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 C

Explanation

A. Nitroprusside is a vasodilator and is not used for managing ICP; it can increase intracranial pressure if not carefully monitored.

B. Furosemide is a diuretic but is less effective for ICP reduction compared to hypertonic saline or mannitol.

C. Hypertonic saline (3% Normal Saline) is used to reduce intracranial pressure by drawing fluid out of the brain tissue and into the bloodstream, which can help prevent cerebral edema.

D. Norepinephrine is a vasopressor and is not used specifically to manage intracranial pressure.

A. Encourage the patient to cough to expectorate secretions B. Elevate the head of the bed to 30-45 degrees C. Stimulate the patient with active range of motion exercises D. Perform serial neurologic assessments while hospitalized E. Contact the healthcare provider if the ICP is sustained between 30-40mmHg

Correct Answer is ["B","D","E"]

Explanation

A. Coughing can increase ICP by increasing intrathoracic pressure and should be minimized in patients with head injuries.

B. Elevating the head of the bed to 30-45 degrees promotes venous drainage from the head, reducing ICP.

C. Active stimulation can increase ICP and is generally avoided in patients with acute head injuries.

D. Serial neurologic assessments help monitor any changes in the patient’s condition and ICP, allowing for timely intervention.

E. Sustained ICP levels between 30-40 mmHg are significantly elevated and require immediate communication with the healthcare provider, as they are above the normal range and could lead to further complications

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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

When considering the pharmacologic management of a patient who has sustained a traumatic head injury, the nurse can anticipate a prescription for which of the following medications to manage increases in intracranial pressure (ICP)?

Correct Answer is C

Explanation

The nurse has established a goal to maintain intracranial pressure (ICP) within the normal range for the patient with an acute head injury. Which action(s) should the nurse take to achieve this goal? (SELECT ALL THAT APPLY)

Correct Answer is ["B","D","E"]

Explanation

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