A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?
pH 7.25, HCO3- 19mEq / L PaCO2 30 mm Hg
pH 7.30, HCO3-26 26mEq / L PaCO2 50 mm Hg
pH 7.50 0. HCO * 3 - 20mE /L, PaCO2 32 mm Hg
pH 7.55, HCO3- 30mEq / L PaCO2 31 mm Hg
The Correct Answer is A
In a client with chronic kidney disease (CKD), metabolic acidosis is a common acid-base disorder due to impaired excretion of acid and decreased bicarbonate reabsorption in the kidneys. The arterial blood gas values associated with metabolic acidosis in CKD are a low pH (acidemia), low bicarbonate (HCO3-), and normal or low partial pressure of carbon dioxide (PaCO2). Option A fits this pattern, with a pH of 7.25 (acidic), HCO3- of 19 mEq/L (low), and a PaCO2 of 30 mm Hg (within the normal to low range).
Option B shows a pH of 7.30 (acidic) but with a higher bicarbonate level of 26 mEq/L, which is not consistent with metabolic acidosis. The elevated bicarbonate level suggests metabolic alkalosis, which is not expected in a client with CKD.
Option C has a pH of 7.50 (alkaline) with an elevated bicarbonate level of 20 mEq/L and a low PaCO2 of 32 mm Hg. This set of values is indicative of metabolic alkalosis, which is not expected in a client with CKD.
Option D has a pH of 7.55 (alkaline) with an elevated bicarbonate level of 30 mEq/L and a low PaCO2 of 31 mm Hg. This set of values is indicative of metabolic alkalosis, which is not expected in a client with CKD.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A 3 lb weight gain in a short period, especially overnight, is indicative of fluid overload in a client with end-stage kidney disease receiving hemodialysis. Hemodialysis is performed to remove excess fluid and waste products from the body. If the client is experiencing fluid overload, it means that their body is retaining more fluid than it should, and this can lead to complications such as pulmonary edema, heart failure, and other cardiovascular problems. The nurse should identify this finding as an indication of potential fluid overload and report it to the healthcare provider for further evaluation and intervention.
Correct Answer is A
Explanation
During the 48 hours after a myocardial infarction (MI), the highest priority for monitoring the patient is for dysrhythmias. After an MI, the heart's electrical system can be disrupted, leading to various types of abnormal heart rhythms (dysrhythmias). Dysrhythmias can be life-threatening and require prompt recognition and intervention.
Other options:
B) Anxiety and fear: Anxiety and fear are common emotional responses after an MI, but they are not the highest priority for monitoring during the immediate post-MI period. Emotional support and counseling are essential, but they do not require continuous monitoring.
C) Metabolic acidosis: Metabolic acidosis is not a common complication of an acute MI. It may occur in certain situations, such as when there is inadequate perfusion to tissues, but it is not the highest priority during the immediate post-MI period.
D) Medication side effects: Monitoring for medication side effects is important but is not the highest priority during the immediate post-MI period. Many patients will receive medications to manage pain, reduce clot formation, and stabilize their heart function. The nurse should monitor for side effects but not as a higher priority compared to dysrhythmias.
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