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The nurse should interpret these results to indicate that the client has Laboratory: pH 7.50 [7.35-7.45], PaCO2 28 mmHg [35-45 mm Hg], HCO3- 25 mEq/L [22-28 mEq/L]
- A. metabolic alkalosis
- B. respiratory acidosis
- C. respiratory alkalosis
- D. metabolic acidosis
Correct Answer: C
Rationale: High pH (7.50) and low PaCO2 (28 mm Hg) with normal HCO3- indicate respiratory alkalosis (C) due to hyperventilation.
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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 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.
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.
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.
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.