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 B

Explanation

A. "Discussing organ donation with the family": While organ donation is important, it is not the priority in the setting of an actively dying client. The primary concern at this stage should be addressing the immediate needs of the client and their family, focusing on emotional support and comfort.
B. "Communicating sensitively with the client and family.": When caring for a client who is actively dying, providing emotional support and clear communication with the family is critical. Sensitively addressing the family’s concerns and the client’s comfort is essential in this stage of care.
C. "Creating a plan for pain relief, nutrition, and hydration.": While ensuring pain relief is important, in the context of an actively dying patient, the focus should primarily be on comfort rather than ongoing interventions like nutrition and hydration, which may no longer be beneficial.
D. "Contacting the family's spiritual advisor.": While spiritual support is valuable, it should not be the first priority. Ensuring the client’s comfort and providing emotional support to the family should be prioritized initially, and the spiritual advisor can be contacted afterward if desired.

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

Correct Answer is B

Explanation

A. Metabolic alkalosis: This condition is characterized by an elevated pH above 7.45 and an increased bicarbonate level. In this case, the pH is low and the HCO₃⁻ is also decreased, ruling out metabolic alkalosis.
B. Metabolic acidosis, uncompensated: A pH of 7.25 indicates acidemia, and a bicarbonate level of 16 mEq/L confirms a metabolic origin. The PaCO₂ is normal at 40 mmHg, indicating that respiratory compensation has not yet occurred, making this an uncompensated metabolic acidosis.
C. Respiratory acidosis: Respiratory acidosis involves a low pH and elevated PaCO₂ due to hypoventilation. This client’s PaCO₂ is within normal range, so respiratory causes can be ruled out.
D. Respiratory alkalosis, partially compensated: This condition presents with a high pH and low PaCO₂, typically due to hyperventilation. The client has an acidic pH and a normal PaCO₂, which does not support respiratory 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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