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Mrs. Jamerson, who had undergone surgery in the post-anesthesia care unit (PACU), is difficult to arouse two hours following surgery. Nurse Williams in the PACU has been administering Morphine Sulfate intravenously to the client for complaints of post-surgical pain. The client's respiratory rate is 7 per minute and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the ABCs (remember Airway, Breathing, Circulation!) and obtains ABGS STAT! Arterial blood gas measurement shows pH 7.10. PaCO2 70 mm Hg, and HCO3 24 mEq/L

What does this mean?

A.

Metabolic Acidosis, Uncompensated

B.

Respiratory Alkalosis. Partially Compensated

C.

Respiratory Acidosis. Uncompensated

D.

Metabolic Alkalosis. Partially Compensated

Answer and Explanation

The Correct Answer is C

A.    Metabolic Acidosis, Uncompensated, is ruled out because the elevated PaCO2 and low pH indicate a respiratory problem rather than a metabolic one.
B.    Respiratory Alkalosis. Partially Compensated is ruled out because the pH and PaCO2 levels are both abnormal and indicate acidosis rather than alkalosis.
C.    The low pH (acidosis) along with the high PaCO2 indicate respiratory acidosis, and there is no evidence of compensation by the kidneys (normal HCO3).
D.    Metabolic Alkalosis. Partially Compensated, is ruled out because the pH is low (acidosis) rather than high (alkalosis), and the PaCO2 is elevated, suggesting a respiratory problem rather than a metabolic one.
 


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Related Questions

Correct Answer is D

Explanation

A. Respiratory acidosis would typically involve an elevated PaCO2, which is not seen in this case.
B. Metabolic alkalosis is characterized by an elevated bicarbonate level, which is not present in this scenario.
C. Respiratory alkalosis would present with a low PaCO2 and an elevated pH, which is not the case here.
D. The low bicarbonate level (HCO3) 18mEq/L (normal range of 22-26 mEq/L), and low pH 7.30 (normal range of 7.35-7.45), indicate metabolic acidosis. suggesting acidemia. The PaCO2 is also low at 28 mm Hg, indicating a respiratory compensation for the metabolic acidosis.

Correct Answer is C

Explanation

A. Making a list of favorite beverages shows awareness but does not necessarily indicate an understanding of fluid restriction.
B. Putting beverages in large containers to deceive fluid intake is not a recommended or appropriate strategy for managing fluid restriction.
C. Not adding fluid-rich foods like ice cream to the total fluid intake demonstrates an understanding of fluid restriction and adherence to the prescribed limit.
D. Consuming most fluids during the evening is not an appropriate strategy for fluid restriction; fluid intake should be evenly distributed throughout the day.

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