A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 68 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement?Reference Range:
Arterial Blood Gas (ABG)
pH [Adult/child: 7.35 to 7.45]
PaCO2 [Adult/child: 35 to 45 mm Hg)
HCO- [Adult/child: 21 to 28 mEq/L (21 to 28 mmol/L)] PaO2 [Adult/child: 80 to 100 mm Hg)
Increase rate of ventilation.
Decrease expiratory flow time.
Increase ventilator tidal volume.
Decrease expiratory pressure.
The Correct Answer is A
Rationale
A. The client's pH is low (acidotic), and the PaCO2 is high (respiratory acidosis). Increasing the rate of ventilation (respiratory rate) can help to decrease PaCO2 by increasing alveolar ventilation, thereby helping to correct respiratory acidosis.
B. Expiratory flow time affects the time available for exhalation. While this may affect the overall mechanics of ventilation, it is not directly targeting the primary issue of elevated PaCO2 and acidosis.
C. Increasing tidal volume increases the volume of air delivered with each breath. This can improve ventilation efficiency but may not address the underlying problem of elevated PaCO2 unless it leads to increased minute ventilation.
D. Expiratory pressure is related to positive end-expiratory pressure (PEEP), which helps maintain alveolar recruitment and improve oxygenation. Decreasing expiratory pressure may not directly address the elevated PaCO2 and acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale
A. Green leafy vegetables do not interact with cefdinir. They are generally a healthy choice and can be encouraged without any concerns related to the antibiotic therapy.
B. Fresh fruits are also safe to consume with cefdinir. There are no interactions between fruits and this antibiotic.
C. Yogurt and buttermilk contain probiotics, which are beneficial bacteria that can help maintain gut health. Antibiotics like cefdinir can disrupt the normal gut flora, leading to diarrhea or other gastrointestinal issues. Consuming yogurt or buttermilk with live cultures may help replenish beneficial bacteria in the gut and reduce the risk of antibiotic-associated diarrhea.
D. Avocados and cheese are also safe choices. There are no specific interactions between these foods and cefdinir.
Correct Answer is A
Explanation
Rationale
A. Acute pain following laser trabeculoplasty could indicate increased intraocular pressure, inflammation, or other complications. Reporting the pain to the surgeon allows for prompt evaluation and intervention, which may include further assessment of intraocular pressure, examination of the surgical site, and consideration of additional treatment modalities such as pain management or anti- inflammatory medications.
B. Postoperative antibiotics are typically prescribed to prevent infection after surgery. However, acute pain alone may not indicate an infection, and starting antibiotics without assessing the cause of pain could delay appropriate management. Antibiotics are not indicated as the first-line response to acute pain in this context.
C. Eye shields are commonly used after eye surgery to protect the eye from light and potential trauma. While important for protecting the eye, applying eye shields addresses a different aspect of postoperative care (protecting the eye from external factors), rather than addressing the acute pain reported by the client.
D. Nausea and vomiting can sometimes occur postoperatively due to anesthesia or medications. However, administering an antiemetic is not the appropriate action in response to acute eye pain following laser trabeculoplasty. It does not address the underlying cause of the pain and is not part of the standard immediate management for this situation.
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