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A client with severe bronchial pneumonia has been receiving oxygen, respiratory treatments, antibiotics, and intravenous fluids.
Which arterial blood gas result would indicate that the treatment has been effective?

A.

pH, 7.32; pCO2, 47 mm Hg; HCO3, 29 mEq/L; pO2, 80.

B.

pH, 7.34; pCO2, 49 mm Hg; HCO3, 27 mEq/L; pO2, 77.

C.

pH, 7.38; pCO2, 40 mm Hg; HCO3, 25 mEq/L; pO2, 88.

D.

pH, 7.48; pCO2, 43 mm Hg; HCO3, 23 mEq/L; pO2, 85.

Answer and Explanation

The Correct Answer is C

This is because it shows a normal pH, pCO2, HCO3 and pO2, indicating that the treatment has been effective in restoring normal gas exchange and acid- base balance.

Choice A is wrong because it shows a low pH, high pCO2 and high HCO3, indicating a mixed respiratory and metabolic acidosis.

Choice B is wrong because it shows a low pH, high pCO2 and low HCO3, indicating a combined respiratory and metabolic acidosis.

Choice D is wrong because it shows a high pH, low pCO2 and low HCO3, indicating a mixed respiratory and metabolic alkalosis.

The normal ranges for arterial blood gas (ABG) are:

  • pH: 7.35 – 7.45
  • pO2: 10 – 14 kPa or 75 – 105 mmHg
  • pCO2: 4.5 – 6 kPa or 34 – 45 mmHg


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Related Questions

Correct Answer is B

Explanation

This indicates that the client has a fluid volume deficit, which is consistent with the signs and symptoms of low urine output, weight gain, irritability, and headache. The normal range for serum osmolality is 275 to 295 mOsm/Kg.

Choice A is wrong because hemoglobin 15.3 mg/dL is within the normal range of 12 to 18 mg/dL and does not correlate with fluid imbalance.

Correct Answer is D

Explanation

Offer a glass of warm milk. According to some studies, warm milk may have a relaxing effect on the body and help induce sleep. It also contains tryptophan, an amino acid that is converted to serotonin and melatonin, which are neurotransmitters that regulate sleep cycles.

Choice A is wrong because a warm shower may increase the body temperature and make it harder to fall asleep.

Choice C is wrong because notifying the healthcare provider is not necessary for a client with insomnia unless there are other signs of distress or complications.

Choice D is wrong because watching television may stimulate the brain and interfere with the production of melatonin, a hormone that promotes sleep.

Some other nursing interventions for insomnia are:

  • Educate the patient on the proper food and fluid intake such as avoiding heavy meals, alcohol, caffeine, or smoking before bedtime.
  • Evaluate the patient’s sleep hygiene such as having a regular bedtime and wake-up time, avoiding naps during the day, and limiting exposure to light at night.
  • Provide a conducive environment for sleep such as reducing noise, adjusting temperature and lighting, and using comfortable bedding.
  • Help the patient develop a sleeping plan such as engaging in relaxing activities before bed, avoiding checking the clock, and getting out of bed if unable to sleep after 20 minutes.
  • Understand the proper use of sleep aids or other medications such as following the prescription, avoiding over-the-counter drugs without consulting the provider, and being aware of the side effects and interactions.

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