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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.
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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 nurse interprets this ABG result as Laboratory: pH 7.62 [7.35-7.45], PaCO2 19 mmHg [35-45 mm Hg], HCO3- 24 mEq/L [22-28 mEq/L], PaO2 85 mmHg [80-100 mm Hg]
- A. compensated metabolic acidosis
- B. uncompensated metabolic acidosis
- C. compensated respiratory acidosis
- D. uncompensated respiratory alkalosis
Correct Answer: D
Rationale: High pH (7.62) and low PaCO2 (19 mm Hg) with normal HCO3- indicate uncompensated respiratory alkalosis (D) due to hyperventilation.
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.
The nurse in the emergency department (ED) is caring for a client with dyspnea and coughing up purulent sputum. The nurse reviews the arterial blood gas (ABG) results: pH 7.25 [7.35-7.45], PaO2 93 mmHg [80-100 mmHg], PaCO2 69 mmHg [35-45 mm Hg], HCO3 25 mmol/L [22-28 mEq/L]. The nurse should interpret these results to indicate that the client has
- A. respiratory alkalosis
- B. respiratory acidosis
- C. metabolic alkalosis
- D. metabolic acidosis
Correct Answer: B
Rationale: The ABG shows low pH (7.25) and high PaCO2 (69 mm Hg), indicating respiratory acidosis (B) due to CO2 retention, likely from impaired ventilation due to pneumonia.
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.