The nurse is caring for a patient receiving a continuous albuterol nebulizer for an acute asthma attack. Which arterial blood gas result would indicate that the treatment has been effective?

ABG Value

Normal Range

pH

7.35- 7.45

PaCO2

35-45 mm Hg

HCO3

22-25 mEq/L

Base excess

-2 to +2

PaO2

80-95 mm Hg

SaO2

>95%

pH 7.39, PaO2 88 mmHg, PaCO2 35 mmHg, HCO3 23 mEq/L

pH 7.52, PaO2 86 mmHg, PaCO2 30 mmHg, HCO3 22 mEq/L

pH 7.35, PaO2 75 mmHg, PaCO2 48 mmHg, HCO3 27 mEq/L

pH 7.30, PaO2 90 mmHg, PaCO2 44 mmHg, HCO3 18 mEq/L

Answer and Explanation

The Correct Answer is A

A. A pH within the normal range, a PaCO2 within the normal range, and an improved PaO2 level suggest effective treatment for an asthma attack, indicating adequate gas exchange and resolution of respiratory distress.

B. A pH of 7.52 and low PaCO2 suggest respiratory alkalosis, which can occur with hyperventilation and may indicate overventilation rather than effective asthma treatment.

C. This result shows elevated PaCO2 and borderline low PaO2, indicating ongoing respiratory acidosis and hypoxia, suggesting the treatment is not yet effective.

D. This ABG result shows low pH, indicating acidosis, and a low bicarbonate level, which may indicate metabolic acidosis rather than effective asthma management.

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Correct Answer is B

Explanation

A. While taking some medications with food or milk can help with absorption, this is not a specific requirement for lisinopril.

B. Lisinopril, an ACE inhibitor, can lead to elevated potassium levels. Periodic monitoring of potassium levels is essential to prevent hyperkalemia, a potentially dangerous side effect.

C. Increasing intake of green vegetables is generally healthy but does not directly impact lisinopril's effects.

D. Many salt substitutes contain potassium, which could elevate potassium levels further when taken with ACE inhibitors like lisinopril, posing a risk for hyperkalemia.

A. Suction the patient to minimize secretions B. Continue with the assessment and document the finding C. Notify the physician and raise HOB to 35-45 degrees D. Lower the head of the bed and pad the side rails

Correct Answer is C

Explanation

A. Suctioning can increase ICP due to the Valsalva response and should only be done if absolutely necessary.

B. Documenting without intervention could lead to worsening of the patient's condition.

C. Notifying the physician and raising the head of the bed helps to reduce ICP by promoting venous drainage. An ICP of 30 mmHg is critically high, requiring immediate intervention to prevent further damage.

D. Lowering the head of the bed can increase ICP further; head elevation is recommended to improve cerebral drainage.

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ABG Value	Normal Range
pH	7.35- 7.45
PaCO2	35-45 mm Hg
HCO3	22-25 mEq/L
Base excess	-2 to +2
PaO2	80-95 mm Hg
SaO2	>95%

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who will be discharged with a prescription for lisinopril. What discharge teaching should be provided related to this medication?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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