A nurse is caring for a client in the emergency department (ED) who has high anxiety and shallow respirations at a rate of 30/min. Which of the following acid-base disturbances is the client most likely experiencing?

Respiratory acidosis

Respiratory alkalosis

Metabolic acidosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is B

A. Respiratory acidosis occurs due to hypoventilation, resulting in carbon dioxide retention. This condition is characterized by slow, shallow breathing and confusion, which is not consistent with the client's rapid respiratory rate of 30/min.
B. Respiratory alkalosis is typically caused by hyperventilation, where excessive breathing leads to a decrease in carbon dioxide levels. The client's symptoms of high anxiety and rapid, shallow respirations are indicative of hyperventilation, making respiratory alkalosis the most likely diagnosis.
C. Metabolic acidosis is characterized by deep, rapid breathing (Kussmaul respirations) as the body attempts to expel excess acid. The client's shallow respirations are inconsistent with the breathing pattern seen in metabolic acidosis.
D. Metabolic alkalosis usually presents with symptoms such as dizziness and tingling, often with compensatory slow respirations. The rapid respiratory rate in this case does not suggest metabolic alkalosis, making this option unlikely.

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Correct Answer is D

Explanation

A. Respiratory alkalosis: This condition is characterized by a high pH and low PaCO2. In this case, the pH is low and PaCO2 is high, indicating that respiratory alkalosis is not present.

B. Metabolic acidosis: Metabolic acidosis is indicated by a low pH and a low bicarbonate level. Here, the pH is low but the bicarbonate level is normal, so metabolic acidosis is not the primary diagnosis.

C. Metabolic alkalosis: This condition involves a high pH and elevated bicarbonate. The pH in this case is low, so metabolic alkalosis is not present.

D. Respiratory acidosis: Respiratory acidosis is indicated by a low pH and high PaCO2. The client's pH is 7.22 (acidic) and PaCO2 is 68 mm Hg (elevated), which is consistent with respiratory acidosis. The bicarbonate level is normal, indicating that there is no significant metabolic compensation yet.

A. Oral antibiotics B. Oral decongestants C. Nasal saline irrigation D. Intranasal corticosteroids

Correct Answer is D

Explanation

A. Oral antibiotics: Antibiotics are not indicated for allergic rhinitis, as it is an allergic condition rather than an infection.
B. Oral decongestants: While decongestants can provide temporary relief from nasal congestion, they can also cause rebound congestion if used for prolonged periods.
C. Nasal saline irrigation: Nasal saline irrigation can help to clear out mucus and allergens but is not a primary treatment for allergic rhinitis.
D. Intranasal corticosteroids: Intranasal corticosteroids are the most effective treatment for allergic rhinitis, as they reduce inflammation in the nasal passages and help to alleviate symptoms.

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A nurse is caring for a client in the emergency department (ED) who has high anxiety and shallow respirations at a rate of 30/min. Which of the following acid-base disturbances is the client most likely experiencing?

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Correct Answer is D

Explanation

Exhibits Which of the following is the most appropriate treatment strategy for this patient, who is likely experiencing allergic rhinitis?

Correct Answer is D

Explanation

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