The nurse is caring for a client with the following arterial blood gas (ABG) results: pH 7.32, PaCO2 33 mmHg, Pa02 88 mmHg, HCO3 16 mEg/L. The nurse would Interpret these results as:

Table 9.9 Normal Arterial Blood Gas Values

ABG Value.                                                             Normal Value

pH                                                                             7.35-7.45

PaCO2                                                                                                            35-45 mmHg

HCO3-                                                                         22-25mEq/L

Base excess                                                               -2 to +2

PaO2                                                                            80-95 mmHg

SaO2                                                                            >95%

fully compensated respiratory acidosis.

partially compensated respiratory acidosis.

uncompensated metabolic acidosis.

partially compensated metabolic acidosis.

Answer and Explanation

The Correct Answer is D

A. Fully compensated respiratory acidosis: Fully compensated respiratory acidosis would involve a low pH (indicative of acidosis), elevated PaCO2 (due to impaired ventilation), and a normal HCO3 level as compensation by the kidneys. The given ABG results show metabolic acidosis with partial respiratory compensation, not respiratory acidosis.

B. Partially compensated respiratory acidosis: In respiratory acidosis, you would expect an elevated PaCO2 (not low, as seen here) and a compensatory increase in HCO3. However, the ABG results show low HCO3 and low PaCO2, indicating that this is metabolic acidosis, not respiratory acidosis.

C. Uncompensated metabolic acidosis: Uncompensated metabolic acidosis would be indicated by a low pH and low bicarbonate (HCO3), with normal PaCO2. Since the PaCO2 is low, this suggests partial respiratory compensation, making this scenario not uncompensated but partially compensated.

D. Partially compensated metabolic acidosis: To interpret these ABG results, let's break down the values:

pH 7.32 (normal range: 7.35–7.45) indicates acidosis, as it is below the normal range.

PaCO2 33 mmHg (normal range: 35–45 mmHg) is low, suggesting that respiratory compensation is occurring to counteract the acidosis. In metabolic acidosis, the lungs typically attempt to blow off CO2 to reduce acid levels, which is why PaCO2 is low here.

HCO3 16 mEq/L (normal range: 22–25 mEq/L) is low, confirming a metabolic acidosis. The low bicarbonate level is characteristic of metabolic acidosis, where the body loses too much bicarbonate or produces too much acid. PaO2 88 mmHg (normal range: 80–95 mmHg) is within the normal range and does not indicate a significant respiratory issue.

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Correct Answer is ["3.9"]

Explanation

Step-by-Step Solution:

Convert the toddler's weight from pounds to kilograms.

1 pound is =0.453592 kilograms.

So, 26 pounds = 26 x 0.453592 = 11.793592 kilograms.

Calculate the total daily dose of prednisolone.

The prescribed dose is 2 mg/kg/day.

The toddler weighs 11.793592 kg.

The total daily dose = 2 mg/kg/day x 11.793592 kg = 23.587184 mg/day.

Determine the dose per administration.

The total daily dose is divided into two equal doses (every 12 hours).

The dose per administration = 23.587184 mg/day / 2 = 11.793592 mg per dose.

Calculate the volume of prednisolone syrup to administer.

The available prednisolone syrup is 15 mg/5 ml.

We need to administer 11.793592 mg per dose.

To find the volume, we can set up a proportion:

15 mg / 5 ml = 11.793592 mg / x ml

Cross-multiplying:

15x = 5 x 11.793592

Solving for x:

x = (5 x 11.793592) / 15 = 3.931197 ml

Round the answer to the nearest tenth.

3.9 ml.

A. use pyridostigmine as needed to relieve symptoms of muscle weakness and fatigue." B. be able to crush the sustained release tablet because of difficulty swallowing." C. skip a dose if I have symptoms of fatigue to minimize side effects of the medications." D. take pyridostigmine 30-60 minutes before meals to improve muscle function."

Correct Answer is D

Explanation

A. Use pyridostigmine as needed to relieve symptoms of muscle weakness and fatigue: Pyridostigmine should not be used on an "as-needed" basis, as it is a long-acting medication that works by maintaining a steady level of acetylcholine at the neuromuscular junction. The client needs to take the medication regularly at prescribed intervals, not sporadically, to maintain consistent symptom control. This statement reflects a misunderstanding of the medication's use.

B. Be able to crush the sustained release tablet because of difficulty swallowing: Sustained-release (or extended-release) tablets should not be crushed because doing so can cause the medication to be released too quickly, leading to potential side effects or overdose. If the client has difficulty swallowing, an alternative form of the medication, such as a liquid or split tablet, should be considered. This statement reflects a lack of understanding regarding the proper administration of the medication.

C. Skip a dose if I have symptoms of fatigue to minimize side effects of the medications: Skipping doses of pyridostigmine is not appropriate. The medication should be taken as prescribed, even if the client feels fatigued. Fatigue is a symptom of myasthenia gravis, not necessarily a side effect of the medication. Consistent dosing is important for controlling the disease and preventing worsening of symptoms. Skipping doses can lead to inadequate symptom control and potential exacerbation of weakness.

D. Take pyridostigmine 30-60 minutes before meals to improve muscle function: This statement indicates that the client understands the appropriate use of pyridostigmine for managing myasthenia gravis (MG). Pyridostigmine is an acetylcholinesterase inhibitor that helps improve neuromuscular transmission, and it is typically taken 30-60 minutes before meals. This timing helps optimize muscle strength during the period when the client is eating, as muscle weakness can make swallowing more difficult. By taking the medication before meals, the client is more likely to experience improved muscle function when needed most.

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Naxlex Comprehensive Predictor Exams

A client is receiving a continuous infusion of IV insulin at 8 mL/hour. Pharmacy makes an infusion of 75 units of regular insulin in 150 mL of Normal Saline for this institution. How many units per hour is the client receiving? (Round to the nearest whole number)

Correct Answer is ["3.9"]

Explanation

The nurse is providing education for a client diagnosed with myasthenia gravis (MG) taking pyridostigmine. The nurse understands teaching has been effective when the client states, "I will

Correct Answer is D

Explanation

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