Lactic Acid | Arterial Blood Gas NCLEX & Nursing School Exams Like A Boss

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LACTIC ACID NCLEX QUIZ QUESTIONS

Question 1: The nurse is caring for 70-year-old patient diagnosed with sepsis from an untreated, infected foot wound. The patient is experiencing tachypnea, hypotension, and tachycardia. Upon assessment, the nurse notes the patient has a lactic acid of 6.0 mmol/L.  The nurse understands lactic acid production comes from

  1. Production of adenosine triphosphate through energy pathways that require oxygen
  2. Breakdown of glucose into alcohol and carbon dioxide; and lactic acid due to anaerobic metabolism
  3. Breakdown of bone marrow causing a decrease in red blood cell production
  4. Massive blood transfusions causing lactic acid production

 

Question 2: The nurse is caring for a septic patient in metabolic acidosis. What clinical manifestations might the nurse expect to find with an increased lactic acid? SELECT ALL THAT APPLY

  1. Vomiting
  2. Lethargy
  3. Bradypnea
  4. Dizziness
  5. Violent Behavior

 

Question 3: The nurse is caring for an 87-year-old female presenting with septic shock in the ICU. What are some common medical management interventions for septic patients? SELECT ALL THAT APPLY

  1. IV antibiotic
  2. Vasopressors for hypotension
  3. IV fluid restriction
  4. Oxygen administration




 

LACTIC ACID NCLEX QUIZ ANSWERS

Question 1: The nurse is caring for 70-year-old patient diagnosed with sepsis from an untreated, infected foot wound. The patient is experiencing tachypnea, hypotension, and tachycardia. Upon assessment, the nurse notes the patient has a lactic acid of 6.0 mmol/L.  The nurse understands lactic acid production comes from

  1. Production of adenosine triphosphate through energy pathways that require oxygen
  2. Breakdown of glucose into alcohol and carbon dioxide; and lactic acid due to anaerobic metabolism
  3. Breakdown of bone marrow causing a decrease in red blood cell production
  4. Massive blood transfusions causing lactic acid production

Anaerobic metabolism of glucose leads to the accumulation of lactic acid and alcohol/carbon dioxide building resulting in metabolic acidosis. Lactic acid reacts with bicarbonate causing a serum fall in bicarbonate, resulting in base deficit.  

 

Question 2: The nurse is caring for a septic patient in metabolic acidosis. What clinical manifestations might the nurse expect to find with an increased lactic acid? SELECT ALL THAT APPLY

  1. Vomiting
  2. Lethargy
  3. Bradypnea
  4. Dizziness
  5. Violent Behavior

Signs of rising lactic acid levels include vomiting (most common sign), tachypnea, muscle weakness due to hyperkalemia, lethargy, confusion dizziness, and headache.

 

Question 3: The nurse is caring for an 87-year-old female presenting with septic shock in the ICU. What are some common medical management interventions for septic patients? SELECT ALL THAT APPLY

  1. IV antibiotic
  2. Vasopressors for hypotension
  3. IV fluid restriction
  4. Oxygen administration

Septic patients should receive IV antibiotics, vasopressors for hypotension, IV fluid resuscitation to improve perfusion to the tissues, oxygen administration, and sodium bicarbonate used in conjunction with other treatments.