A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow for continued mechanical ventilation. How should the nurse interpret the following arterial blood gas results: pH 7.48, PaO₂ 85 mm Hg, PaCO₂ 32 mm Hg, and HCO₃ 25 mEq/L?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
The Correct Answer is D
Choice A reason: Metabolic acidosis is characterized by a decrease in blood pH (less than 7.35) due to a primary decrease in bicarbonate (HCO₃). The arterial blood gas results in this scenario do not indicate metabolic acidosis, as the pH is elevated and HCO₃ is within the normal range.
Choice B reason: Metabolic alkalosis is characterized by an increase in blood pH (greater than 7.45) due to a primary increase in bicarbonate (HCO₃). In this case, the pH is indeed elevated, but the bicarbonate level is normal, making this condition unlikely.
Choice C reason: Respiratory acidosis is characterized by a decrease in blood pH (less than 7.35) due to a primary increase in PaCO₂. The arterial blood gas results show an elevated pH and a decreased PaCO₂, which are not consistent with respiratory acidosis.
Choice D reason: Respiratory alkalosis is characterized by an increase in blood pH (greater than 7.45) due to a primary decrease in PaCO₂. In this scenario, the pH is elevated at 7.48, and the PaCO₂ is decreased at 32 mm Hg, indicating respiratory alkalosis. The bicarbonate level is within the normal range, further supporting this interpretation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: The nurse assistant typically performs tasks such as patient hygiene, ambulation, and basic monitoring under the supervision of registered nurses. They are not usually responsible for documenting vital signs during the intra-operative period.
Choice B reason: The anesthesiologist is primarily focused on managing the patient's anesthesia and monitoring their physiological status during surgery. While they do keep track of vital signs, the formal documentation is typically the responsibility of the circulating nurse.
Choice C reason: The scrub nurse is focused on maintaining the sterile field, handling surgical instruments, and assisting the surgeon. They do not leave the sterile field to document vital signs.
Choice D reason: The circulating nurse is responsible for overall patient care in the operating room, including documentation of vital signs. They manage the operating room environment, ensure patient safety, and record all necessary information during the intra-operative period.
Correct Answer is ["A","C"]
Explanation
Choice A reason: Offering high-calorie protein snacks between meals and at bedtime is appropriate for a patient with COPD who is losing weight and eating very little. These snacks can help meet their nutritional needs and provide the extra calories and protein necessary to prevent muscle wasting and support overall health.
Choice B reason: While increasing the intake of whole grains and vegetables is generally healthy, it may not be the priority for a patient who has lost significant weight and needs to focus on higher-calorie, nutrient-dense foods. The primary goal is to address the calorie and protein deficit first.
Choice C reason: Encouraging rest before meals is beneficial as it helps conserve energy for eating. Patients with COPD often experience fatigue, which can reduce their appetite and ability to eat. Resting before meals can help them feel more energetic and better able to consume their meals.
Choice D reason: Providing a large glass of juice with each meal is not ideal for increasing calorie and protein intake. While juice can provide some calories and nutrients, it is not a good source of protein. Additionally, large volumes of liquid can create a feeling of fullness, reducing the patient's appetite for nutrient-dense foods.
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