A nurse is reviewing the laboratory results of a client who has DKA. The client's ABG results are pH 7.30, PaCO2 34 mm Hg and HCO3 21 mEq/L. The nurse should identify that these values indicate which of the following acid-base imbalances?
Respiratory alkalosis
Metabolic alkalosis
Metabolic acidosis
Respiratory acidosis
The Correct Answer is C
A. Respiratory alkalosis: This condition is characterized by low levels of carbon dioxide
(PaCO2) in the blood and an elevated pH. The ABG results in DKA show a low pH, ruling out respiratory alkalosis.
B. Metabolic alkalosis: Metabolic alkalosis is characterized by high bicarbonate (HCO3) levels and an elevated pH. The ABG results in DKA show low bicarbonate levels, ruling out metabolic alkalosis.
C. Metabolic acidosis: Metabolic acidosis is characterized by low pH and low bicarbonate (HCO3) levels. The ABG results in DKA demonstrate both low pH and low bicarbonate levels, consistent with metabolic acidosis.
D. Respiratory acidosis: Respiratory acidosis is characterized by high carbon dioxide (PaCO2) levels and low pH. The ABG results in DKA show a normal or slightly decreased PaCO2, ruling out respiratory acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Completing an incident report is crucial whenever an error occurs in patient care. This helps to ensure that the error is properly documented, investigated, and addressed to prevent recurrence and promote patient safety.
B. Allowing the incorrect solution to finish infusing could potentially harm the patient. Once the error is identified, the infusion should be stopped immediately, and corrective action should be taken.
C. Documenting that an error occurred in the client's medical record is important, but completing an incident report is a separate step that ensures a thorough investigation and response to the error.
D. Removing the IV catheter may be necessary if the infusion needs to be stopped, but it does not address the need to document and report the error to prevent future occurrences and ensure patient safety.
Correct Answer is A
Explanation
A. A suction device is necessary for the nasogastric tube insertion procedure to remove gastric contents and ensure the tube is correctly placed in the stomach.
B. An infusion pump is not typically required for nasogastric tube insertion.
C. A disposable feeding bag is used for enteral feeding and is not directly related to the insertion of a nasogastric tube.
D. Sterile gloves are not typically used during nasogastric tube insertion, as it is a clean procedure rather than a sterile one.
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