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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A) High-pitched bowel sounds: High-pitched bowel sounds, also known as "tinkling" sounds, are characteristic of mechanical bowel obstructions. These sounds are created by the intestines as they try to move contents past the obstruction, resulting in increased peristaltic activity. In the case of intussusception, where one segment of the intestine telescopes into another, the obstruction can cause these distinctive high-pitched sounds due to the narrowing of the bowel lumen.

B) Abdominal bruit: An abdominal bruit is a swishing sound heard over the abdomen, usually indicating turbulent blood flow through narrowed arteries. It is commonly associated with vascular conditions such as atherosclerosis or renal artery stenosis. It is not related to bowel obstruction, as bowel sounds in obstruction cases are generally due to changes in peristaltic activity rather than blood flow.

C) Bruising on the flank area: Bruising on the flank area, known as Grey Turner's sign, is typically seen in conditions involving retroperitoneal hemorrhage, such as severe pancreatitis or trauma. It is not a symptom of bowel obstruction. Bowel obstruction symptoms generally relate to the gastrointestinal tract and include abdominal pain, distension, and altered bowel sounds.

D) Coffee-ground emesis: Coffee-ground emesis is vomit that appears like coffee grounds, indicating the presence of partially digested blood. This is a sign of upper gastrointestinal bleeding, often due to peptic ulcers or gastritis. In mechanical bowel obstruction, vomiting is more likely to contain bile (bilious vomiting) and may occur if the obstruction is high in the small intestine. The appearance of coffee-ground emesis is not typical for bowel obstructions and indicates a different type of gastrointestinal issue.

A. Drowsiness B. Diminished patellar reflexes C. Generalized muscle weakness D. Bradycardia

Correct Answer is D

Explanation

A) Drowsiness: While drowsiness can be a symptom of elevated magnesium levels, it is not the most critical finding to report immediately. Drowsiness can be observed with other conditions as well.

B) Diminished patellar reflexes: This can be indicative of hypermagnesemia, but it is a less immediate concern compared to other symptoms. Monitoring reflexes is important, but not the priority.

C) Generalized muscle weakness: Muscle weakness is a common symptom of elevated magnesium levels, but it is less urgent compared to cardiac issues. Although important, it does not pose an immediate risk like bradycardia.

D) Bradycardia: Elevated magnesium levels can cause serious cardiac complications, including bradycardia. This can be life-threatening and requires prompt attention to prevent severe outcomes, making it the priority to report to the provider.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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