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A client has a nasogastric (NG) tube placed during abdominal surgery. During postoperative convalescence, the nurse identifies that the client is manifesting a hand tremor, muscle twitching, and confusion. Which arterial blood gases consistent with metabolic alkalosis should the nurse report to the healthcare provider?

Reference Range pH 17.35 to 7.45]

PaCO2 135 to 45 mm Hg]

HCO3 [21 to 28 mEq/L or 21 to 28 mmol/L]

PaO2 [80 to 100 mm Hg]

pH 7.30, PCO, 20 mm Hg, HCO, 22 mEq/L (22 mmol/L), PO, 85 mm Hg.

pH 7.46, PCO, 55 mm Hg, HCO, 36 mEq/L (36 mmol/L), PO, 95 mm Hg.

pH 7.49, PCO, 45 mm Hg, HCO, 32 mEq/L (32 mmol), PO, 90 mm Hg.

pH 7.29, PCO, 35 mm Hg, HCO, 25 mEq/L (25 mmol/L), PO, 99 mm Hg.

Answer and Explanation

The Correct Answer is B

B. pH 7.46, PCO2 55 mm Hg, HCO3 36 mEq/L, PO2 95 mm Hg

The pH is high (alkalotic).

The HCO3 level is elevated, indicating metabolic alkalosis.

The PCO2 is high (respiratory acidotic picture due to secondary response). This option matches the criteria for metabolic alkalosis.

A. pH 7.30, PCO2 20 mm Hg, HCO3 22 mEq/L, PO2 85 mm Hg

The pH is low (acidic), not alkalotic.

The HCO3 level is within the normal range.

The PCO2 is low, which could indicate respiratory alkalosis. This option does not match the criteria for metabolic alkalosis.

C. pH 7.49, PCO2 45 mm Hg, HCO3 32 mEq/L, PO2 90 mm Hg The pH is high (alkalotic).

The HCO3 level is elevated, indicating metabolic alkalosis. The PCO2 is within the normal range.

This option does not meet the criteria for metabolic alkalosis D pH 7.29, PCO2 35 mm Hg, HCO3 25 mEq/L, PO2 99 mm Hg

The pH is low (acidic), not alkalotic. The HCO3 level is low, not elevated. The PCO2 is within the normal range.

This option does not match the criteria for metabolic alkalosis.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Isoniazid is an antitubercular medication commonly used in the treatment of active tuberculosis (TB). One of the primary goals of TB treatment is to reduce the symptoms associated with the infection, such as cough and sputum production.

B. While weight loss and decreased appetite can be symptoms of active tuberculosis, the goal of treatment with isoniazid is to improve symptoms and promote recovery.

C. A positive sputum smear and culture would indicate ongoing TB infection or treatment failure, rather than the effectiveness of isoniazid therapy.

D. Vertigo (dizziness) and tinnitus (ringing in the ears) are not typical side effects or outcomes associated with isoniazid therapy.

A. "I should use this medication in its handihaler every day." B. "I will use my other inhaler in between uses." C. "When I cough up sputum, the secretions should be less thick." D. "If I have sudden shortness of breath, I will use this inhaler."

Correct Answer is A

Explanation

A. Tiotropium is commonly delivered via a handihaler device for inhalation. Using the medication every day is consistent with the recommended dosing regimen for managing chronic obstructive pulmonary disease (COPD) symptoms.

B. While it's important for clients with COPD to have access to a rescue inhaler for sudden shortness of breath, it's also crucial for them to understand the specific instructions for using each medication.

C. Tiotropium is a long-acting bronchodilator that helps relax the airway muscles. It does not have direct effect on the thickness of mucus secretions.

D. While tiotropium can help prevent exacerbations and reduce the frequency of sudden shortness of breath, it is not typically used as a rescue inhaler for acute symptom relief.

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Naxlex Comprehensive Predictor Exams

The antitubercular drug isoniazid is prescribed for a client with active tuberculosis. To evaluate the effectiveness of this medication, which outcome can the nurse expect this client to exhibit?

Correct Answer is A

Explanation

A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new prescription for tiotropium via an inhalation device. Which statement indicates that the client understands the instructions for using this medication?

Correct Answer is A

Explanation

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