Arterial blood gases on a postoperative client with pneumonia indicate the client is in respiratory acidosis. To best improve this acid-base imbalance, which intervention should the nurse implement?

Discontinue use of supplemental oxygen

Encouraging use of incentive spirometer

Implement fluid restrictions

Administering an antitussive agent

Answer and Explanation

The Correct Answer is B

A. Discontinue use of supplemental oxygen: This option is incorrect because supplemental oxygen is used to increase the oxygen levels in the blood, which is not directly related to addressing respiratory acidosis. In respiratory acidosis, the problem is primarily with the elimination of CO2 rather than oxygenation.
B. Encouraging use of incentive spirometer: This is the correct choice as using an incentive spirometer helps improve lung expansion and promotes alveolar ventilation, which aids in reducing CO2 levels in the blood, thereby addressing respiratory acidosis.
C. Implement fluid restrictions: This option is not suitable because fluid restrictions do not directly address the underlying issue of respiratory acidosis. Fluid restrictions might be necessary for other conditions, but they are not effective in correcting respiratory acid-base imbalances.
D. Administering an antitussive agent: This is incorrect because antitussive agents suppress cough reflexes, which can be counterproductive. In respiratory acidosis, coughing is often a protective mechanism to help clear secretions, so suppressing it may worsen the acid-base imbalance.

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Correct Answer is C

Explanation

A. Serum glucose and a Complete Blood Count: While a complete blood count (CBC) is useful in assessing overall health, serum glucose is less relevant in the context of renal disease. The focus should be on kidney function rather than glucose levels.
B. Arterial blood gas and coagulation tests: Arterial blood gas (ABG) and coagulation tests may be important for other conditions, but they are not specifically targeted to evaluate renal function or related preoperative risks in renal disease.
C. Serum creatinine and a Basic Metabolic Panel: This is the correct choice as serum creatinine is a key marker of kidney function, and a Basic Metabolic Panel (BMP) provides information on electrolyte levels and overall metabolic status, which are crucial in evaluating the impact of renal disease on surgery.
D. Chest X-ray and cardiac enzymes: These tests are more relevant for evaluating cardiac function and lung status rather than directly assessing kidney function, which is the primary concern in the context of renal disease.

A. Poorly controlled pain, moves all extremities, reports continued nausea B. 2-hour total urinary output of 30 mL, pulse oximetry 94% on 3L oxygen, turning from side to side C. Afebrile, adventitious breath sounds, responds to painful stimuli D. SaO2 of 95%, vital signs stable for last 30 minutes, active gag reflex

Correct Answer is D

Explanation

A. Poorly controlled pain, moves all extremities, reports continued nausea: Poorly controlled pain and nausea are not ideal for discharge, as they indicate the patient might need further monitoring and management.
B. 2-hour total urinary output of 30 mL, pulse oximetry 94% on 3L oxygen, turning from side to side: Low urinary output and low oxygen saturation indicate potential complications that require further assessment and treatment.
C. Afebrile, adventitious breath sounds, responds to painful stimuli: Responding to painful stimuli and adventitious breath sounds suggest the patient may still be experiencing complications and is not ready for discharge.
D. SaO2 of 95%, vital signs stable for last 30 minutes, active gag reflex: This response indicates stable oxygen saturation, stable vital signs, and an active gag reflex, suggesting the patient is ready for discharge from the PACU.

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Arterial blood gases on a postoperative client with pneumonia indicate the client is in respiratory acidosis. To best improve this acid-base imbalance, which intervention should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a preoperative review of systems, the client reveals a history of renal disease. This finding suggests the need for which relevant preoperative diagnostic tests?

Correct Answer is C

Explanation

Which client response best supports the decision to discharge the client from the Post-Anesthesia Care Unit?

Correct Answer is D

Explanation

Orders were written for a client to be weaned off of total parenteral nutrition (TPN) and started on a low-residue diet. The TPN solution has been infusing at a continuous rate of 90 ml/hr for three weeks. Which of the following orders should the nurse anticipate next?

To promote effective coughing, deep breathing, and ambulation in the postoperative client, what nursing action is most important?

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A nurse is providing education in a community setting to several clients taking daily calcium supplements and encourages them to drink 2,500 mL of fluid daily. The nurse explains that this intervention is important to prevent which complication?

The nurse identifies that which of the following clients is at risk for developing metabolic acidosis? (Select All That Apply)

The client is admitted with a serum sodium level of 110 mEq/L. What nursing intervention should be implemented?