A nurse is reviewing laboratory results for a client who has metabolic alkalosis. Which of the following blood gas values should the nurse expect?
pH 7.36 (7.35 to 7.45), PaCO2 38 mm Hg (35 to 45 mmHg) HCO3 25 mEq/L (22 to 26 mEq/L)
pH 7.48 (7.35 to 7.45), PaCO, 32 mm Hg (35 to 45 mm Hg). HCO3 24 mEq/L (22 to 26 mE q/L)
pH 7.46 (7.35 to 7.45). PaCO2 36 mm Hg (35 to 45 mm Hg). HCO3 29 mEq/L (22 to 26 mEq/L)
pH 7.26 (7.35 to 7.45). PaCO, 35 mm Hg (35 to 45 mm Hg). HCO3 18 mEq/L (22 to 26 mEq/L)
The Correct Answer is C
A) pH 7.36 (7.35 to 7.45), PaCO2 38 mm Hg (35 to 45 mmHg), HCO3 25 mEq/L (22 to 26 mEq/L): This is a normal set of arterial blood gas (ABG) values, with a pH within normal range, a normal PaCO2, and a normal HCO3. It does not suggest metabolic alkalosis.
B) pH 7.48 (7.35 to 7.45), PaCO2 32 mm Hg (35 to 45 mm Hg), HCO3 24 mEq/L (22 to 26 mEq/L): Although the pH is elevated, indicating alkalosis, the PaCO2 is slightly low, and the bicarbonate (HCO3) is within the normal range. This set of values does not indicate metabolic alkalosis, but could indicate respiratory alkalosis or compensated alkalosis.
C) pH 7.46 (7.35 to 7.45), PaCO2 36 mm Hg (35 to 45 mm Hg), HCO3 29 mEq/L (22 to 26 mEq/L): This is consistent with metabolic alkalosis. The elevated pH (alkalosis) combined with an increased bicarbonate level (HCO3 > 26 mEq/L) and a normal PaCO2 suggests metabolic alkalosis, as the kidneys retain bicarbonate to compensate for the condition.
D) pH 7.26 (7.35 to 7.45), PaCO2 35 mm Hg (35 to 45 mm Hg), HCO3 18 mEq/L (22 to 26 mEq/L): This set of values indicates acidosis, not alkalosis. The pH is low, indicating acidosis, and the bicarbonate (HCO3) is also low, which suggests metabolic acidosis. The PaCO2 is normal, which further supports a metabolic origin of the acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) "I will make sure that my baby's diaper is applied snugly":
A snug diaper could potentially cause irritation or pressure on the circumcision site, increasing the risk of complications such as discomfort or delayed healing. Diapers should be fitted appropriately but not excessively tight around the area to avoid friction on the circumcised site.
B) "I will wipe away yellow crusts that form around the incision":
Yellow crusts are a normal part of the healing process following a Plastibell circumcision, and they should not be wiped away. These crusts form as part of the natural healing process, and removing them prematurely can disrupt the healing tissue or cause unnecessary bleeding or infection.
C) "I will apply antibiotic ointment to my baby's penis":
Antibiotic ointment is generally not recommended for use after a Plastibell circumcision, as it can interfere with the healing process. The Plastibell procedure typically heals with just proper care and the use of a clean diaper. Applying ointments can cause excess moisture that might lead to infection.
D) "I will apply pressure with gauze if I see bleeding":
This is the correct response. If bleeding occurs after a Plastibell circumcision, the appropriate action is to apply gentle pressure with sterile gauze to control the bleeding. Excessive bleeding or uncontrolled bleeding after the procedure may require medical attention, but applying pressure is the first step in addressing this issue.
Correct Answer is B
Explanation
A) Open the fireplace dampers in the day room:
Opening the fireplace dampers in the event of an external chemical disaster would not be appropriate. In fact, this could allow toxic air or chemicals to enter the facility. It is important to seal off ventilation points that might allow the chemicals to enter, such as windows, doors, and any other openings, rather than opening the dampers.
B) Move clients to a room above ground with few windows:
In the event of an external chemical disaster, moving clients to a room above ground with few windows is a key safety measure. Rooms that are above ground level tend to be safer in such situations because chemicals may settle at ground level, increasing exposure risks to those below ground. A room with few windows is also important because it minimizes potential entry points for toxic substances from outside. The focus is on containing the air supply and limiting exposure to harmful agents.
C) Turn on fans in the facility to circulate air:
Turning on fans in the facility during a chemical disaster could worsen the situation by spreading toxic air or chemicals throughout the building. Fans are generally used to circulate air, but in this context, they would not be helpful and could potentially increase exposure to harmful substances. Instead, the focus should be on reducing airflow from the outside and sealing off the building.
D) Cover the electrical outlets with wet towels:
Covering electrical outlets with wet towels is not an effective response to an external chemical disaster. While wet towels can be useful in some scenarios for filtering or protecting from certain substances, in a chemical disaster, the priority is to ensure proper ventilation control and to protect from airborne chemicals by sealing the room. Electrical outlets should be covered for safety only when there is a risk of electrical hazards, but not necessarily in the case of a chemical disaster unless there is specific concern about sparks or fire.
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