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

Answer and Explanation

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.

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Correct Answer is ["B","D"]

Explanation

Choice A reason: Poor nutrition related to alcoholism can lead to abdominal obesity, but it is not a direct cause of ascites in liver cirrhosis. Ascites is primarily due to factors like portal hypertension and decreased colloid oncotic pressure.

Choice B reason: Portal hypertension is a significant cause of ascites in liver cirrhosis. The increased pressure in the portal vein causes proteins to leak from the blood vessels into the peritoneal cavity, leading to fluid accumulation.

Choice C reason: Osmoreceptors in the hypothalamus stimulating thirst can lead to excessive fluid intake, but this is not a direct cause of ascites related to liver cirrhosis. Ascites is more directly linked to portal hypertension and decreased colloid oncotic pressure.

Choice D reason: Decreased colloid oncotic pressure due to the liver's inability to synthesize albumin is a key factor in the development of ascites. Albumin helps maintain fluid balance in the blood vessels, and its deficiency leads to fluid leakage into the peritoneal cavity.

A. Respiratory status B. Liver enzymes C. Blood pressure D. Neurological status E. Potassium level

Correct Answer is ["A","C","D"]

Explanation

Choice A reason: Respiratory status is crucial to monitor because patients with acute neurological deficits, such as those seen in strokes, are at risk of respiratory compromise. This can be due to weakened respiratory muscles or aspiration, which could lead to pneumonia or other respiratory complications.

Choice B reason: Monitoring liver enzymes is not directly related to the acute management of a stroke patient. Liver enzymes would be more relevant in cases where liver function or hepatic issues are suspected, but not for this specific scenario.

Choice C reason: Blood pressure monitoring is vital, as hypertension is a significant risk factor for stroke. Maintaining appropriate blood pressure is essential to prevent further neurological damage and complications. Acute changes in blood pressure can indicate worsening or improvement of the patient's condition.

Choice D reason: Neurological status should be continuously monitored to assess the progression of the patient's stroke symptoms. This includes checking for changes in level of consciousness, motor function, speech, and other neurological signs. Prompt detection of changes can guide immediate interventions.

Choice E reason: Potassium level monitoring is not a primary focus in the acute management of stroke. While electrolyte balance is important, it is not as critical as respiratory status, blood pressure, and neurological status in this context.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Identify two causes of ascites related to liver cirrhosis:

Correct Answer is ["B","D"]

Explanation

Correct Answer is ["A","C","D"]

Explanation

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