The nurse is caring for a patient who is anxious and dizzy following a traumatic experience. The arterial blood gas findings include: pH 7.48, PaO2 110, PaCO2 25, and HCO3 24. Which intervention should the nurse expect to be prescribed to correct this problem?
Encourage the patient to breathe in and out slowly into a paper bag.
Immediately administer oxygen via a mask and monitor oxygen saturation.
Anticipate the administration of intravenous sodium bicarbonate.
Prepare to start an intravenous fluid bolus using isotonic fluids.
The Correct Answer is A
The correct answer is choice A: Encourage the patient to breathe in and out slowly into a paper bag.
Choice A rationale: The patient’s arterial blood gas (ABG) results indicate respiratory alkalosis, as evidenced by the elevated pH (7.48) and decreased PaCO2 (25 mm Hg). Respiratory alkalosis often results from hyperventilation, which can occur due to anxiety. Breathing into a paper bag helps to increase CO2 levels in the blood, thereby correcting the alkalosis.
Choice B rationale: Administering oxygen is not appropriate in this scenario because the patient’s PaO2 is already elevated (110 mm Hg), indicating that oxygenation is not the issue. Providing additional oxygen would not address the underlying problem of hyperventilation and respiratory alkalosis.
Choice C rationale: Intravenous sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis. In this case, the patient’s HCO3 is within the normal range (24 mEq/L), indicating that there is no metabolic acidosis present.
Choice D rationale: Starting an intravenous fluid bolus with isotonic fluids is not indicated for correcting respiratory alkalosis. This intervention is more appropriate for patients experiencing hypovolemia or dehydration, which is not suggested by the patient’s ABG results.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Increased urine ketones are not indicative of fluid volume deficit. Instead, they may suggest diabetic ketoacidosis or starvation ketosis.
Choice B rationale:
Decreased Hgb (hemoglobin) is not specific to fluid volume deficit and can be seen in various conditions such as anemia or bleeding.
Choice C rationale:
Decreased urine specific gravity is not consistent with fluid volume deficit, as it usually results in concentrated urine with increased specific gravity.
Choice D rationale:
An increased blood urea nitrogen (BUN) level is expected in fluid volume deficit due to reduced kidney perfusion and function. BUN is a marker of kidney function and is elevated when fluid volume is low.
Correct Answer is {"dropdown-group-1":"C"}
Explanation
Choice A rationale:
Target conditions are not mentioned in the sentence, and there is no context to suggest their relevance to the client's situation.
Choice B rationale:
Hyperactive reflexes are not commonly associated with a urinary tract infection or the prescribed medications.
Choice C rationale:
The client with a urinary tract infection and the medications mentioned (Furosemide and Trimethoprim/sulfamethoxazole) are at an increased risk of hypokalemia (low potassium levels) due to Furosemide's diuretic effect, fluid volume deficit (dehydration) from the infection, and hypertension (high blood pressure) as a potential side effect of Trimethoprim/sulfamethoxazole.
Choice D rationale:
Urinary retention is not expected in a client with a urinary tract infection; it is more commonly associated with urinary obstruction or other urinary conditions unrelated to an infection.
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