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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Vancomycin is primarily excreted by the kidneys, and monitoring serum creatinine levels helps assess renal function. Impaired renal function can affect vancomycin clearance and increase the risk of toxicity.
A. Measuring oxygen saturation is not directly related to the administration of vancomycin for Clostridium difficile infection.
B. Assessing body temperature may not be the most pertinent action before administering vancomycin for Clostridium difficile infection.
C. Auscultating bowel sounds is also not directly related to the administration of vancomycin for Clostridium difficile infection.
Correct Answer is A
Explanation
A Hematemesis refers to vomiting blood, which can occur when esophageal varices rupture and bleed into the gastrointestinal tract. It is a hallmark sign of upper gastrointestinal bleeding and requires immediate medical attention. Monitoring for hematemesis allows for early detection of variceal bleeding and prompt intervention to prevent further complications.
B Brown, foamy urine may indicate the presence of blood or protein in the urine, which can occur in various kidney and urinary tract disorders.
C Clay-colored stool may indicate a lack of bile in the stool, which can occur in conditions affecting the liver or bile ducts, such as obstructive jaundice.
D Anorexia, or loss of appetite, is a common symptom in clients with chronic liver disease, including cirrhosis. However, while anorexia may impact nutritional status and overall health, it is not directly related to the complications of esophageal varices.
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