A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have?
pH 7.49, HCO3 24, PaCO2 30
pH 7.26, HCO3 24, PaCO2 46
pH 7.26, HCO3 14, PaCO2 30
pH 7.49, HCO3 30, PaCO2 40
The Correct Answer is C
Choice A Reason: This choice is incorrect because it indicates respiratory alkalosis, not AKI. Respiratory alkalosis is a condition in which the lungs eliminate too much carbon dioxide (CO2) from the blood, resulting in a low level of CO2 (PaCO2) and a high level of pH. A normal PaCO2 range is 35 to 45 mm Hg, and a normal pH range is 7.35 to 7.45, so a value of 30 mm Hg and 7.49 indicate respiratory alkalosis.
Choice B Reason: This choice is incorrect because it indicates respiratory acidosis, not AKI. Respiratory acidosis is a condition in which the lungs cannot eliminate enough CO2 from the blood, resulting in a high level of CO2 (PaCO2) and a low level of pH. A value of 46 mm Hg and 7.26 indicate respiratory acidosis.
Choice C Reason: This choice is correct because it indicates metabolic acidosis, which is a common complication of AKI. Metabolic acidosis is a condition in which the body produces too much acid or loses too much base, resulting in a low level of bicarbonate (HCO3) and a low level of pH. A normal HCO3 range is 22 to 26 mEq/L, so a value of 14 mEq/L indicates metabolic acidosis. The low PaCO2 value (30 mm Hg) is due to the respiratory compensation mechanism that tries to restore the acid-base balance by increasing the ventilation and eliminating more CO2.
Choice D Reason: This choice is incorrect because it indicates metabolic alkalosis, not AKI. Metabolic alkalosis is a condition in which the body loses too much acid or gains too much base, resulting in a high level of bicarbonate (HCO3) and a high level of pH. A value of 30 mEq/L and 7.49 indicate metabolic alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason: Equal amount of fluid drainage in each collection chamber is not a sign of proper chest tube function. The amount of fluid drainage depends on the type and extent of the client's injury or surgery, and may vary from one chamber to another.
Choice B Reason:Fluctuation of the fluid level in the water seal chamber(tidaling) indicates that the chest tube is functioning properly. This fluctuation corresponds with the client's respirations and shows that air or fluid is being effectively removed from the pleural space.
Choice C Reason:Continuous bubbling within the water seal chamber: Continuous bubbling in the water seal chamber indicates an air leak, which is not normal unless the client has a pneumothorax and air is being evacuated. Otherwise, it suggests a problem with the system.
Choice D Reason: Absence of fluid in the drainage tubing is not a sign of proper chest tube function. It may indicate that the chest tube is obstructed, kinked, or clamped, or that the suction is not working properly. The nurse should assess and troubleshoot the chest tube system.
Correct Answer is D
Explanation
Choice A: Eliciting the gag reflex is a way to assess cranial nerve IX (glossopharyngeal) and X (vagus), which are responsible for the sensation and motor function of the pharynx and larynx.
Choice B: Testing visual acuity is a way to assess cranial nerve II (optic), which is responsible for the sense of vision.
Choice C: Observing for facial symmetry is a way to assess cranial nerve VII (facial), which is responsible for the motor function of the facial muscles and the sensation of taste.
Choice D: Checking the pupillary response to light is a way to assess cranial nerve III (oculomotor), which is responsible for the motor function of most of the eye muscles, including those that control pupil size and lens shape.
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