A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 88 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement?
Reference Range:
Arterial Blood Gas (ABG)
pH Adult/child: 7.35 to 7.45]
PaCO2 [Adult/child: 35 to 45 mm Hg]
HCO-[Adult/child: 21 to 28 mEq/L (21 to 28 mmol/L)]
Increase ventilator tidal volume.
Decrease expiratory flow time.
Decrease expiratory pressure.
Increase rate of ventilation.
The Correct Answer is D
A. Increasing the ventilator tidal volume could improve the client's ventilation but may not adequately address the severe hypercapnia indicated by the elevated PaCO2.
B. Decreasing expiratory flow time is not a priority and may not improve ventilation effectively.
C. Decreasing expiratory pressure does not directly address the underlying problem of carbon dioxide retention.
D. Increasing the rate of ventilation is the most appropriate intervention to improve carbon dioxide elimination and correct the acid-base imbalance indicated by the low pH and high PaCO2.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Notifying the healthcare provider about allergies to iodine or shellfish is crucial, as IVP contrast agents often contain iodine, and allergic reactions can occur. This is a safety measure that can prevent adverse reactions.
B. While keeping the legs straight may be necessary during the procedure, there is no requirement for them to be kept straight for 6 to 8 hours afterward.
C. While hydration is important, the focus should be on hydration after the procedure to help flush out the contrast material rather than specifically drinking large volumes before the procedure.
D. Inserting an indwelling urinary catheter is not routinely required for IVP unless specified by the healthcare provider; preparation usually focuses on the client’s hydration and allergy history.
Correct Answer is B
Explanation
A. While close living quarters may contribute to disease spread, it is not the most direct source of contamination related to diarrhea.
B. Drinking water contaminated by sewage is a significant concern during disasters, often leading to gastrointestinal illnesses such as diarrhea due to pathogens.
C. Nosocomial transmission is less likely in a disaster medical area if proper infection control measures are in place.
D. Food contamination from floodwaters is a possibility, but drinking contaminated water poses a more immediate and severe risk for diarrhea.
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