Nokea
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.
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The nurse caring for a client in the intensive care unit (ICU) is reviewing the arterial blood gas (ABG) results, which reveal a PaO2 = 70 mm Hg [80-100 mm Hg]. On assessment, the client has labored breathing, tachypnea, and an altered mental status. The nurse should anticipate the physician will order
- A. intubation via endotracheal tube (ETT)
- B. 12-lead electrocardiogram (ECG)
- C. capillary blood glucose
- D. the insertion of an additional peripheral vascular access device (PVAD)
Correct Answer: A
Rationale: Low PaO2 (70 mm Hg) with labored breathing, tachypnea, and altered mental status suggests severe hypoxemia, warranting intubation (A) for airway protection and ventilation. ECG (B), glucose (C), and PVAD (D) do not address hypoxemia.
The nurse should recognize that the client is experiencing which acid-base imbalance? Laboratory: pH 7.30 [7.35-7.45], PaCO2 58 mm Hg [35-45 mm Hg], HCO3 29 mEq/L [22-28 mEq/L], PaO2 91 mm Hg [80-100 mm Hg]
- A. respiratory acidosis, partially compensated
- B. respiratory acidosis, fully compensated
- C. metabolic acidosis, partially compensated
- D. metabolic acidosis, fully compensated
Correct Answer: A
Rationale: Low pH (7.30) and high PaCO2 (58 mm Hg) indicate respiratory acidosis. Elevated HCO3- (29 mEq/L) suggests partial compensation (A), as pH is not normalized.
The nurse is reviewing the arterial blood gas results of a client with chronic obstructive pulmonary disease (COPD) reporting dyspnea. The ABG results: pH 7.18 [7.35-7.45], PaCO2 67 mmHg [35-45 mm Hg], HCO3-
- A. respiratory acidosis
- B. metabolic acidosis
- C. respiratory alkalosis
- D. metabolic alkalosis
Correct Answer: A
Rationale: Low pH (7.18) and high PaCO2 (67 mm Hg) indicate respiratory acidosis (A), common in COPD due to CO2 retention.
The nurse is working in the emergency department caring for a client with diabetic ketoacidosis (DKA). Which of the following arterial blood gas (ABG) results would be expected?
- A. pH = 7.50 [7.35-7.45]; PaO2 = 90 mm Hg [80-100 mm Hg]; PaCO2 = 37 mm Hg [35-45 mm Hg]; HCO3- = 31 mEq/L [22-28 mEq/L]
- B. pH = 7.31 [7.35-7.45]; PaO2 = 90 mm Hg [80-100 mm Hg]; PaCO2 = 56 mm Hg [35-45 mm Hg]; HCO3- = 23 mEq/L [22-28 mEq/L]
- C. pH = 7.51 [7.35-7.45]; PaO2 = 94 mm Hg [80-100 mm Hg]; PaCO2 = 31 mm Hg [35-45 mm Hg]; HCO3- = 24 mEq/L [22-28 mEq/L]
- D. pH = 7.31 [7.35-7.45]; PaO2 = 90 mm Hg [80-100 mm Hg]; PaCO2 = 37 mm Hg [35-45 mm Hg]; HCO3- = 15 mEq/L [22-28 mEq/L]
Correct Answer: D
Rationale: DKA causes metabolic acidosis due to ketone accumulation, lowering pH and HCO3-. Option D (pH 7.31, HCO3- 15 mEq/L) reflects uncompensated metabolic acidosis. Options A and C show alkalosis, and B shows respiratory acidosis.
The nurse would anticipate which of the following arterial blood gas (ABG) results?
- A. pH 7.29, PCO2 56, PaO2 83, HCO3 22
- B. pH 7.38, PCO2 40, PaO2 92, HCO3 25
- C. pH 7.49, PCO2 30, PaO2 96, HCO3 28
- D. pH 7.50, PCO2 44, PaO2 93, HCO3 34
Correct Answer: A
Rationale: Acute respiratory failure causes CO2 retention and hypoxemia, leading to respiratory acidosis. Option A (pH 7.29, PaCO2 56, HCO3 22) reflects uncompensated respiratory acidosis.