A patient's ABG shows: pH 7.32. PaCO2 50 mmHg. HCO3 24 mEq/L. What is the correct diagnosis?

Metabolic acidosis

Respiratory acidosis

Respiratory alkalosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is B

A. Metabolic acidosis would be indicated by a low pH and a low HCO3, which is not present in this case since HCO3 is normal.
B. The pH of 7.32 indicates acidemia, and a PaCO2 of 50 mmHg suggests respiratory acidosis as the body is retaining carbon dioxide, contributing to the low pH. The HCO3 is normal, indicating that there is no metabolic compensation occurring.
C. Respiratory alkalosis would show a high pH and low PaCO2, which is not the case here.
D. Metabolic alkalosis would present with a high pH and elevated HCO3, which is also not present in these ABG results.

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Correct Answer is D

Explanation

A. Encouraging oral intake may not be effective due to the patient's likely need for more rapid rehydration given his low blood pressure and heart rate.
B. A potassium-sparing diuretic is inappropriate in this situation, as the patient is already experiencing fluid loss and requires rehydration, not diuresis.
C. Restricting fluid intake would be contraindicated as the patient is in a state of dehydration and hypotension.
D. Administering an IV bolus of normal saline is the priority intervention to quickly restore fluid volume and improve blood pressure and hydration status.

A. Obtain a urine specimen. B. Type and cross-match for 2 units of packed RBCs. C. Insert a nasogastric (NG) tube. D. Measure lactate level. E. Administer broad-spectrum antibiotics. F. Rapidly administer 30 mL/kg of normal saline. G. Obtain blood cultures. H. Obtain a wound culture.

Correct Answer is ["D","E","F","G"]

Explanation

D. Measure lactate level: Elevated lactate levels are a strong indicator of sepsis and can help guide treatment.

E. Administer broad-spectrum antibiotics: Prompt administration of antibiotics is crucial to combat the infection.

F. Rapidly administer 30 mL/kg of normal saline: Aggressive fluid resuscitation is necessary to improve blood pressure and tissue perfusion.

G. Obtain blood cultures: Blood cultures can help identify the specific organism causing the infection and guide antibiotic therapy.

Other interventions that may be considered, but not necessarily within the first hour, include:

A. Obtain a urine specimen: This can help identify a urinary tract infection as a potential source of sepsis.

B. Insert a nasogastric tube: This may be necessary if the client is unable to tolerate oral intake or requires gastric decompression.

C. Type and cross-match for 2 units of packed RBCs: This may be necessary if the client develops significant anemia or requires blood transfusion.

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A patient's ABG shows: pH 7.32. PaCO2 50 mmHg. HCO3 24 mEq/L. What is the correct diagnosis?

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Naxlex Comprehensive Predictor Exams

A 45-year-old male presents to the emergency department after experiencing profuse vomiting and diarrhea for 3 days. His blood pressure is 90/60 mmHg, heart rate is 110 beats per minute, and mucous membranes are dry. Which of the following interventions should the nurse prioritize?

Correct Answer is D

Explanation

A nurse is caring for a 73-year-old client in the emergency department (ED) Exhibits It has been identified that the client is in sepsis. Select the 4 actions that the nurse should complete in the first hour to manage sepsis and prevent further complications?

Correct Answer is ["D","E","F","G"]

Explanation

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