What condition do these results indicate? A nurse is reviewing arterial blood gas lab values on her newly admitted elderly client. The ABG results are as follows: pH 7.21, PaCO2 50, HCO3 26.

Respiratoty acidosis

Metabolic alkalosis

Respiratory alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is A

A) Respiratory acidosis:
This condition is characterized by an increase in PaCO2 and a decrease in pH, which is exactly what is seen in these ABG results. The pH of 7.21 indicates acidosis (normal pH range is 7.35–7.45), and the PaCO2 of 50 is elevated (normal PaCO2 range is 35–45 mmHg), indicating that carbon dioxide retention is contributing to the acidosis. In respiratory acidosis, the lungs are unable to adequately expel CO2, leading to an accumulation of CO2 in the blood, which decreases the pH. The HCO3 (bicarbonate) is within normal range (22–28 mEq/L), suggesting that there has not yet been compensation by the kidneys, which would typically increase bicarbonate levels to buffer the acidosis.

B) Metabolic alkalosis:
Metabolic alkalosis is characterized by an elevated pH (above 7.45) and an elevated HCO3 (above 28 mEq/L). In this case, the pH is low (7.21), and the bicarbonate level (HCO3) is normal (26), so metabolic alkalosis is not the correct diagnosis.

C) Respiratory alkalosis:
Respiratory alkalosis occurs when there is decreased PaCO2 (below 35 mmHg) and an elevated pH (above 7.45), typically due to hyperventilation. Since the PaCO2 is elevated (50 mmHg) in this case, it rules out respiratory alkalosis.

D) Metabolic acidosis:
Metabolic acidosis is characterized by a low pH (below 7.35) and a low HCO3 (below 22 mEq/L). While the pH is low in this case, the HCO3 is normal (26 mEq/L), which suggests that the acidosis is not metabolic in origin. Metabolic acidosis would typically show a low bicarbonate level, indicating that the kidneys are not able to compensate effectively.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A) Prepare the client for mechanical ventilation:
A myasthenic crisis is a medical emergency characterized by severe weakness of the respiratory muscles, leading to respiratory failure. This can result from insufficient levels of acetylcholine due to insufficient medication (e.g., pyridostigmine) or from an infection. In such cases, airway support is the priority. The nurse should first prepare the client for potential mechanical ventilation to ensure they can breathe properly and to prevent respiratory arrest.

B) Instruct the client to perform pursed-lip breathing:
While pursed-lip breathing is a useful technique to help with shortness of breath and improve ventilation in certain respiratory conditions (like COPD), it is not the first action in managing a myasthenic crisis. The immediate priority is to ensure the client can breathe and maintain oxygenation, which may require mechanical ventilation if the respiratory muscles are too weak to support breathing effectively.

C) Prepare to administer IVIG:
IV immunoglobulin (IVIG) can be used in the treatment of myasthenic crisis by suppressing the immune response and increasing acetylcholine receptor activity. However, IVIG is not typically the first intervention. Respiratory support and stabilization should take precedence, especially if there is significant respiratory distress.

D) Administration of an immunosuppressant:
Immunosuppressive therapy, such as corticosteroids or azathioprine, may be used to manage myasthenia gravis over the long term, but it is not an acute intervention for a myasthenic crisis. The immediate priority in a crisis situation is to manage respiratory distress and ensure airway protection.

A. Have the client swish with commercial mouthwash before therapy. B. Place fresh flowers in the clients room C. Tell the client to expect dark stools following chemotherapy. D. Administer an antiemetic prior to the procedure.

Correct Answer is D

Explanation

A) Have the client swish with commercial mouthwash before therapy:
Some commercial mouthwashes contain alcohol, which can be irritating to the mucous membranes, especially in clients undergoing chemotherapy. Chemotherapy can cause mucositis or stomatitis, making the oral cavity more sensitive, so alcohol-based mouthwashes should be avoided

B) Place fresh flowers in the client's room:
Fresh flowers are not recommended in the rooms of clients undergoing chemotherapy because they can introduce bacteria into the environment, which is particularly concerning for clients with weakened immune systems due to chemotherapy. Chemotherapy suppresses the immune system, increasing the risk of infection.

C) Tell the client to expect dark stools following chemotherapy:
Chemotherapy can cause a variety of gastrointestinal side effects, but dark stools are not a typical or expected side effect. Dark stools may indicate gastrointestinal bleeding, which requires immediate attention.

D) Administer an antiemetic prior to the procedure:
Chemotherapy commonly causes nausea and vomiting, and preemptive administration of antiemetic medications can help prevent these symptoms. The nurse should follow the healthcare provider's orders and administer antiemetics as prescribed, which can significantly improve the client's comfort and adherence to the treatment plan.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

What condition do these results indicate? A nurse is reviewing arterial blood gas lab values on her newly admitted elderly client. The ABG results are as follows: pH 7.21, PaCO2 50, HCO3 26.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse suspects a client who has myasthenia gravis is experiencing a myasthenic crisis. Which of the following interventions should the nurse prepare to take first?

Correct Answer is A

Explanation

A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take?

Correct Answer is D

Explanation

A senior nurse is providing instructions to a newly hired nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The senior nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

A nurse receives the following medication orders while caring for multiple clients. Which medication should the nurse plan to administer first?

A home health nurse is making a home visit to a client with multiple sclerosis. The nurse reviews the home medications taken by the client. Which question should the nurse ask to determine the effectiveness of the client's medication, baclofen (Lioresal)?

The nurse is assessing a client who is diagnosed with heart failure and reports slight limitation of physical activity, is comfortable at rest but ordinary physical activity causes symptoms. What heart failure classification does this patient fall under?

A nurse discusses the self-care guidelines to minimize the side effects of radiation on the skin. Which self-care instructions can the nurse provide the client receiving radiation? [Select all that apply.]

A client with a diagnosis of multiple sclerosis is scheduled to receive plasmapheresis treatments. A nurse explains to the client's spouse that the purpose of plasmapheresis is to:

The patient asks the nurse what the P Wave indicates on an EKG strip. The nurse informs the patient that the P Wave represents: