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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

PacO2 50 mm Hg. Choice A rationale:

Potassium levels are not directly related to respiratory acidosis. Potassium levels may be affected in certain conditions, but they are not specific indicators of respiratory acidosis.

Choice B rationale:

HCO3- (bicarbonate) levels may be elevated in metabolic alkalosis, not respiratory acidosis. In respiratory acidosis, the primary abnormality is an increased PacO2, not HCO3-.

Choice C rationale:

The partial pressure of carbon dioxide (PacO2) is a key parameter in diagnosing respiratory acidosis. In this case, a PacO2 of 50 mm Hg suggests hypoventilation and an excess of carbon dioxide in the blood, contributing to acidosis.

Choice D rationale:

The pH level given (pH 7.45) is within the normal range, which contradicts the diagnosis of respiratory acidosis. In respiratory acidosis, the pH would be expected to be below the normal range of 7.35-7.45 due to increased carbon dioxide levels.

A. Phosphorus 4.5 mEq/L. B. Potassium 2.9 mEq/L. C. Calcium 8.2 mg/dL. D. Sodium 145 mEq/L.

Correct Answer is B

Explanation

Choice A rationale:

A phosphorus level of 4.5 mEq/L falls within the normal range, which is typically between 2.5 to 4.5 mEq/L. Although it's essential to monitor phosphorus levels, it is not the priority finding in this scenario.

Choice B rationale:

A potassium level of 2.9 mEq/L is the priority finding. The normal range for potassium is typically between 3.5 to 5.0 mEq/L. A potassium level of 2.9 mEq/L indicates severe hypokalemia, which can lead to life-threatening cardiac arrhythmias and muscle weakness. Immediate intervention is necessary to address the potassium imbalance.

Choice C rationale:

A calcium level of 8.2 mg/dL falls within the normal range (typically 8.5 to 10.2 mg/dL). While calcium levels are essential to monitor, they do not take precedence over the critically low potassium level in this situation.

Choice D rationale:

A sodium level of 145 mEq/L falls within the normal range, which is usually around 135 to 145 mEq/L. Although monitoring sodium levels is important, it is not the priority finding when compared to the critically low potassium level.

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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?

Nursing Test Bank

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