A nurse is assessing a client who has hypoxemic respiratory failure. Which of the following findings should the nurse expect?

Pulmonary edema

Opioid toxicity

Myasthenia gravis

Flail chest

Answer and Explanation

The Correct Answer is A

A. Pulmonary edema: Pulmonary edema occurs when fluid accumulates in the lungs, impairing gas exchange and leading to hypoxemia. This condition is a common cause of hypoxemic respiratory failure, and patients often present with symptoms such as dyspnea, crackles on auscultation, and hypoxemia. The nurse would expect this finding in a client experiencing hypoxemic respiratory failure.
B. Opioid toxicity: Opioid toxicity can cause respiratory depression, but it typically leads to hypoventilation, which results in hypercapnic respiratory failure (elevated carbon dioxide levels) rather than hypoxemic respiratory failure. Therefore, while opioid toxicity affects breathing, it is not directly associated with hypoxemic respiratory failure.
C. Myasthenia gravis: Myasthenia gravis is a neuromuscular disorder that leads to muscle weakness, including respiratory muscles. While it can cause respiratory failure in severe cases, it does not directly cause hypoxemic respiratory failure. Respiratory failure in myasthenia gravis is often due to insufficient ventilation rather than impaired oxygenation, so this is not the expected finding in hypoxemic respiratory failure.
D. Flail chest: Flail chest occurs due to multiple rib fractures that result in a segment of the chest wall moving paradoxically, impairing ventilation. While this condition can lead to respiratory failure, it typically causes hypercapnic rather than hypoxemic respiratory failure. Therefore, it is less likely to be the cause of hypoxemic respiratory failure in this scenario.

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Correct Answer is C

Explanation

A. Treatment is not needed if the client is hemodynamically stable. Even if a client is hemodynamically stable, a pulmonary embolism still poses a serious risk of progression or recurrence and requires anticoagulation or other appropriate interventions to prevent complications or death.
B. Treatment is not needed if the client is asymptomatic. An asymptomatic pulmonary embolism is still clinically significant. Without treatment, clots can enlarge or lead to future embolic events. Thus, treatment is still warranted regardless of symptom presence.
C. Treatment is needed for all clients who have a pulmonary embolism. All clients with a diagnosed pulmonary embolism should receive prompt treatment, such as anticoagulants or thrombolytics depending on severity, to prevent morbidity and mortality from clot progression or recurrence.
D. Treatment is not needed if the pulmonary embolism is intermediate. Intermediate-risk pulmonary embolisms require medical management and close monitoring. Treatment decisions may vary, but anticoagulation is still generally indicated to avoid complications like right ventricular failure.

A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis, uncompensated D. Metabolic alkalosis, uncompensated

Correct Answer is C

Explanation

A. Respiratory acidosis: Respiratory acidosis is characterized by a high PaCO2 level due to hypoventilation or impaired lung function, which is not reflected in this ABG result. The pH of 7.30 indicates acidosis, but the normal PaCO2 of 40 mmHg suggests it is not respiratory in nature.
B. Respiratory alkalosis: Respiratory alkalosis involves a decrease in PaCO2, which is not present here. The PaCO2 of 40 mmHg is within normal range, ruling out this possibility.
C. Metabolic acidosis, uncompensated: The low HCO3- of 20 mEq/L and the pH of 7.30 indicate metabolic acidosis. Since there is no compensation by the lungs (i.e., PaCO2 is not lowered), this is considered uncompensated metabolic acidosis.
D. Metabolic alkalosis, uncompensated: Metabolic alkalosis would involve an elevated HCO3- level and a higher pH, which is not seen in this case. The HCO3- is low, supporting metabolic acidosis, not alkalosis.

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A nurse is assessing a client who has hypoxemic respiratory failure. Which of the following findings should the nurse expect?

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