Nokea
The nurse would anticipate which of the following arterial blood gas (ABG) results?
- A. pH 7.29, PCO2 56, PaO2 83, HCO3 22
- B. pH 7.38, PCO2 40, PaO2 92, HCO3 25
- C. pH 7.49, PCO2 30, PaO2 96, HCO3 28
- D. pH 7.50, PCO2 44, PaO2 93, HCO3 34
Correct Answer: A
Rationale: Acute respiratory failure causes CO2 retention and hypoxemia, leading to respiratory acidosis. Option A (pH 7.29, PaCO2 56, HCO3 22) reflects uncompensated respiratory acidosis.
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The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is currently receiving mechanical ventilation. After reviewing the client's arterial blood gas (ABG), the nurse identifies this ABG as Laboratory: pH 7.24 [7.35-7.45], PaCO2 48 mm Hg [35-45 mm Hg], HCO3 23 mEq/L [22-28 mEq/L], PaO2 90 mm Hg [80-100 mm Hg]
- A. metabolic alkalosis
- B. metabolic acidosis
- C. respiratory alkalosis
- D. respiratory acidosis
Correct Answer: D
Rationale: The ABG shows low pH (7.24) and elevated PaCO2 (48 mm Hg), indicating respiratory acidosis (D) due to CO2 retention, common in COPD. HCO3 is normal, suggesting no compensation.
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 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 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.
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.