A 25-year-old patient with generalized anxiety disorder presents to the ED with shortness of breath, dizziness, and tingling in the fingers. The nurse reviews the ABG results: pH: 7.50, PaCO2: 30 mmHg HCO3: 24 mEq/L. What is the most likely acid-base imbalance?
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
The Correct Answer is C
A. Respiratory acidosis would present with a low pH (acidotic) and a high PaCO2, which is not the case here.
B. Metabolic alkalosis would be suggested by an elevated pH and elevated HCO3, but here, the bicarbonate level is normal (24 mEq/L).
C. Respiratory alkalosis is indicated by a pH of 7.50 (alkalosis) and a PaCO2 of 30 mmHg, which is lower than the normal range (35-45 mmHg). This low PaCO2 suggests that the patient is hyperventilating, likely due to anxiety, which causes the body to excrete too much CO2.
D. Metabolic acidosis would present with a low pH and a low bicarbonate level, neither of which are seen in this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Propranolol: Propranolol is a beta-blocker that can be used to treat physical symptoms of anxiety, such as a racing heart. While it may help reduce physiological symptoms, it does not address the psychological components of anxiety and is not commonly prescribed for acute anxiety episodes like test-taking anxiety. Propranolol is more effective for individuals with performance anxiety (e.g., public speaking).
B. Lorazepam: Lorazepam is a benzodiazepine that works by depressing the central nervous system, providing rapid relief of acute anxiety symptoms. It is often used for short-term management of anxiety and can effectively reduce symptoms such as racing heart and trembling hands, making it appropriate for episodic anxiety like test-taking anxiety. However, it is typically prescribed for short-term use due to its potential for dependence.
C. Sertraline: Sertraline is a selective serotonin reuptake inhibitor (SSRI) used for chronic anxiety and depression, but it is not effective for acute episodic anxiety. SSRIs are typically prescribed for long-term management of anxiety disorders, rather than immediate symptom relief.
D. Buspirone: Buspirone is an anxiolytic medication used for generalized anxiety disorder (GAD) but has a delayed onset of action and is not effective for acute, episodic anxiety relief. It is more suitable for long-term management rather than immediate symptom control.
Correct Answer is D
Explanation
A. Isolating the client is not appropriate, as it can increase anxiety and exacerbate the compulsive behaviors.
B. Setting strict limits can lead to increased anxiety and resistance, making it harder to manage the compulsive behaviors.
C. Confronting the client about the senselessness of their compulsions can increase anxiety and worsen the behavior. It is more helpful to provide a supportive environment that allows for the rituals, gradually decreasing their frequency and intensity.
D. Clients with OCD often perform compulsive rituals to reduce anxiety. Planning time for rituals helps to manage the behavior while maintaining the therapeutic structure and routine on the unit.
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