A woman was brought to the emergency department of a hospital after she fell into the ground and hurt her left leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she started complaining that she is still in pain and now experiencing muscle cramps, tingling, and paraesthesia. Measurement of arterial blood gas reveals pH 7.6, PaO2 120 mm Hg. PaCO2 31 mm Hg, and HCO3 25 mmol/L.
What does this mean?
Respiratory Acidosis, Partially Compensated
Respiratory Alkalosis, Uncompensated
Metabolic Alkalosis. Uncompensated
Metabolic Alkalosis. Partially Compensated
The Correct Answer is B
A. This is incorrect because the pH is indicative of alkalosis, not acidosis, and the body has not compensated.
B. The arterial blood gas (ABG) values provided indicate a pH of 7.6, which is above the normal range (7.35-7.45), suggesting alkalosis. The PaCO2 is low at 31 mm Hg, indicating hyperventilation, which is a respiratory process. Since the HCO3 is normal at 25 mmol/L, it suggests that the metabolic system is not the cause of the alkalosis. The body has not had time to compensate for the high pH with renal adjustments to the bicarbonate level, which would be seen in a partially compensated state.
C. This is incorrect because the bicarbonate level is normal, suggesting the metabolic system is not the cause.
D. This is incorrect because the bicarbonate level is normal, suggesting the metabolic system is not the cause.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Administering corticosteroids is crucial during an Addisonian crisis but typically involves intravenous corticosteroids (not oral) during the crisis to quickly restore hormone levels. Oral corticosteroids are part of regular maintenance therapy but not an immediate intervention in the crisis.
B. Weighing the client daily is important to monitor for potential fluid loss, dehydration, or weight changes related to Addison's disease and Addisonian crisis. Clients with Addison’s disease may experience fluid and electrolyte imbalances, so daily weight tracking helps detect early signs of fluid shifts, which are critical in crisis prevention and management.
C. A low-carbohydrate diet is not recommended for clients with Addison’s disease, as they may need a balanced diet with sufficient carbohydrates to prevent hypoglycemia.
D. Fluid intake should not be restricted; rather, maintaining adequate hydration is vital. Clients in Addisonian crisis are often at risk for dehydration due to fluid losses and low aldosterone levels, making fluid replacement essential.
Correct Answer is B
Explanation
A. A urine output of 50 mL in 4 hours is inadequate and may indicate decreased renal perfusion. Magnesium sulfate can further compromise renal perfusion, so this finding warrants careful evaluation and potential adjustment of the infusion rate.
B. This indicates that the client is not experiencing respiratory depression, a potential side effect of magnesium sulfate toxicity.
C. Diminished deep tendon reflexes is an expected finding in magnesium sulfate toxicity.
D. A heart rate of 56/min is below the normal range for an adult but may be a common finding in clients receiving magnesium sulfate due to its cardiac depressant effects.
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