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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.
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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.
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 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 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 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.