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 A
Explanation
The correct answer is choice A. Client has an NG tube to gastric suction.
Choice A rationale:
Having an NG tube to gastric suction can lead to hypokalemia because the suctioning process removes potassium from the stomach contents, leading to a decrease in serum potassium levels.
Choice B rationale:
While a history of alcohol abuse disorder can lead to various electrolyte imbalances, it is not the most direct cause of hypokalemia compared to gastric suction.
Choice C rationale:
Drinking 3.5 to 4 liters of water each day can lead to dilutional hyponatremia but is less likely to cause hypokalemia directly.
Choice D rationale:
Spironolactone is a potassium-sparing diuretic, which means it helps retain potassium in the body. Therefore, it is not a causative factor for hypokalemia.
Correct Answer is B
Explanation
The correct answer is choice B) Administering sodium polystyrene sulfonate.
Choice A rationale:
Administering a potassium-sparing diuretic is not appropriate for a client with hyperkalemia (high potassium levels). Potassium-sparing diuretics would further increase potassium levels, worsening the condition.
Choice B rationale:
Sodium polystyrene sulfonate is used to treat hyperkalemia. It works by exchanging sodium ions for potassium ions in the intestines, which helps to lower serum potassium levels by excreting it through the stool.
Choice C rationale:
Initiating an IV potassium infusion would be contraindicated in this situation as it would increase the already elevated potassium levels, potentially leading to dangerous cardiac complications.
Choice D rationale:
Encouraging the client to eat bananas is not advisable because bananas are high in potassium, which would exacerbate hyperkalemia.
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