A nurse is caring for a client whose arterial blood gas results show the following results:. pH: 7.2. PaCO2: 50 mm Hg. HCO3: 24 mEq/L. The nurse should identify the client is experiencing which of the following acid-base conditions?
Respiratory acidosis.
Metabolic alkalosis.
Metabolic acidosis.
Respiratory alkalosis.
The Correct Answer is A
Choice A rationale:
The client's arterial blood gas (ABG) results indicate a low pH (acidemia) and high PaCO2, which is characteristic of respiratory acidosis. Respiratory acidosis occurs when there is inadequate removal of carbon dioxide (CO2) from the body, leading to an accumulation of CO2 and a decrease in pH. In this case, the high PaCO2 (50 mm Hg) indicates that the client is retaining carbon dioxide, likely due to impaired ventilation. The normal pH range is 7.35 to 7.45, and the normal PaCO2 range is 35 to 45 mm Hg. These ABG values reflect an acid-base imbalance in the respiratory system, specifically, respiratory acidosis.
Choice B rationale:
Metabolic alkalosis is characterized by an elevated pH and an increase in bicarbonate (HCO3) levels. This is not the condition described in the client's ABG results, as the pH is low (acidemic) and HCO3 levels are within the normal range (24 mEq/L).
Choice C rationale:
Metabolic acidosis is characterized by a low pH and a decreased HCO3 level. The client's ABG results do not align with metabolic acidosis since the pH is low (acidemic) and the HCO3 level is within the normal range (24 mEq/L).
Choice D rationale:
Respiratory alkalosis is characterized by a high pH and low PaCO2. The client's ABG results do not match this condition as the pH is low (acidemic) and the PaCO2 is high (50 mm Hg), indicating respiratory acidosis. Therefore, choice A, respiratory acidosis, is the correct interpretation of the ABG results.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is: C.
Choice A reason: A pH of 7.50 and HCO3 of 31 mm Hg suggest a metabolic alkalosis due to the high bicarbonate level. However, during a panic attack, hyperventilation leads to respiratory alkalosis, not metabolic, due to the excessive exhalation of CO2, which is not consistent with this option.
Choice B reason: A pH of 7.30 and HCO3 of 19 mm Hg indicate a metabolic acidosis due to the low bicarbonate level. This is not typically associated with hyperventilation during a panic attack, which usually causes respiratory alkalosis, characterized by a decrease in CO2 levels and an increase in pH.
Choice C reason: A pH of 7.47 and PaCO2 of 31 mm Hg are indicative of respiratory alkalosis, which is expected during hyperventilation as a result of a panic attack. Hyperventilation causes a decrease in carbon dioxide (PaCO2) levels, leading to an increase in pH. The normal ranges for arterial blood gases are: pH 7.35-7.45, PaCO2 35-45 mm Hg, and HCO3 22-26 mEq/L.
Choice D reason: A pH of 7.32 and PaCO2 of 50 mm Hg suggest respiratory acidosis due to the elevated PaCO2 level. This would be more consistent with hypoventilation, which is not the case during a panic attack where hyperventilation occurs.
Correct Answer is A
Explanation
Choice A rationale:
The nurse should instruct the client to discontinue the dose of acetylsalicylic acid (aspirin) 2 weeks before surgery. Aspirin is an antiplatelet medication that can increase the risk of bleeding during and after surgery. Discontinuing it before surgery helps reduce the risk of excessive bleeding during the procedure. The recommended time frame for discontinuation may vary based on the patient's surgical procedure and the surgeon's preferences. However, 2 weeks is a common guideline to ensure that the antiplatelet effects of aspirin have diminished.
Choice B rationale:
Decreasing the dose by half 2 weeks before surgery may not be sufficient to minimize the risk of bleeding associated with aspirin. It is generally recommended to discontinue the medication completely to ensure that the antiplatelet effect has worn off.
Choice C rationale:
Taking the originally prescribed dose of aspirin the week of surgery is not advisable because it can increase the risk of bleeding during the surgical procedure. It is important to discontinue aspirin well before the surgery.
Choice D rationale:
Doubling the dose of aspirin the week of surgery is contraindicated as it can significantly increase the risk of bleeding. This choice is not recommended in the context of preoperative management.
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