A nurse is reviewing the arterial blood gas (ABG) values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?
pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg
pH 7.50, HCO3- 20 mEq/L, PaCO2 32 mm Hg
pH 7.55, HCO3- 30 mEq/L, PaCO2 31 mm Hg
pH 7.30, HCO3- 26 mEq/L, PaCO2 50 mm Hg
The Correct Answer is A
Choice A reason:
This set of values indicates metabolic acidosis, which is common in chronic kidney disease due to the accumulation of acids in the body as the kidneys fail to eliminate them effectively³.
Choice B reason:
A pH of 7.50 is considered alkalotic, and while HCO3- and PaCO2 are within normal ranges, this set of values does not typically represent chronic kidney disease.
Choice C reason:
A pH of 7.55 is also alkalotic, and an HCO3- of 30 mEq/L indicates metabolic alkalosis, which is not characteristic of chronic kidney disease.
Choice D reason:
While a pH of 7.30 is on the lower end of the normal range, an HCO3- of 26 mEq/L is within the normal range, and a PaCO2 of 50 mm Hg indicates respiratory acidosis, not typically seen in chronic kidney disease without concurrent respiratory issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Asterixis, also known as “liver flap,” is a type of tremor characterized by rapid, nonrhythmic extensions and flexions in the wrist and fingers. It is associated with hepatic encephalopathy, a condition that can occur with severe liver disease, but it is not a direct indicator of low albumin levels.
Choice B reason: Peripheral edema is a common clinical finding in patients with hypoalbuminemia, which is a low level of albumin in the blood. When albumin levels are low, fluid from the bloodstream can leak into body tissues, causing swelling, especially in the lower limbs. When assessing a client with liver disease and low albumin levels, palpating for peripheral edema would be the most relevant nursing assessment, as it directly correlates with the effects of hypoalbuminemia on fluid balance in the body. Albumin is a protein made by the liver that helps keep fluid in your blood vessels and plays a role in transporting substances throughout your body. Low levels of albumin can lead to fluid leaking out of blood vessels into tissues, causing swelling or edema.
Choice C reason: Decreased level of consciousness can be a sign of various conditions, including hepatic encephalopathy or other complications of liver disease, but it is not specifically indicative of low albumin levels.
Choice D reason: Petechiae are small red or purple spots caused by bleeding into the skin and may be associated with various conditions, including liver disease, but they are not a specific sign of low albumin levels.
Correct Answer is C
Explanation
Choice A reason:Shaking the bag is not recommended as it may not adequately mix the solution and could cause emulsion instability.
Choice B reason:Administering the bag as is could be harmful due to the risk of fat embolism or other complications from an unstable emulsion.
Choice C reason:Returning the bag to the pharmacy is the appropriate action to ensure the client receives a properly mixed and safe emulsion.
Choice D reason:Turning the bag upside down one time is not sufficient to mix the emulsion and does not address the potential instability of the solution.
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