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A healthcare professional is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following findings should the healthcare professional expect?
- A. HCO3- 30 mEq/L
- B. PaCO2 50 mm Hg
- C. pH 7.45
- D. Potassium 3.3 mEq/L
Correct Answer: B
Rationale: In respiratory acidosis, the primary disturbance is an increase in PaCO2 levels above the normal range of 35-45 mm Hg. Option B, PaCO2 50 mm Hg, indicates an elevated partial pressure of carbon dioxide, which is consistent with respiratory acidosis. Options A, C, and D are not directly indicative of respiratory acidosis. HCO3- (Option A) is more related to metabolic acidosis or alkalosis, pH (Option C) is within the normal range indicating no acid-base imbalance, and potassium (Option D) levels are not specific to respiratory acidosis.
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A nurse is caring for four clients. For which of the following clients should the nurse auscultate the fetal heart rate during the prenatal visit?
- A. A client who has an ultrasound that confirms a molar pregnancy
- B. A client who has a crown-rump length of 7 weeks gestation
- C. A client who has a positive urine pregnancy test 1 week after missed menses
- D. A client who has felt quickening for the first time
Correct Answer: B
Rationale: The nurse should auscultate the fetal heart rate during the prenatal visit for the client who has a crown-rump length of 7 weeks gestation. At this stage, the fetal heart is usually visible on ultrasound, and auscultating the fetal heart rate can provide valuable information about the health and development of the fetus. It is an important part of prenatal care to monitor the fetal heart rate regularly to ensure the well-being of the baby. In the other scenarios provided:
The nurse is monitoring a client in labor who is receiving oxytocin. What finding requires immediate intervention?
- A. Contractions lasting 90 seconds.
- B. Contractions every 2–3 minutes.
- C. Fetal heart rate of 100 beats/minute.
- D. Maternal heart rate of 85 beats/minute.
Correct Answer: C
Rationale: A fetal heart rate of 100 bpm indicates bradycardia, which may signify fetal distress and requires immediate action.
A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, PaCO2 68 mm Hg, Base excess -2, PaO2 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L
- A. Respiratory acidosis
- B. Metabolic acidosis
- C. Metabolic alkalosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: The ABG values provided indicate respiratory acidosis. In respiratory acidosis, there is an increase in PaCO2 above the normal range (35-45 mm Hg) leading to a decrease in pH (<7.35). In this case, the pH is 7.22 (below normal) with an elevated PaCO2 of 68 mm Hg. The other values do not suggest metabolic acidosis (which would typically show low bicarbonate levels) or metabolic alkalosis. Therefore, the correct interpretation of the ABGs is respiratory acidosis.
The nurse is assessing a client with ruptured membranes. What finding suggests chorioamnionitis?
- A. Clear amniotic fluid.
- B. Foul-smelling vaginal discharge.
- C. Fetal heart rate of 140 beats/minute.
- D. Absence of maternal fever.
Correct Answer: B
Rationale: Foul-smelling discharge is a key indicator of chorioamnionitis, an infection of the amniotic fluid.
Platypelloid pelvis
- A. Places the client as risk for dystocia
- B. Has an increased probability of cesarean section
- C. Has a flat shape that may impede fetal descent
- D. A Gynecoid pelvis is roomy and ideal for vaginal birth. An Anthropoid pelvis has an oval shape, and an android pelvis is heart shape.
Correct Answer: A
Rationale: A platypelloid pelvis is characterized by a flat shape with a shortened anteroposterior diameter, which can impede fetal descent during labor. This pelvic type is associated with an increased risk of dystocia, which is difficulty in childbirth due to inadequate progress of labor. The flat shape of the pelvis may lead to improper positioning of the baby, making it challenging for the fetus to navigate through the birth canal. This can result in prolonged labor, increased risk of birth injuries, and potential complications for both the mother and the baby. In some cases, it may necessitate interventions such as labor induction or cesarean delivery to ensure a safe outcome for the mother and the baby.