The child is a 2-year-old who fell into a pool. He was retrieved from the pool by a family member but was not breathing. The family member started CPR, and the ambulance brought him to the hospital.
What factors are important in determining the level of hypoxemia that the child may have experienced during the submersion?
Select all that apply.
Temperature of water
The weight of the child
Oxygen concentration of the ambient air
Whether or not anyone witnessed the fall into the pool
The amount of time the child was submerged
Correct Answer : A,E
The level of hypoxemia that the child may have experienced during the submersion depends on several factors, but the most important ones are:
- The **temperature of water**: Cold water can induce a diving reflex, which lowers the heart rate and oxygen consumption, and may protect the brain from hypoxic injury. Cold water can also cause laryngospasm, which prevents water aspiration but also impairs gas exchange.
- The **amount of time the child was submerged**: The longer the submersion, the more severe the hypoxemia and the higher the risk of brain damage and death. The survival rate decreases significantly after 5 minutes of submersion.
The other factors are less relevant or not directly related to the level of hypoxemia:
- The **weight of the child**: This may affect the buoyancy and the ability to float or swim, but not the oxygen consumption or gas exchange during submersion.
- The **oxygen concentration of the ambient air**: This may affect the pre-submersion oxygen saturation, but not the rate of oxygen depletion or gas exchange during submersion.
- The **witnessing of the fall into the pool**: This may affect the time to rescue and resuscitation, but not the level of hypoxemia during submersion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice b. Respiratory alkalosis.
Choice A rationale:
Metabolic alkalosis occurs when there is a loss of acid or an increase in bicarbonate in the body. This can be due to vomiting, diuretic use, or excessive bicarbonate intake. It is not typically associated with hyperventilation.
Choice B rationale:
Respiratory alkalosis is caused by hyperventilation, which leads to a decrease in carbon dioxide (CO2) levels in the blood. This condition is often triggered by anxiety, fear, pain, or fever, all of which are present in this adolescent.
Choice C rationale:
Metabolic acidosis occurs when there is an accumulation of acid or a loss of bicarbonate in the body. This can be due to conditions like diabetic ketoacidosis, renal failure, or severe diarrhea. It is not typically associated with hyperventilation.
Choice D rationale:
Respiratory acidosis occurs when there is an accumulation of CO2 in the blood due to hypoventilation or impaired lung function. This condition is not consistent with hyperventilation, which reduces CO2 levels.
Correct Answer is D
Explanation
Choice A rationale:
Continue with the blood pressure assessment. Continuing with the blood pressure assessment without addressing the observed auscultatory gap could lead to an inaccurate reading. It's important to investigate and note the presence of an auscultatory gap before proceeding with the assessment.
Choice B rationale:
Reposition the stethoscope over the brachial artery. Repositioning the stethoscope may not resolve the issue of hearing silence followed by a Korotkoff sound. It is important to assess the situation further before making adjustments.
Choice C rationale:
Reinflate the cuff to a higher number. Reinflating the cuff to a higher number without addressing the auscultatory gap can result in an inaccurate reading. The presence of an auscultatory gap should be noted and managed appropriately.
Choice D rationale:
Note the presence of an auscultatory gap. This is the correct choice. An auscultatory gap is a temporary disappearance of sounds during the blood pressure measurement, and it may indicate underlying cardiovascular issues. The nurse should note its presence, document it, and take appropriate action if necessary.
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