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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A potassium level of 2.9 mEq/L is below the normal range (typically 3.5-5.0 mEq/L). Abnormal potassium levels can affect cardiac function, leading to arrhythmias (irregular heartbeats), especially if the potassium level drops further or if there is rapid fluctuation. This is a critical finding that requires immediate attention from the surgical team to assess the client's cardiac status and determine if potassium replacement is needed before proceeding with surgery.
B. Creatinine levels are used to assess kidney function. A creatinine level of 1.2 mg/dL is within the normal range (typically 0.6-1.2 mg/dL). While kidney function is important to evaluate before surgery, this result is not immediately concerning enough to require an urgent call to the surgical team.
C. Hemoglobin levels are assessed to evaluate oxygen-carrying capacity of the blood. A hemoglobin level of 14.8 g/dL is within the normal range (typically 12-16 g/dL for women and 13-18 g/dL for men). This result indicates adequate oxygen-carrying capacity and does not require immediate communication with the surgical team.
D. Sodium levels are important for fluid balance and nerve function. A sodium level of 134 mEq/L is within the normal range (typically 135-145 mEq/L). While sodium levels should be monitored, this result is not critically abnormal and does not necessitate an urgent call to the surgical team.
Correct Answer is D
Explanation
A. A pH of 7.45 indicates alkalosis, not acidosis. In respiratory acidosis, the pH would be lower than normal (below 7.35) due to the accumulation of carbon dioxide.
B. A bicarbonate (HCO3-) level of 30 mEq/L is within the normal range (typically 22-26 mEq/L). Bicarbonate levels may be normal or slightly elevated in respiratory acidosis as a compensatory mechanism to buffer the excess acid.
C. Potassium levels can vary in respiratory acidosis but are not typically specified by a specific value. The level of potassium is more directly related to metabolic acid-base disturbances rather than respiratory acidosis.
D. An elevated PaCO2 level above 45 mm Hg indicates respiratory acidosis. In this scenario, a PaCO2 of 50 mm Hg suggests that the client is retaining carbon dioxide, leading to an acidotic state (lower pH).
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