A nurse is reviewing the laboratory results of a client who was an unrestrained passenger in a motor-vehicle crash. The ABG results are as follows: pH 7.32, HCO3 24 mEq/L, PaCO2 48 mm Hg. The nurse should identify the client is experiencing which of the following acid-base imbalances?

Respiratory acidosis

Metabolic acidosis

Respiratory alkalosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is A

A) Respiratory acidosis: This condition is indicated by a low pH (7.32) and an elevated PaCO2 (48 mm Hg), while HCO3 remains normal (24 mEq/L). Respiratory acidosis occurs when there is an accumulation of carbon dioxide in the blood, usually due to hypoventilation or impaired gas exchange in the lungs.

B) Metabolic acidosis: Metabolic acidosis is characterized by a low pH and a decreased HCO3 level. In this scenario, the HCO3 level is normal, ruling out metabolic acidosis.

C) Respiratory alkalosis: Respiratory alkalosis is indicated by a high pH and a decreased PaCO2. In this case, the pH is low, and the PaCO2 is elevated, which contradicts the characteristics of respiratory alkalosis.

D) Metabolic alkalosis: Metabolic alkalosis would show a high pH and an elevated HCO3 level. Since the pH is low and the HCO3 is normal, this condition does not fit the criteria for metabolic alkalosis.

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Correct Answer is B

Explanation

A) Maintain the client on bed rest for 48 hr following surgery: While some bed rest is recommended initially post-surgery, maintaining bed rest for 48 hours is excessive and can increase the risk of complications like deep vein thrombosis. Early mobilization is generally encouraged to enhance recovery.

B) Check the tubing for kinks and blood clots at least every 2 hr: Regularly checking the catheter tubing for kinks and blood clots is essential to ensure the continuous flow of urine and prevent catheter blockage. This can help in reducing the risk of complications such as bladder distension and urinary retention.

C) Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate: Continuous bladder irrigation is often done post-TURP to prevent clot formation, but 5% dextrose in Ringer's lactate is not the recommended solution. Typically, normal saline is used to minimize the risk of electrolyte imbalance and maintain the correct osmolarity.

D) Remove the catheter if the client reports severe bladder spasms: Severe bladder spasms can occur post-TURP, but removing the catheter is not the immediate solution. The catheter is necessary for drainage and should be managed with antispasmodic medications or adjusting the irrigation flow rather than removal.

A. "A parent is supposed to pass before their child." B. "My partner and I have plans to open a small business." C. "I have put all the pictures of my child in the attic." D. "My partner says I seem to forget things frequently."

Correct Answer is B

Explanation

A) "A parent is supposed to pass before their child": This statement reflects ongoing grief and a struggle with the loss, indicating the client is still grappling with the emotional impact rather than moving toward reorganization and acceptance.

B) "My partner and I have plans to open a small business": This statement demonstrates that the client is beginning to focus on future goals and engaging in activities that signify a return to normalcy and investment in life. This reflects reorganization and acceptance of the loss as they are planning for the future.

C) "I have put all the pictures of my child in the attic": Putting away pictures of the child might indicate avoidance or difficulty coping with reminders of the loss. This action suggests the client may still be in the process of dealing with grief rather than having reached acceptance.

D) "My partner says I seem to forget things frequently": Frequent forgetfulness can be a symptom of ongoing grief and emotional distress. This indicates that the client may still be experiencing significant emotional and cognitive impacts from the loss.

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A nurse is reviewing the laboratory results of a client who was an unrestrained passenger in a motor-vehicle crash. The ABG results are as follows: pH 7.32, HCO3 24 mEq/L, PaCO2 48 mm Hg. The nurse should identify the client is experiencing which of the following acid-base imbalances?

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A nurse is reviewing the laboratory results of a client who was an unrestrained passenger in a motor-vehicle crash. The ABG results are as follows: pH 7.32, HCO3 24 mEq/L, PaCO2 48 mm Hg. The nurse should identify the client is experiencing which of the following acid-base imbalances?