For an arterial blood gas (ABG) to have full compensation, which of the following statements is correct?
pCO2 and pHCO3 and pH are abnormal but the pa02 remains between 80-100 mmHg
arterial pH & pCO2 are abnormal but the pHCO3 is starting to change
pCO2, pHCO3 and pH have adjusted in expected range in 72 hours
arterial pH is between 7.35-7.45 and the pCO2 & pO2 are abnormal
The Correct Answer is C
C. Full compensation typically occurs within 2 to 3 days (approximately 72 hours) after the onset of an acid-base disturbance. During full compensation, the primary acid-base disorder (e.g., respiratory acidosis or alkalosis, metabolic acidosis or alkalosis) is still present, but the compensatory mechanisms have effectively brought the pH, pCO2, and bicarbonate (pHCO3) levels back towards normal range.
A. Full compensation occurs when both the primary disorder (respiratory or metabolic) and the compensatory mechanism (renal or respiratory) are functioning to return the pH towards normal. In this option, while the pO2 is within the normal range, the pH, pCO2, and bicarbonate (pHCO3) are all abnormal, indicating an ongoing imbalance.
B. Full compensation occurs when all components of the ABG are within or approaching normal range, indicating that the body's compensatory mechanisms have effectively counteracted the primary acid- base disturbance. In this option, the bicarbonate (pHCO3) is mentioned as starting to change, indicating incomplete compensation.
D. While the pH is within the normal range, both the pCO2 and pO2 are abnormal, indicating a primary respiratory disturbance. In the case of full compensation, the pH, pCO2, and bicarbonate (pHCO3) levels would all be within or approaching normal range, indicating that the compensatory mechanisms have effectively counteracted the primary acid-base disturbance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. Encourage the client to discuss his feelings about his health status: This option directly targets the affective domain by facilitating the expression and exploration of the client's emotions, attitudes, and beliefs related to their health status. Discussing feelings can help the client process emotions such as fear, anxiety, or frustration, and can promote emotional coping, self-awareness, and acceptance, all of which are important aspects of affective learning.
A. This option primarily involves the psychomotor domain, as it focuses on the client's ability to perform a physical skill (self-measurement of blood pressure). While this activity may indirectly influence the affective domain by building the client's confidence and sense of empowerment in managing their health, its primary focus is on the acquisition of motor skills.
B. This option engages the cognitive domain by encouraging the client to identify and express their informational needs about their diagnosis. While this approach can help address cognitive aspects of learning, such as knowledge acquisition and understanding, it may not directly target the affective domain unless the client's emotional responses and concerns are explicitly addressed.
D. Providing educational materials on exercise and nutrition guidelines can contribute to cognitive learning by imparting information about health behaviors but it may not directly address the affective domain unless the content specifically addresses emotional or motivational aspects of behavior change. However, if the brochures include content that inspires or motivates the client to adopt healthy lifestyle changes by appealing to their values, beliefs, or emotions, then it could indirectly influence the affective domain.
Correct Answer is C
Explanation
C. Assisting the client in slowed breathing techniques is the most appropriate initial intervention for a client experiencing hyperventilation due to acute psychological stress. Slowed breathing techniques, such as pursed-lip breathing or diaphragmatic breathing, can help normalize respiratory rate and depth, thereby correcting the respiratory alkalosis. Encouraging the client to breathe slowly and deeply can help reduce the respiratory rate and restore a more balanced acid-base status.
A. Administering a sedative may not be the initial intervention for a client experiencing hyperventilation due to acute psychological stress. Sedatives can depress the respiratory drive further and may exacerbate respiratory alkalosis. Additionally, administering sedatives should be based on a comprehensive assessment and medical prescription, rather than as a first-line intervention for hyperventilation.
B. While hyperventilation can sometimes lead to symptoms resembling seizure activity (such as muscle twitching or numbness), assessing for seizure activity is not typically the initial intervention for respiratory alkalosis. In the context of acute psychological stress causing hyperventilation, addressing the hyperventilation itself is the priority.
D. While monitoring vital signs, including blood pressure, is important in assessing the client's overall condition, it is not the initial intervention specifically for addressing respiratory alkalosis due to hyperventilation. The priority in this situation is to address the hyperventilation itself through appropriate breathing techniques.
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