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The nurse is reviewing a client's arterial blood gas (ABG) results who has a nasogastric tube (NGT) attached to continuous suction. The ABG results reveal the following: pH 7.50 [7.35-7.45], PaCO2 42 mmHg [35-45 mm Hg], HCO3- 35 mEq/L [22-28 mEq/L]. The nurse should interpret these results to indicate that the client has
- A. respiratory acidosis
- B. respiratory alkalosis
- C. metabolic acidosis
- D. metabolic alkalosis
Correct Answer: D
Rationale: High pH (7.50) and elevated HCO3- (35 mEq/L) with normal PaCO2 indicate metabolic alkalosis (D), likely due to loss of gastric acid from NGT suction.
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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 should interpret these results to indicate that the client has? Laboratory: pH 7.30 [7.35-7.45], PaCO2 50 mmHg [35-45 mm Hg], HCO3- 24 mEq/L [22-28 mEq/L]
- A. Respiratory Acidosis
- B. Respiratory Alkalosis
- C. Metabolic Acidosis
- D. Metabolic Alkalosis
Correct Answer: A
Rationale: Low pH (7.30) and high PaCO2 (50 mm Hg) with normal HCO3- indicate uncompensated respiratory acidosis (A).
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.
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.
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.