic H+ ions and a decrease in HCO+ ions places clients at increased risk for developing metabolic acidosis.
Metabolic acidosis occurs when H+ ions build up within the body or HCO+ is excreted in high amounts or not produced in adequate amounts. The kidneys are responsible for the production of HCO3+ and excretion of H+. When a client is experiencing acute kidney injury, the risk for developing metabolic acidosis is high as acidic H+ ions build up within the circulation without adequate amounts of HCO3 to maintain acid-base balance.
Test Taking Tip
When studying acid-base balance, focus on the most common disorders that cause acid base imbalances such as acute kidney injury, DKA, COPD, and vomiting. Learn and understand why these disorders lead to certain acid-base imbalances as opposed to simply memorizing.