A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, PacO₂ 68 mm Hg, Base excess -2, PaO₂ 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L.
Metabolic alkalosis.
Respiratory acidosis.
Metabolic acidosis.
Respiratory alkalosis.
The Correct Answer is B
Respiratory acidosis.
Choice A rationale:
Metabolic alkalosis occurs when there is an increase in pH and bicarbonate (HCO₃⁻) levels, which is not the case here. The pH value in this scenario is 7.22, indicating acidosis.
Choice B rationale:
Respiratory acidosis results from the retention of carbon dioxide (PaCO₂) in the blood, leading to a decrease in pH. In this case, the pH is low (7.22), and the PacO₂ is elevated (68 mm Hg), supporting the diagnosis of respiratory acidosis.
Choice C rationale:
Metabolic acidosis is characterized by a decrease in pH and bicarbonate levels, along with a possible negative base excess. However, in this scenario, the base excess is -2, which does not indicate metabolic acidosis.
Choice D rationale:
Respiratory alkalosis occurs when there is a decrease in PaCO₂, leading to an increase in blood pH. The ABG values provided (pH 7.22, PacO₂ 68 mm Hg) are not consistent with respiratory alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Digoxin. Choice A rationale:
Potassium chloride (KCL) is a supplement used to treat or prevent low potassium levels. While it can have side effects, visual disturbances are not typically associated with KCL. Therefore, it is not the medication the nurse suspects to be causing the problem.
Choice B rationale:
Warfarin (Coumadin) is an anticoagulant used to prevent blood clot formation. Visual disturbances are not a known side effect of warfarin. Therefore, it is unlikely to be the cause of the patient's symptoms.
Choice C rationale:
Aspirin (ASA) is a pain reliever and antiplatelet medication, and while it can cause visual disturbances in some cases, it is not a common or significant side effect. Aspirin is also not specifically linked to atrial fibrillation.
Choice D rationale:
Digoxin (Lanoxin) is used to treat atrial fibrillation and heart failure. Visual disturbances are a known side effect of digoxin toxicity. Given the patient's diagnosis of atrial fibrillation and the reported symptoms, the nurse suspects the problem lies with digoxin and should further investigate and report to the provider.
Correct Answer is C
Explanation
Choice A rationale:
While acute renal failure can affect phosphorus levels, potassium is the electrolyte most commonly affected in this condition. Kidneys play a crucial role in regulating potassium levels in the body, and when they fail, potassium levels can become dangerously elevated.
Choice B rationale:
Acute renal failure can lead to alterations in magnesium levels, but potassium is typically more affected. Magnesium imbalances may occur but are not the primary concern in this condition.
Choice C rationale:
As mentioned earlier, potassium imbalances are common in acute renal failure. The nurse should closely monitor the patient's potassium levels and be prepared to intervene if they become too high or too low.
Choice D rationale:
Calcium levels may also be affected in acute renal failure, but potassium remains the most critical electrolyte to monitor in this condition.
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