Nokea
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.
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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 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 of the following arterial blood gas (ABG) results would the nurse expect if the client's condition is left untreated?
- A. pH 7.50, PCO2 48, PaO2 70, HCO3 44, SaO2 88%
- B. pH 7.28, PCO2 53, PaO2 55, HCO3 28, SaO2 82%
- C. pH 7.36, PCO2 44, PaO2 66, HCO3 28, SaO2 84%
- D. pH 7.48, PCO2 48, PaO2 70, HCO3 24, SaO2 86%
Correct Answer: B
Rationale: Untreated ARDS causes severe hypoxemia and CO2 retention, leading to respiratory acidosis. Option B (pH 7.28, PaCO2 53, PaO2 55, SaO2 82%) reflects this.
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.
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.