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

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A Reason: This choice is incorrect because furosemide is a diuretic that helps to reduce ﬂuid retention and edema. It may be used for clients who have heart failure or hypertension, but it does not treat pulmonary embolism.

Choice B Reason: This choice is correct because heparin is an anticoagulant that helps to prevent blood clots from forming or growing larger. It may be used for clients who have pulmonary embolism, which is a blockage of a pulmonary artery by a blood clot that usually originates from a deep vein thrombosis (DVT). Heparin can reduce the risk of complications such as pulmonary infarction or death.

Choice C Reason: This choice is incorrect because dexamethasone is a corticosteroid that helps to reduce inﬂammation and immune response. It may be used for clients who have allergic reactions, asthma, or autoimmune diseases, but it does not treat pulmonary embolism.

Choice D Reason: This choice is incorrect because epinephrine is a sympathomimetic that helps to stimulate the heart and blood vessels. It may be used for clients who have cardiac arrest, anaphylaxis, or severe asthma, but it does not treat pulmonary embolism.

Choice E Reason: This choice is incorrect because atropine is an anticholinergic that helps to block the eﬀects of acetylcholine on the heart and smooth muscles. It may be used for clients who have bradycardia, atrioventricular block, or organophosphate poisoning, but it does not treat pulmonary embolism.

A. Contact the provider for further orders. B. Notify the blood bank of the discrepancy. C. Administer the blood as ordered. D. Complete an incident report.

Correct Answer is C

Explanation

Choice A: Contacting the provider for further orders is not necessary, because the client has type AB blood, which is compatible with any other blood type. The client can receive type B blood without any adverse reactions.

Choice B: Notifying the blood bank of the discrepancy is not required, because there is no discrepancy. The blood bank sent the correct type of blood for the client, according to their blood type.

Choice C: Administering the blood as ordered is the correct action, because type B blood is compatible with type AB blood. The client will not have any transfusion reactions or complications from receiving this type of blood.

Choice D: Completing an incident report is not appropriate, because there is no incident. The nurse did not make any error or mistake in administering the blood to the client. There is no need to document or report anything unusual.

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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?

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