Which blood gas result will the nurse expect to observe in a patient with respiratory alkalosis?

pH 7.53, PaCO2 30 mm Hg, HCO3-24 mEq/L

pH 7.35, PaCO2 35 mm Hg. HCO3-26 mEq/L

pH 7.25, PaCO2 48 mm Hg. HCO3-23 mEq/L

pH 7.60, PaCO2 40 mm Hg, HCO3-30 mEq/L

Answer and Explanation

The Correct Answer is A

A.   pH: Elevated (above 7.45), indicating alkalosis. PaCO₂: Decreased (below 35 mm Hg), reflecting hyperventilation and CO₂ loss. HCO₃⁻: Usually normal (around 24 mEq/L) or slightly decreased, as metabolic compensation might not be immediate. The results here show an elevated pH, decreased PaCO₂, and normal HCO₃⁻, which are consistent with respiratory alkalosis.
B.   pH: Decreased (acidic), indicating acidosis. PaCO₂: Slightly elevated (near normal), not indicative of respiratory alkalosis. HCO₃⁻: Normal (around 26 mEq/L), suggesting no significant metabolic component or compensation. This profile does not match respiratory alkalosis; it is more consistent with a mixed or different type of acid-base imbalance.
C.   pH: Decreased (acidic), indicating acidosis. PaCO₂: Elevated (above 45 mm Hg), indicating CO₂ retention, which is characteristic of respiratory acidosis, not alkalosis. HCO₃⁻: Normal (around 23 mEq/L), showing no significant metabolic compensation or disturbance. This profile indicates respiratory acidosis rather than respiratory alkalosis.
D.   pH: Elevated (alkaline), which is consistent with alkalosis. PaCO₂: Normal (around 40 mm Hg), indicating that CO₂ levels are not the primary cause of the alkalosis. HCO₃⁻: Elevated (above 28 mEq/L), suggesting a metabolic alkalosis or compensation for a respiratory acidosis, but not respiratory alkalosis alone.

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Correct Answer is B

Explanation

A. While administering 0.9% sodium chloride is an important step to maintain venous access and to help dilute any blood that might still be in the tubing, it is not the first action to take if a transfusion reaction is suspected. This step should occur after the transfusion is stopped and the patient’s safety is ensured.
B. The immediate priority when a transfusion reaction is suspected is to stop the transfusion immediately. This action helps to prevent further exposure to the potentially harmful blood product and mitigates the risk of worsening the reaction. Stopping the transfusion also allows for prompt medical assessment and intervention.
C. Returning the unit of blood to the blood bank is important for investigation and to determine the cause of the reaction, but it should be done after stopping the transfusion and ensuring the client’s safety. The blood bank may require the returned unit to confirm any issues with the blood product.

D. Obtaining a blood sample from the client is crucial for diagnostic purposes and to identify the cause of the reaction, but this should be done after the transfusion has been stopped. The sample may help in diagnosing the type of reaction or in managing it, but it does not address the immediate safety concerns.

A. Plan to administer sodium bicarbonate to the client. B. Have the client place their head between their knees. C. Have the client breath into a paper bag. D. Plan to administer insulin to the client.

Correct Answer is C

Explanation

A. Sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis. It helps to neutralize excess acid in the blood, which is not the issue in respiratory alkalosis where the problem is a deficit of CO₂, not an excess of acid.
B. Placing the head between the knees might help with dizziness or lightheadedness but does not address the underlying issue of hyperventilation or help with CO₂ retention.
C. Breathing into a paper bag can help the client re-breathe exhaled CO₂, which helps to correct the imbalance caused by hyperventilation. This method assists in raising CO₂ levels in the blood, which can help normalize the pH and alleviate symptoms of respiratory alkalosis.
D. Insulin is used to manage blood glucose levels in diabetes and is not relevant to the treatment of respiratory alkalosis.

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Which blood gas result will the nurse expect to observe in a patient with respiratory alkalosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving a unit of PRBCs. The nurse suspects the client is experiencing a transfusion reaction. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

A nurse is caring for a client who has respiratory alkalosis and is hyperventilating. Which of the following actions should the nurse take?

Correct Answer is C

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