A nurse is collecting data from a client who has pneumonia and is experiencing acute respiratory acidosis. Which of the following manifestations should the nurse expect to find?

Circumoral numbness and tingling

Muscle flaccidity

Decreased level of consciousness

Cool, clammy skin

Answer and Explanation

The Correct Answer is C

Acute respiratory acidosis occurs when there is inadequate excretion of carbon dioxide due to respiratory dysfunction, leading to an increase in carbon dioxide levels (hypercapnia) and subsequent acidosis (decrease in pH).

Manifestations of acute respiratory acidosis include:

A. Circumoral numbness and tingling - This is associated with respiratory alkalosis, not acidosis. B. Muscle flaccidity - This is more commonly seen in hyperkalemia or conditions affecting neuromuscular transmission. C. Decreased level of consciousness - This is a key manifestation of acute respiratory acidosis due to the effects of hypercapnia on the central nervous system. D. Cool, clammy skin - This is not typically associated with acute respiratory acidosis; instead, it might be seen in shock or hypoperfusion states.

Therefore, the nurse should expect to find a decreased level of consciousness in a client experiencing acute respiratory acidosis.

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Correct Answer is A

Explanation

(A) Place the client in high-Fowler’s position and encourage the use of incentive spirometer and coughing: This is the most appropriate action. The high-Fowler’s position can help improve lung expansion and gas exchange, while the use of an incentive spirometer and coughing can help clear secretions and improve ventilation. This is particularly important for a client who is postoperative following an open thoracotomy.

(B) Switch oxygen to a nonrebreather mask: Switching to a nonrebreather mask may deliver a higher concentration of oxygen, but it does not address the underlying issue of impaired gas exchange due to decreased lung expansion and retained secretions.

(C) Position the client prone and have the respiratory therapist perform postural drainage: While postural drainage can help clear secretions, it may not be comfortable or safe for a client who is 1 day postoperative following an open thoracotomy.

(D) Increase oxygen to 70%: Increasing the oxygen concentration may improve the client’s oxygen saturation, but it does not address the underlying issue of impaired gas exchange due to decreased lung expansion and retained secretions. Furthermore, excessively high concentrations of oxygen can have harmful effects, such as oxygen toxicity or suppression of the respiratory drive in some clients.

A. Qualitative studies are considered to be one type of Level I evidence. B. Level Vil evidence comes from a meta-analysis of multiple peer-reviewed studies C. Level I evidence includes evidence found in nursing textbooks. D. Level I evidence is considered to be the best evidence to support EBP

Correct Answer is D

Explanation

A. Qualitative studies are considered to be one type of Level I evidence: Qualitative studies are not typically considered Level I evidence. The hierarchy of evidence is a rating system used to evaluate the strength of evidence presented in medical research. Level I evidence usually includes systematic reviews, meta-analyses, and randomized controlled trials.

B. Level Vil evidence comes from a meta-analysis of multiple peer-reviewed studies: This statement is not accurate. Meta-analyses and systematic reviews are usually considered Level I evidence, as they provide the highest level of evidence. They synthesize and analyze multiple studies on a topic to provide a comprehensive view of the current evidence.

C. Level I evidence includes evidence found in nursing textbooks: Nursing textbooks are not considered Level I evidence. They often include a mix of different levels of evidence, from expert opinion to systematic reviews. While they are a valuable resource for background information and clinical guidelines, they do not represent the highest level of evidence.

D. Level I evidence is considered to be the best evidence to support EBP: This is correct. Level I evidence, which includes systematic reviews, meta-analyses, and randomized controlled trials, is considered the highest level of evidence and provides the most reliable basis for decision-making in evidence-based practice

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A nurse is collecting data from a client who has pneumonia and is experiencing acute respiratory acidosis. Which of the following manifestations should the nurse expect to find?

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Correct Answer is A

Explanation

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Correct Answer is D

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