ATI Fluid Electrolyte and Acid-Base Regulation

Correct Answer: C

Rationale: The correct answer is C: Hyperchloremia. In this scenario, the patient's symptoms point towards fluid overload, which can lead to hyperchloremia due to excessive chloride intake. 3+ pitting edema suggests fluid retention, a common symptom of hyperchloremia. Additionally, tachypnea can occur as a compensatory mechanism for metabolic acidosis seen in hyperchloremia. Lethargy, weakness, and diminished cognitive ability can be attributed to electrolyte imbalances impacting nerve and muscle function. Choice A: Hypocalcemia is less likely as it typically presents with neuromuscular irritability, not lethargy. Choice B: Hyponatremia usually presents with neurological symptoms like confusion and seizures, not the symptoms described. Choice D: Hypophosphatemia typically presents with muscle weakness, not the full constellation of symptoms described.

Correct Answer: C

Rationale: Rationale: Guillain-Barr syndrome can cause inadequate ventilation due to paralysis of the respiratory muscles. This results in respiratory acidosis. Endocarditis, multiple myeloma, and amphetamine overdose do not directly affect ventilation. Endocarditis is an infection of the heart valves, multiple myeloma is a cancer of plasma cells, and amphetamine overdose primarily affects the central nervous system and cardiovascular system, not ventilation. Therefore, Guillain-Barr syndrome is the most likely diagnosis in this case.

Correct Answer: D

Rationale: To interpret the given ABG results: 1. pH <7.35 indicates acidosis. 2. PaCO2 <35 indicates respiratory alkalosis. 3. HCO3 <22 indicates metabolic acidosis. Therefore, the ABG results show metabolic acidosis (low pH, low HCO3) with compensatory respiratory alkalosis (low PaCO2). This means the body is trying to compensate for the metabolic acidosis by decreasing PaCO2 through hyperventilation. Option D is correct. Options A, B, and C are incorrect as they do not align with the ABG results and the principles of acid-base balance.

Correct Answer: A

Rationale: Step-by-step rationale for why option A is correct: 1. Inhibition of aldosterone secretion leads to decreased sodium reabsorption and increased water excretion. 2. Decreased aldosterone can result in decreased blood volume and BP, leading to decreased urine output. 3. Monitoring urine output is crucial to assess renal function and fluid balance. 4. A urine output of 25 mL/hr is considered inadequate and can indicate renal impairment or dehydration. Summary: Option A is correct as it directly relates to the mechanism of action of inhibiting aldosterone secretion. Options B, C, and D are incorrect as they do not align with the expected complications of aldosterone inhibition.

Correct Answer: D

Rationale: The correct answer is D: Presence of an ulnar pulse. This is the most important assessment to complete first because the presence of an ulnar pulse indicates adequate circulation in the hand, ensuring that the radial artery catheter is not compromising blood flow. If the ulnar pulse is absent, it may signify impaired circulation and potential complications such as ischemia. Choice A is incorrect because the amount of pressure in the fluid container is not directly related to the assessment of the radial artery catheter. Choice B is incorrect because the date of catheter tubing change is important for infection control but not the immediate priority in this situation. Choice C is incorrect as the percent of heparin in the infusion container is important for anticoagulation therapy but does not take precedence over assessing circulation in the hand.