A nurse is reviewing the arterial blood gas (ABG) results for a patient diagnosed with progressive Chronic Obstructive Pulmonary Disease (COPD). Which ABG results should the nurse expect for a patient with progressive COPD?
pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L
pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L
pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L
pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L .
The Correct Answer is C
Choice A rationale
A pH of 7.55, PaCO2 of 30 mm Hg, PaO2 of 80 mm Hg, and HCO3 of 24 mEq/L would indicate respiratory alkalosis, which is not typically associated with progressive COPD67.
Choice B rationale
A pH of 7.40, PaCO2 of 40 mm Hg, PaO2 of 94 mm Hg, and HCO3 of 22 mEq/L represent normal ABG values.
Choice C rationale
A pH of 7.30, PaCO2 of 60 mm Hg, PaO2 of 70 mm Hg, and HCO3 of 30 mEq/L are indicative of respiratory acidosis with metabolic compensation, which is commonly seen in patients with progressive COPD67.
Choice D rationale
A pH of 7.38, PaCO2 of 45 mm Hg, PaO2 of 88 mm Hg, and HCO3 of 26 mEq/L would indicate a slight respiratory acidosis, which is not typically associated with progressive COPD67.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Collective bargaining activity at a nearby hospital may be of interest, but it is not directly related to the quality improvement of the unit.
Choice B rationale
Systems that make it difficult for the nurses to do their job directly impact the quality of care provided in the unit. Addressing these issues can lead to improvements in workflow, patient care, and nurse satisfaction.
Choice C rationale
While nurse pay is an important issue, it is typically addressed through human resources or union negotiations, not a unit-based quality improvement project.
Choice D rationale
The number of medication errors committed by another nurse is a serious concern, but it is a specific personnel issue. It should be addressed, but it may not reflect the overall quality of the unit.
Correct Answer is C
Explanation
Choice A rationale
While the application of anti-embolism stockings can be beneficial in preventing deep vein thrombosis in postoperative patients, it is not the most prioritized nursing intervention in the immediate postoperative period for a patient who has undergone a left pneumonectomy. The immediate postoperative period after a pneumonectomy is critical for monitoring and managing potential complications such as respiratory distress, hemorrhage, and bronchopleural fistula.
Choice B rationale
The use of the incentive spirometer is an important nursing intervention for postoperative patients to promote lung expansion and prevent atelectasis. However, in the immediate postoperative period following a pneumonectomy, the priority is to monitor for complications and ensure the stability of the patient.
Choice C rationale
Assessment of the chest tube and pleur-evac is the most prioritized nursing intervention in the immediate postoperative period for a patient who has undergone a left pneumonectomy. After a pneumonectomy, a chest tube is placed to drain air, blood, and fluid from the pleural space to allow the remaining lung to re-expand. It is crucial to monitor the chest tube system for proper functioning and to assess for complications such as excessive bleeding, infection, or pneumothorax.
Choice D rationale
Repositioning the patient in bed is a standard nursing intervention in postoperative care to enhance comfort, promote lung expansion, and prevent complications such as pressure ulcers and deep vein thrombosis. However, it is not the most prioritized intervention in the immediate postoperative period following a pneumonectomy, where monitoring for respiratory complications and ensuring the stability of the patient are paramount.
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