A client recently had aortic valve regurgitation treated with placement of a mechanical valve. Which laboratory test would be ordered for management of this type of prosthetic valve?

Brain natriuretic peptide (BNP)

Cardiac enzymes

Blood urea nitrogen and creatinine

PT/INR

Answer and Explanation

The Correct Answer is D

Brain natriuretic peptide (BNP): BNP is a hormone released by the heart in response to increased ventricular pressure and volume overload. It is typically elevated in conditions such as heart failure. While monitoring BNP levels may provide information about cardiac function and volume status, it is not specifically ordered for managing a mechanical valve.

b. Cardiac enzymes: Cardiac enzymes, such as troponin and creatine kinase (CK), are markers of myocardial damage and are typically elevated in conditions such as myocardial infarction. They are not specifically ordered for managing a mechanical valve unless there are signs or symptoms suggestive of myocardial ischemia or infarction.

c. Blood urea nitrogen and creatinine:- Monitoring blood urea nitrogen (BUN) and creatinine levels is important for assessing renal function, especially in individuals at risk of renal impairment due to factors such as medications or underlying conditions. While renal function is important in overall cardiac management, these tests are not specifically ordered for managing a mechanical valve unless there are concerns about renal function due to medications such as anticoagulants.

d. PT/INR (Prothrombin Time/International Normalized Ratio): PT/INR monitoring is crucial for managing patients with mechanical heart valves, as these valves are thrombogenic and increase the risk of thromboembolic events such as stroke or valve thrombosis. Warfarin, an oral anticoagulant, is commonly prescribed to maintain therapeutic anticoagulation. PT/INR monitoring helps ensure that the patient is within the target therapeutic range to prevent both thrombotic and bleeding complications associated with the mechanical valve.

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Correct Answer is D

Explanation

a. Uncompensated respiratory alkalosis: Respiratory alkalosis is characterized by a high pH (above 7.45) and a low PaCO2 (below 35mmHg). In this case, the pH is below the normal range and the PaCO2 is elevated, which does not support the diagnosis of respiratory alkalosis.

b. Uncompensated metabolic alkalosis: Metabolic alkalosis is characterized by a high pH and an elevated bicarbonate (HCO3) level. In this case, the pH is below the normal range and the HCO3 level is within the normal range, which does not support the diagnosis of metabolic alkalosis.

c. Uncompensated metabolic acidosis: Metabolic acidosis is characterized by a low pH and a low bicarbonate (HCO3) level. In this case, the pH is below the normal range, but the HCO3 level is within the normal range, which does not support the diagnosis of metabolic acidosis.

d. Uncompensated respiratory acidosis: The pH is below the normal range (7.35-7.45), indicating acidosis. The PaCO2 is elevated at 49mmHg (normal range: 35-45mmHg), indicating respiratory acidosis. The HCO3 is within the normal range at 26mEq/L (normal range: 22-26mEq/L), indicating that compensation has not occurred. Therefore, the ABG results suggest uncompensated respiratory acidosis.

A. Metabolic alkalosis B. Metabolic acidosis C. Respiratory alkalosis D. Respiratory acidosis

Correct Answer is A

Explanation

a. Metabolic alkalosis: Metabolic alkalosis can occur due to loss of gastric acid through suctioning of gastric contents via the nasogastric tube. Continuous suctioning of gastric contents can lead to loss of hydrogen ions (H+) and chloride ions (Cl-) from the stomach, resulting in metabolic alkalosis.

b. Metabolic acidosis: Metabolic acidosis is less likely in this scenario unless there are other factors contributing to acidosis, such as renal dysfunction or excessive administration of certain medications. Suctioning of gastric contents would lead to loss of acid, which could potentially predispose the client to metabolic alkalosis rather than metabolic acidosis.

c. Respiratory alkalosis: Respiratory alkalosis is less likely to occur in this scenario. Although the client is NPO and may be experiencing some respiratory compensation due to metabolic alkalosis, the primary acid-base disturbance would be metabolic rather than respiratory.

d. Respiratory acidosis: Respiratory acidosis is not typically associated with suctioning of gastric contents. Instead, it occurs due to inadequate alveolar ventilation, leading to retention of carbon dioxide (CO2) and subsequent respiratory acidosis. This imbalance is more commonly seen in conditions such as respiratory depression, neuromuscular disorders, or airway obstruction.

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A client recently had aortic valve regurgitation treated with placement of a mechanical valve. Which laboratory test would be ordered for management of this type of prosthetic valve?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted to the hospital with an acid base imbalance. Arterial blood gas (ABG) results are: Ph 7.33 (7.35-7.45), PaCO2 49mmHg (35-45mmHg), HCO3 26mEq/L (22-26mEq/L). How should the nurse interpret these results?

Correct Answer is D

Explanation

The nurse is caring for a client who is post-operative following a bowel resection. The client is NPO with a nasogastric tube connected to suction. Which acid base imbalance is this client at risk to develop?

Correct Answer is A

Explanation

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