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 D

Explanation

A. Gonorrhea: This is a sexually transmitted infection (STI) and is not specifically associated with CD4 count decline. Clients with low CD4 levels are more vulnerable to opportunistic infections rather than common STIs.
B. Hepatitis: Although clients with HIV are at increased risk for hepatitis B or C co-infection, hepatitis is not considered an opportunistic infection tied to a CD4 count below 200/mm³.
C. Chlamydia: Like gonorrhea, chlamydia is an STI and not opportunistic in nature. It can occur at any stage of HIV, regardless of CD4 count, and does not specifically correlate with immune suppression.
D. Tuberculosis: Tuberculosis is an opportunistic infection that becomes more likely when CD4 counts fall below 200/mm³. Clients with advanced HIV are at high risk for reactivation of latent TB or new infection due to compromised cellular immunity.

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

Correct Answer is A

Explanation

A. Respiratory acidosis: Clients with COPD have chronic difficulty exhaling carbon dioxide due to airflow obstruction, leading to CO₂ retention. This accumulation of carbon dioxide causes a drop in blood pH, resulting in respiratory acidosis, a common acid-base imbalance in COPD patients.
B. Metabolic acidosis: Metabolic acidosis results from increased acid production or loss of bicarbonate through the kidneys or gastrointestinal tract, such as in diabetic ketoacidosis or severe diarrhea. It is not typically associated with impaired ventilation or chronic lung disease like COPD.
C. Respiratory alkalosis: Respiratory alkalosis occurs when there is excessive loss of carbon dioxide due to hyperventilation. Clients with COPD generally hypoventilate rather than hyperventilate, making this acid-base imbalance unlikely in this case.
D. Metabolic alkalosis: Metabolic alkalosis is typically caused by loss of hydrogen ions through vomiting or diuretic use, or excessive bicarbonate intake. It is unrelated to the impaired gas exchange and CO₂ retention seen in clients with COPD.

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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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