A nurse is assisting with the care of a client who has chronic obstructive pulmonary disease (COPD) and is short of breath. When reviewing the client's arterial blood gases (ABGs), which of the following conditions should the nurse anticipate the client to be experiencing?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
The Correct Answer is A
A. Respiratory acidosis: COPD often results in impaired gas exchange and decreased removal of carbon dioxide, leading to its accumulation in the blood. This results in respiratory acidosis, characterized by elevated PaCO2 and a decreased pH.
B. Respiratory alkalosis: This condition is generally associated with hyperventilation, where excessive loss of carbon dioxide leads to a higher blood pH. It is less common in COPD, where hypoventilation is more typical.
C. Metabolic acidosis: While COPD can sometimes lead to metabolic acidosis, it is not the primary condition associated with the disease. Metabolic acidosis usually results from conditions affecting the kidneys or metabolic processes.
D. Metabolic alkalosis: This is characterized by an increased blood pH due to a loss of acid or an excess of bicarbonate. It is not typically associated with COPD.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Respiratory alkalosis: Respiratory alkalosis is generally associated with hyperventilation and is not directly caused by tension pneumothorax. In tension pneumothorax, the primary issues are related to pressure changes within the thoracic cavity, not respiratory alkalosis.
B. Increased venous return: In tension pneumothorax, venous return is actually decreased due to the increased intrathoracic pressure compressing the great vessels, which impedes blood flow back to the heart.
C. Decreased cardiac output: Tension pneumothorax causes a significant increase in intrathoracic pressure, leading to compression of the heart and great vessels, which results in decreased venous return and ultimately decreased cardiac output. This is a critical and life-threatening consequence of tension pneumothorax.
D. Dilated ventricles: Dilated ventricles are more commonly seen in chronic heart conditions such as heart failure, rather than in acute tension pneumothorax. Tension pneumothorax typically results in reduced ventricular filling rather than dilation.
Correct Answer is D
Explanation
A. Impaired carbon dioxide elimination due to shunting: In ARDS, shunting can impair oxygenation but not directly carbon dioxide elimination. Shunting refers to blood flow through areas of the lung that are not ventilated properly, primarily affecting oxygenation.
B. Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch: ARDS is typically associated with increased, not decreased, pulmonary arterial pressure due to the inflammatory process and reduced lung compliance. V/Q mismatch in ARDS usually results in elevated pulmonary arterial pressure.
C. Hypoxemia due to dead space: ARDS hypoxemia results from impaired gas exchange in damaged alveoli rather than dead space, which is more related to ventilation without perfusion.
D. Decreased pulmonary compliance due to stiffness: ARDS is characterized by decreased pulmonary compliance, which is due to the stiffening of lung tissue from inflammation and edema. This stiffness makes lung expansion more difficult and is a key feature of ARDS.
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