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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.
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Which essential action should the nurse take based on the results? Laboratory: pH 7.30 [7.35-7.45], PaCO2 66 mm Hg [35-45 mm Hg], HCO3 23 mEq/L [22-28 mEq/L], PaO2 77 mm Hg [80-100 mm Hg]
- A. Review the most recent chest radiograph (x-ray)
- B. Apply supplemental oxygen
- C. Instruct the client how to use incentive spirometry
- D. Obtain a prescription to infuse sodium bicarbonate
Correct Answer: B
Rationale: The ABG indicates respiratory acidosis (pH 7.30, PaCO2 66 mm Hg) and hypoxemia (PaO2 77 mm Hg). Supplemental oxygen (B) addresses low PaO2. Chest radiograph (A) and incentive spirometry (C) are secondary. Sodium bicarbonate (D) is for metabolic acidosis, not respiratory.
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 should recognize that the client is experiencing Laboratory: pH 7.19 [7.35-7.45], PaCO2 36 mm Hg [35-45 mm Hg], HCO3 12 mEq/L [22-28 mEq/L], PaO2 90 mm Hg [80-100 mm Hg]
- A. compensated metabolic acidosis
- B. uncompensated metabolic acidosis
- C. compensated respiratory acidosis
- D. uncompensated respiratory alkalosis
Correct Answer: B
Rationale: Low pH (7.19) and low HCO3- (12 mEq/L) with normal PaCO2 indicate uncompensated metabolic acidosis (B). No compensation is evident as PaCO2 is normal.
The nurse reviews a client's arterial blood gas results. Based on the results, the nurse plans to obtain a physician's order to Laboratory: pH 7.33 [7.35-7.45], PaCO2 39 mm Hg [35-45 mm Hg], HCO3 24 mEq/L [22-28 mEq/L], PaO2 72 mm Hg [80-100 mm Hg]
- A. administer supplemental oxygen
- B. administer a benzodiazepine
- C. administer sodium bicarbonate intravenously
- D. reassess the ABG in two hours
Correct Answer: A
Rationale: The ABG shows normal pH and PaCO2 but low PaO2 (72 mm Hg), indicating hypoxemia. Supplemental oxygen (A) is needed. Benzodiazepines (B) are irrelevant, sodium bicarbonate (C) is for acidosis, and reassessing (D) delays treatment.
What arterial blood gas (ABG) values suggest this? pH 7.30 [pH 7.35-7.45], CO2 38 [PCO2 35-45 mm Hg], HCO3 18 mEq/L [HCO3 22-28 mEq/L]; pH 7.48 [pH 7.35-7.45], CO2 31 [PCO2 35-45 mm Hg], HCO3 24 [HCO3 22-28 mEq/L]; pH 7.42 [pH 7.35-7.45], CO2 36 [PCO2 35-45 mm Hg], HCO3 24 [HCO3 22-28 mEq/L]; pH 7.30 [pH 7.35-7.45], CO2 52 [PCO2 35-45 mm Hg], HCO3 29 [HCO3 22-28 mEq/L]
- A. pH 7.30, CO2 38, HCO3 18 mEq/L
- B. pH 7.48, CO2 31, HCO3 24
- C. pH 7.42, CO2 36, HCO3 24
- D. pH 7.30, CO2 52, HCO3 29
Correct Answer: D
Rationale: Respiratory acidosis is characterized by low pH and high PaCO2. Option D (pH 7.30, PaCO2 52, HCO3 29) shows respiratory acidosis with partial compensation.