A nurse is reviewing the arterial blood gas (ABG) result for a client diagnosed with progressive chronic obstructive pulmonary disease (COPD). The nurse should expect which of the following ABG findings for a client diagnosed with progressive COPD?
pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L
pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L
pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L
pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L
The Correct Answer is B
A. pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L: This ABG finding indicates respiratory alkalosis, as evidenced by the elevated pH and decreased PaCO2. In progressive COPD, clients typically retain carbon dioxide rather than blow it off, so this finding would not be expected in a patient with chronic respiratory issues.
B. pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L: This is the most consistent finding for a client with progressive COPD. The low pH indicates acidosis, and the elevated PaCO2 suggests respiratory acidosis due to carbon dioxide retention, a common problem in COPD. The elevated HCO3 indicates a compensatory metabolic response, as the body attempts to retain bicarbonate to buffer the acidosis.
C. pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L: These values indicate a normal ABG, which would not be expected in a client with progressive COPD. Patients with chronic lung disease typically present with acid-base imbalances due to respiratory failure, so this finding suggests the client is not exhibiting the expected complications of COPD.
D. pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L: Although these findings show mild acidosis, the PaCO2 is within normal limits, indicating that this patient may not be experiencing significant respiratory failure. In advanced COPD, one would expect to see a higher PaCO2 and more pronounced acidosis, making this option less characteristic of a patient with progressive COPD compared to option B.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["15"]
Explanation
Formula:
Volume to administer (mL) = (Desired dose (mEq) / Available concentration (mEq/mL))
Desired dose = (40 mEq / 2 doses)
=20mEq
Available concentration = 6.7 mEq / 5 mL
Calculate the concentration per mL:
6.7 mEq / 5 mL = 1.34 mEq/mL
Volume to administer = 20 mEq / 1.34 mEq/mL
= 14.925... mL
Round to the nearest whole number:
Volume to administer = 15 mL
Correct Answer is A
Explanation
A. Opening and utilizing supplies that are necessary for the task. The efficiency domain in healthcare quality focuses on minimizing waste, optimizing resource utilization, and reducing unnecessary costs. By ensuring that only necessary supplies are used, healthcare facilities can prevent waste, control expenses, and enhance operational efficiency, making this choice the best representation of the efficiency domain.
B. Working to reduce wait times in the emergency department. Reducing wait times falls under the timeliness domain rather than efficiency. Timeliness ensures that patients receive care without unnecessary delays, improving access to treatment and patient outcomes. While efficiency and timeliness are related, reducing wait times primarily aligns with improving prompt care delivery rather than minimizing waste.
C. Using an interpreter for patients who do not speak the health-care provider's language. This action falls under the equity domain, which ensures that all individuals receive fair and unbiased care regardless of language, socioeconomic status, or cultural background. Providing language services improves access to quality healthcare but does not specifically address efficiency.
D. Utilizing the CAUTI bundle to prevent urinary tract infections when placing indwelling urinary catheters. This initiative falls under the safety domain, which focuses on preventing harm to patients through evidence-based practices. Implementing infection prevention measures improves patient safety but is not directly related to efficiency, which focuses on cost-effectiveness and resource management.
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