The nurse is admitting a patient with pulmonary edema resulting from heart failure. Upon assessment, the nurse notes that the patient is hyperventilating. What lab results will the nurse expect to see?

pH 7.46, PaCO2 30, HCO3 24

pH 7.48, PaCO2 45, HCO3 29

pH 7.26, PaCO2 59, HCO3 30

pH 7.31, PaCO2 34, HCO3 18

Answer and Explanation

The Correct Answer is A

Choice A reason: The lab results pH 7.46, PaCO2 30, HCO3 24 indicate respiratory alkalosis, which can occur due to hyperventilation. In pulmonary edema, the patient may hyperventilate to compensate for reduced oxygenation, leading to a decrease in carbon dioxide (PaCO2) and an increase in pH (alkaline).

Choice B reason: The lab results pH 7.48, PaCO2 45, HCO3 29 indicate metabolic alkalosis with partial compensation. This is not consistent with hyperventilation in pulmonary edema, where respiratory alkalosis is more likely.

Choice C reason: The lab results pH 7.26, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This finding suggests hypoventilation, which is not expected in a patient hyperventilating due to pulmonary edema.

Choice D reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical in a patient with hyperventilation and pulmonary edema.

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Correct Answer is B

Explanation

Choice A reason: "Abdominal ultrasound should not be performed if you are pregnant" is incorrect. Abdominal ultrasound is a safe and non-invasive diagnostic test that can be performed during pregnancy without any risk to the patient or the fetus.

Choice B reason: "Guaiac-based fecal occult blood testing is a non-invasive test that is commonly performed" is correct. This test is used to detect hidden blood in the stool and is commonly used for diagnostic purposes in patients with irritable bowel syndrome (IBS). It is safe and non-invasive.

Choice C reason: "You will have to remove any device containing metal for a flexible sigmoidoscopy" is correct but does not address the safety concern regarding IBS. Patients do need to remove metal objects for certain diagnostic procedures, but the focus should be on providing information about the non-invasive nature of specific tests.

Choice D reason: "The radiologist will perform the hydrogen breath test under general anesthesia to protect your airway" is incorrect. Hydrogen breath tests are typically performed without anesthesia. Patients simply need to blow into a device at specific intervals after ingesting a substance. The test is non-invasive and does not require anesthesia.

A. Weigh patient using bed scale and restrict oral fluids. B. Obtain pulse oximetry levels and assess the respiratory status. C. Elevate lower extremity on two pillows while patient is in bed. D. Obtain a Physical Therapy consultation to evaluate activity tolerance.

Correct Answer is B

Explanation

Choice A reason: Weighing the patient using a bed scale and restricting oral fluids are important interventions for managing fluid balance in heart failure, but they are not the immediate priority. Assessing the respiratory status takes precedence to ensure the patient is not in respiratory distress.

Choice B reason: Obtaining pulse oximetry levels and assessing the respiratory status are priority actions. Dyspnea on exertion and fatigue indicate potential respiratory compromise, and it is crucial to evaluate oxygenation and respiratory function immediately.

Choice C reason: Elevating the lower extremity on two pillows while the patient is in bed can help reduce edema but is not the immediate priority. Respiratory assessment and stabilization take precedence.

Choice D reason: Obtaining a Physical Therapy consultation to evaluate activity tolerance is beneficial for long-term management but is not an immediate priority in acute care. The focus should be on assessing and stabilizing the patient's respiratory and cardiac status.

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The nurse is admitting a patient with pulmonary edema resulting from heart failure. Upon assessment, the nurse notes that the patient is hyperventilating. What lab results will the nurse expect to see?

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