Mrs. Jamerson, who is in the post anesthesia care unit (PACU) following surgery, is difficult to arouse and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the patient and obtains arterial blood gas (ABG) measurements STAT. The ABG shows a pH of 7.10, PaCO2 of 70 mm Hg, and HCO3 of 24 mEq/L. What does this mean?
Respiratory Alkalosis Partially Compensated
Respiratory Acidosis Uncompensated
Metabolic Alkalosis Partially Compensated
Metabolic Acidosis Uncompensated
The Correct Answer is B
Choice A reason: Respiratory Alkalosis Partially Compensated is characterized by an elevated pH over 7.45 and a PaCO2 under 35 mmHg, with a compensatory acidic HCO3 under 22 mEq/L. This does not match the patient's ABG results.
Choice B reason: Respiratory Acidosis Uncompensated is indicated by an acidic pH under 7.35 and an elevated PaCO2 over 45 mmHg, with HCO3 in the normal range of 2226 mEq/L. The patient's ABG results show a low pH and high PaCO2, which aligns with this condition.
Choice C reason: Metabolic Alkalosis Partially Compensated would show a basic pH over 7.45 and a basic HCO3 over 26 mEq/L, with a compensatory acidic PaCO2 over 45 mmHg[^10^]. The patient's ABG values do not support this diagnosis.
Choice D reason: Metabolic Acidosis Uncompensated would present with an acidic pH under 7.35 and an acidic HCO3 under 22 mEq/L, with PaCO2 in the normal range of 3545 mmHg⁸. The patient's normal HCO3 level does not indicate metabolic acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The medication administration record is an important document, but it is not the primary source for verification before administering blood products. It is used to record the administration after the fact.
Choice B reason: The identification wristband is the priority source for verification. It contains the client's essential information, such as name and hospital ID, which must match the blood product label to ensure patient safety⁸.
Choice C reason: The order sheet contains the physician's orders, which is crucial for verifying what has been prescribed but is secondary to the identification wristband for the actual administration process.
Choice D reason: The chart contains a comprehensive record of the client's medical history and care but is not the primary source for verification when administering blood products.
Correct Answer is A
Explanation
Choice A reason: Defibrillation is used in the case of life-threatening cardiac rhythms, such as ventricular fibrillation or pulseless ventricular tachycardia. It is not the first line of treatment for a stable patient with VT.
Choice B reason: CPR is initiated when a patient is unresponsive and not breathing or not breathing normally, indicating cardiac arrest. It is not indicated for a patient who is stable and experiencing VT.
Choice C reason: Elective cardioversion is a procedure where an electrical shock is delivered to the heart to convert an abnormal rhythm back to a normal sinus rhythm. It is typically used for rhythms such as atrial fibrillation or atrial flutter, not first line for VT.
Choice D reason: Radiofrequency catheter ablation is a procedure that uses radiofrequency energy to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. In the case of VT, this procedure is used to target the area causing the abnormal rhythm and is a common treatment for recurrent VT.
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