What assessment is best for distinguishing between hypoxemia and hypercapnia?

Measuring arterial blood gases

Observing for signs and symptoms

Measuring oxygen saturations

Performing pulmonary function testing

Answer and Explanation

The Correct Answer is A

A. Arterial blood gas (ABG) analysis is the most accurate method for distinguishing between hypoxemia (low oxygen levels in the blood) and hypercapnia (elevated carbon dioxide levels). ABG testing measures both the partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), providing a clear distinction between the two conditions.

B. While observing for signs and symptoms is useful, it is not specific enough to distinguish between hypoxemia and hypercapnia, as both conditions may present with similar symptoms like shortness of breath or confusion.

C. Measuring oxygen saturation with a pulse oximeter can detect hypoxemia but does not provide information about carbon dioxide levels, so it cannot distinguish between hypoxemia and hypercapnia.

D. Pulmonary function testing assesses lung volumes and airflow but does not directly measure oxygen or carbon dioxide levels, making it less effective for distinguishing between hypoxemia and hypercapnia.

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Correct Answer is B

Explanation

A. Needle thoracentesis is typically performed in cases of pneumothorax or pleural effusion, not asthma exacerbation. The symptoms described do not indicate a pleural space issue that would require thoracentesis.

B. Emergency intubation may be necessary if the asthma exacerbation is severe and unresponsive to initial interventions such as bronchodilators, corticosteroids, and oxygen therapy. The patient's symptoms of severe dyspnea, accessory muscle use, and wheezing suggest respiratory distress, and intubation may be required to secure the airway and assist with ventilation.

C. Pleurodesis is a procedure used to treat recurrent pleural effusions, not asthma exacerbations. It involves the obliteration of the pleural space, which is not relevant to the current situation.

D. Chest tube insertion is typically performed for pneumothorax or other issues involving the pleural space, not for asthma exacerbation. The described symptoms do not suggest the need for a chest tube.

A. pH 7.50, HCO3- 20 mEq/L. PaCO2 32 mm Hg B. pH 7.25, HCO3- 19 mEq/L, PaCO 30 mm Hg C. pH 7.55, HCO3- 30 mEq/L. PaCO 31 mm Hg D. pH 7.30, HCO3- 26 mEq/L, PaCO2 50 mm Hg

Correct Answer is D

Explanation

A. A pH of 7.50 is alkalotic, and the bicarbonate level is low, which is inconsistent with chronic kidney disease, where metabolic acidosis is more common.

B. The pH of 7.25 indicates acidosis, but the bicarbonate level is too low, and the PaCO2 is too low to be consistent with a typical acid-base imbalance in chronic kidney disease.

C. The pH of 7.55 is alkalotic, which does not fit the typical presentation of chronic kidney disease, which is associated with metabolic acidosis.

D. A pH of 7.30 indicates mild acidosis, and the bicarbonate level is within a normal range for compensatory mechanisms. The elevated PaCO2 of 50 mm Hg indicates respiratory compensation for metabolic acidosis, which is expected in chronic kidney disease, where the kidneys are unable to adequately excrete acid.

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What assessment is best for distinguishing between hypoxemia and hypercapnia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

Correct Answer is D

Explanation

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