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.

Answer and Explanation

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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Correct Answer is B

Explanation

Choice A rationale:
A client who takes glyburide for type 2 diabetes mellitus is not at significant risk for developing digoxin toxicity. Glyburide is an antidiabetic medication and does not interact directly with digoxin.

Choice B rationale: Furosemide, a loop diuretic, can cause electrolyte imbalances such as hypokalemia (normal potassium levels: 3.5 to 5.0 mEq/L) and hypomagnesemia (normal magnesium levels: 1.7 to 2.2 mg/dL). These imbalances increase the sensitivity to digoxin and the risk of toxicity. Digoxin toxicity is associated with symptoms like nausea, vomiting, and arrhythmias. Furosemide's impact on electrolytes makes it a significant risk factor for digoxin toxicity.

Choice C rationale: Cimetidine, a histamine H2 receptor antagonist, can inhibit the metabolism of certain drugs by affecting liver enzymes. However, it does not significantly alter digoxin levels or increase the risk of toxicity. Normal liver enzyme levels include ALT (7 to 56 U/L) and AST (10 to 40 U/L). While cimetidine may interact with other medications, its effect on digoxin is minimal.

Choice D rationale:
A client who takes azelastine for allergic rhinitis is not at significant risk for developing digoxin toxicity. Azelastine is an antihistamine and does not interact directly with digoxin.

A. Withhold the digoxin dose for decreased heart rate. B. Administer digoxin 0.25 mg. C. Administer digoxin 0.125 mg. D. Withhold the digoxin dose for elevated BP. .

Correct Answer is A

Explanation

Choice A rationale:

Withholding the digoxin dose for a decreased heart rate is the correct action. Digoxin is a medication used to treat heart failure, but it can lead to bradycardia (slow heart rate) as a side effect. In this scenario, the client's heart rate is already at 54 beats per minute, which is below the normal range. Administering digoxin could further slow the heart rate, potentially leading to dangerous bradycardia or heart block. Withholding the medication is essential to prevent this adverse event.

Choice B rationale:

Administering digoxin 0.25 mg is not the appropriate action in this case. The client's heart rate is already below the normal range, and giving the full dose of digoxin could further depress the heart rate and increase the risk of bradycardia. Withholding the medication is the safer course of action.

Choice C rationale:

Administering digoxin 0.125 mg is not recommended because the client's heart rate is already below the normal range. While a reduced dose may be considered in some situations, it's essential to withhold the medication and consult with the healthcare provider in this specific case, as the client's heart rate is significantly low.

Choice D rationale:

Withholding the digoxin dose for elevated BP is not the appropriate action. Digoxin is primarily used to treat heart failure by increasing the force of cardiac contractions. Elevated blood pressure is not an indication to withhold digoxin. The focus should be on addressing the low heart rate in this scenario. .

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is reviewing the laboratory results of four clients who take digoxin. Which of the following clients is at risk for developing digoxin toxicity?

Correct Answer is B

Explanation

A nurse is caring for a client who has a prescription for digoxin 0.25 mg P.O. daily for heart failure.The client's current vital signs are: BP 144/96, heart rate 54/min, respirations 18/min, and temperature 37°C (98.6°F). Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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