A nurse has been assigned to care for a client diagnosed with a small bowel obstruction. The client has a nasogastric tube attached to suction for 2 days. Which arterial blood gas result will the nurse expect to see for this client?

Metabolic alkalosis

Respiratory acidosis

Metabolic acidosis

Respiratory alkalosis

Answer and Explanation

The Correct Answer is A

A.   This condition occurs because the suctioning can lead to a significant loss of hydrochloric acid from the stomach. Since hydrochloric acid is one of the components that maintain the acid-base balance in the body, its loss can lead to an increase in blood pH, causing alkalosis
B.   Respiratory acidosis occurs due to retention of carbon dioxide (CO2), leading to an increase in PaCO2 and a decrease in pH. In the context of a small bowel obstruction with nasogastric tube suctioning, this is less likely unless there are concurrent respiratory issues.
C.   This condition occurs because the suctioning can lead to a significant loss of hydrochloric acid from the stomach. Since hydrochloric acid is one of the components that maintain the acid-base balance in the body, its loss can lead to an increase in blood pH, causing alkalosis. Acidosis is, therefore, unlikely.
D.   Respiratory alkalosis occurs due to hyperventilation, leading to a decrease in PaCO2 and an increase in pH. This is less likely in the context of nasogastric tube suctioning unless there are other contributing factors.

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Correct Answer is A

Explanation

A. Metabolic acidosis is characterized by a low pH (<7.35) and a decreased bicarbonate (HCO3) level (<22 mEq/L). The ABG results show a pH of 7.30 and HCO3 of 18 mEq/L, which are consistent with metabolic acidosis. The low HCO3 indicates that there is an accumulation of acids or loss of bicarbonate in the blood.
B. Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate level (>26 mEq/L). The ABG results show a low pH and low HCO3, which do not support metabolic alkalosis.
C. Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). The pH in this scenario is low (7.30), which does not align with respiratory alkalosis.
D. Respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2 (>45 mm Hg). While the pH is low, indicating acidosis, the PaCO2 in this case is low (28 mm Hg), which does not support respiratory acidosis.

A. "I will give you some ice chips instead of a drink of water". B. "I have to assess your gag reflex before giving you any food or water". C. "I will call the primary health care provider and request an order for food and water". D. "Let's try having a small sip of water to see if you can swallow".

Correct Answer is B

Explanation

A. Offering ice chips, might seem like a safe alternative, but it still poses a risk if the gag reflex is not intact.
B. Assessing the gag reflex is crucial before offering food or fluids to ensure the client can protect their airway and swallow safely. This response prioritizes safety and is appropriate to ensure the client does not aspirate.
C. Calling the healthcare provider to request orders for food and water may be necessary if there are specific protocols or if the client's condition requires further assessment or interventions before oral intake can be resumed. However, this response does not address the immediate need for comfort and hydration.
D. This response involves assessing the client's ability to swallow directly. While it addresses the client's request for water, it may not be the safest initial approach without first assessing the client's readiness and ability to swallow safely.

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A nurse has been assigned to care for a client diagnosed with a small bowel obstruction. The client has a nasogastric tube attached to suction for 2 days. Which arterial blood gas result will the nurse expect to see for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has the following arterial blood gas results: HCO3 18 mEq, PaCO2 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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