Nokea
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.
You may also like to solve these questions
The emergency department (ED) nurse cares for a client who reports persistent nausea and vomiting for three days. Which acid-base imbalance would the nurse expect based on the client's manifestations?
- A. A decreased pH and an elevated CO2
- B. An elevated pH and a decreased CO2
- C. A decreased pH and a decreased HCO3-
- D. An increased pH with an increased HCO3-
Correct Answer: D
Rationale: Persistent vomiting causes loss of gastric acid, increasing HCO3- and pH, leading to metabolic alkalosis (D).
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 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).
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.
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.