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Based on the results, which of the following orders should the nurse anticipate the physician would order? Laboratory: pH 7.33 [7.35-7.45], PaCO2 53 mm Hg [35-45 mm Hg], HCO3 24 mEq/L [22-28 mEq/L], PaO2 95 mm Hg [80-100 mm Hg]
- A. supplemental oxygen
- B. bronchodilator
- C. regular insulin
- D. sodium polystyrene
Correct Answer: B
Rationale: The ABG shows respiratory acidosis (pH 7.33, PaCO2 53 mm Hg). Bronchodilators (B) improve ventilation, reducing PaCO2. Supplemental oxygen (A) is unnecessary as PaO2 is normal. Insulin (C) and sodium polystyrene (D) address metabolic issues, not respiratory acidosis.
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The nurse in the emergency department (ED) is caring for a client with dyspnea and coughing up purulent sputum. The nurse reviews the arterial blood gas (ABG) results: pH 7.25 [7.35-7.45], PaO2 93 mmHg [80-100 mmHg], PaCO2 69 mmHg [35-45 mm Hg], HCO3 25 mmol/L [22-28 mEq/L]. The nurse should interpret these results to indicate that the client has
- A. respiratory alkalosis
- B. respiratory acidosis
- C. metabolic alkalosis
- D. metabolic acidosis
Correct Answer: B
Rationale: The ABG shows low pH (7.25) and high PaCO2 (69 mm Hg), indicating respiratory acidosis (B) due to CO2 retention, likely from impaired ventilation due to pneumonia.
The nurse recognizes which of the following are potential causes of metabolic alkalosis? Select all that apply.
- A. Vomiting
- B. Diarrhea
- C. Antacids
- D. Starvation
- E. Hypokalemia
Correct Answer: A,C,E
Rationale: Metabolic alkalosis is caused by an increase in bicarbonate or loss of acid. Vomiting (A) leads to loss of gastric acid, increasing bicarbonate. Antacids (C) neutralize acid, raising bicarbonate levels. Hypokalemia (E) can cause hydrogen ion shifts, contributing to alkalosis. Diarrhea (B) causes bicarbonate loss, leading to acidosis, not alkalosis. Starvation (D) is associated with ketoacidosis, not alkalosis.
The nurse should interpret these results to indicate that the client has Laboratory: pH 7.50 [7.35-7.45], PaCO2 28 mmHg [35-45 mm Hg], HCO3- 25 mEq/L [22-28 mEq/L]
- A. metabolic alkalosis
- B. respiratory acidosis
- C. respiratory alkalosis
- D. metabolic acidosis
Correct Answer: C
Rationale: High pH (7.50) and low PaCO2 (28 mm Hg) with normal HCO3- indicate respiratory alkalosis (C) due to hyperventilation.
The nurse interprets this ABG result as Laboratory: pH 7.59 [7.35-7.45], PaCO2 30 mmHg [35-45 mm Hg], HCO3- 24 mEq/L [22-28 mEq/L], PaO2 85 mmHg [80-100 mm Hg]
- A. Metabolic acidosis
- B. Respiratory acidosis
- C. Metabolic alkalosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: High pH (7.59) and low PaCO2 (30 mm Hg) with normal HCO3- indicate uncompensated respiratory alkalosis (D).
The nurse cares for a client receiving mechanical ventilation and reviews the client's most recent arterial blood gas (ABG). The nurse communicates the result with the primary healthcare provider (PHCP) and should recommend a prescription for which medication? Laboratory: pH 7.33 [7.35-7.45], PaCO2 53 mm Hg [35-45 mm Hg], HCO3 24 mEq/L [22-28 mEq/L], PaO2 89 mm Hg [80-100 mm Hg]
- A. pancuronium
- B. midazolam
- C. theophylline
- D. famotidine
Correct Answer: C
Rationale: The ABG shows respiratory acidosis (pH 7.33, PaCO2 53 mm Hg) due to hypoventilation. Theophylline (C) improves respiratory drive and ventilation. Pancuronium (A) and midazolam (B) suppress ventilation, worsening acidosis. Famotidine (D) addresses gastric issues, not respiratory.