A nurse is reviewing a client's laboratory results. The client's ABGS are as follows: pH 7.6, HCO3 24 mEq/L, PaCO2 30 mm Hg, PaO2 90 mm Hg. Which of the following acid-base imbalances should the nurse identify the client is experiencing?
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
The Correct Answer is C
A) Metabolic alkalosis: Metabolic alkalosis is characterized by a high pH and elevated bicarbonate (HCO3). In this scenario, the pH is elevated at 7.6, which supports alkalosis, but the HCO3 level is normal at 24 mEq/L. The PaCO2 is slightly low, which is not typical for metabolic alkalosis, as it would usually show an elevated HCO3 with a compensatory respiratory alkalosis.
B) Respiratory acidosis: Respiratory acidosis would present with a low pH and an elevated PaCO2. In this case, the pH is high at 7.6, indicating alkalosis, and the PaCO2 is also low at 30 mm Hg, which is inconsistent with respiratory acidosis.
C) Respiratory alkalosis: Respiratory alkalosis is indicated by a high pH with a low PaCO2. Here, the pH is elevated at 7.6, and the PaCO2 is decreased at 30 mm Hg, which fits the profile of respiratory alkalosis. The normal HCO3 level suggests that the bicarbonate is not compensating, supporting a primary respiratory alkalosis.
D) Metabolic acidosis: Metabolic acidosis is characterized by a low pH and a low HCO3. In this scenario, the pH is elevated at 7.6, and the HCO3 level is normal at 24 mEq/L, which does not align with metabolic acidosis. The PaCO2 is also low, which is not typical for metabolic acidosis, as it would usually have a normal or high PaCO2.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Irrigate the affected ear with hydrogen peroxide: Irrigating the ear with hydrogen peroxide is not recommended post-myringotomy. This can cause irritation or infection at the surgical site, which could impede healing and potentially worsen the condition.
B) Drink liquids through a straw: Drinking liquids through a straw can create pressure changes in the ear, which is not advisable post-myringotomy. These pressure changes might affect the healing process of the ear.
C) Swimming is permitted after 1 week: Swimming is typically restricted for a longer period post-myringotomy to prevent water from entering the ear, which can lead to infection or interfere with the healing process.
D) Air travel is allowed after 3 weeks: Air travel restrictions are generally recommended for a few weeks post-myringotomy due to pressure changes that occur during flight, which can affect the ear's healing process. Waiting for 3 weeks allows the surgical site to heal sufficiently, reducing the risk of complications from pressure changes.
Correct Answer is B
Explanation
A) Fever: Myxedema coma is characterized by hypothermia rather than fever. The client with myxedema coma may experience a lowered body temperature, reflecting the severe hypothyroidism associated with this condition.
B) Hypernatremia: Hypernatremia, or elevated sodium levels, is a common finding in myxedema coma. This occurs due to impaired renal function and decreased aldosterone levels, leading to an imbalance in electrolytes, including sodium.
C) Hypertension: Typically, myxedema coma presents with hypotension rather than hypertension. The condition is associated with decreased cardiac output and low blood pressure, not elevated blood pressure.
D) Hypoglycemia: In myxedema coma, hypoglycemia is not typically expected. Instead, patients may experience hypoglycemia due to reduced metabolic rate and decreased glycogen stores. However, hyperglycemia is more commonly observed in other endocrine disorders, not specifically in myxedema coma.
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