A client reports episode of dyspnea and chest pain unrelated to activity. Which valve disorder does the nurse suspect may be causing these symptoms?

Aortic regurgitation

Mitral valve prolapse

Mitral stenosis

Aortic stenosis

Answer and Explanation

The Correct Answer is D

a. Aortic regurgitation: Aortic regurgitation involves the backflow of blood from the aorta into the left ventricle during diastole due to a dysfunctional aortic valve. While aortic regurgitation can cause symptoms such as dyspnea and chest pain, they are typically associated with exertion rather than occurring at rest or unrelated to activity.

b. Mitral valve prolapse: Mitral valve prolapse is characterized by the abnormal movement of the mitral valve leaflets into the left atrium during systole. While mitral valve prolapse can lead to symptoms such as palpitations, chest discomfort, and dyspnea, these symptoms are usually not unrelated to activity. They are often precipitated or exacerbated by physical exertion or stress.

c. Mitral stenosis: Mitral stenosis involves narrowing of the mitral valve opening, which obstructs blood flow from the left atrium to the left ventricle. Symptoms of mitral stenosis, such as dyspnea and chest discomfort, typically occur with exertion or during periods of increased cardiac demand rather than being unrelated to activity.

d. Aortic stenosis: Aortic stenosis is characterized by narrowing of the aortic valve opening, which obstructs blood flow from the left ventricle to the aorta. This obstruction leads to increased pressure in the left ventricle and can cause symptoms such as dyspnea (due to pulmonary congestion) and chest pain (angina) even at rest. These symptoms are often exacerbated during physical activity but can occur spontaneously as well.

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Correct Answer is A

Explanation

a. Assess level of consciousness: Respiratory acidosis in COPD patients can lead to hypercapnia (elevated carbon dioxide levels), which may result in altered mental status, confusion, or decreased level of consciousness due to respiratory depression. Assessing the level of consciousness is important to monitor for signs of worsening respiratory distress or impending respiratory failure.

b. Monitor serum sodium: COPD patients with respiratory acidosis may retain carbon dioxide, leading to respiratory compensation by the kidneys through increased retention of bicarbonate ions. This retention of bicarbonate can result in metabolic alkalosis and potentially affect electrolyte balance, including sodium levels. Monitoring serum sodium levels is essential to detect any electrolyte imbalances that may occur as a result of respiratory acidosis and its compensatory mechanisms.

c. Check skin turgor: While checking skin turgor is a valuable assessment for hydration status, it may not be directly related to respiratory acidosis in COPD. However, it's still important to assess hydration status in COPD patients, especially those with exacerbations, as dehydration can exacerbate respiratory symptoms.

d. Administer diuretics: Diuretics are not typically indicated in the management of respiratory acidosis in COPD. In fact, diuretics can worsen respiratory acidosis by potentially causing volume depletion and further reducing effective gas exchange in already compromised lungs. Diuretics may be used cautiously in COPD patients with concomitant heart failure or volume overload, but their use should be carefully monitored and individualized.

A. Decreasing level of consciousness B. Bradycardia C. Fever D. ABG: Ph 7.31 (7.35-7.45), PaCO2 42 mmHg (35-45mmHg), HCO3 19 mEq/L (22-26 mEq/L)

Correct Answer is D

Explanation

Decreasing level of consciousness: This assessment finding is consistent with respiratory acidosis, especially if it is severe. In respiratory acidosis, carbon dioxide (CO2) levels in the blood increase, leading to respiratory depression and potential alterations in consciousness due to hypercapnia. Therefore, a decreasing level of consciousness is a possible finding in a client with respiratory acidosis.

b. Bradycardia: Bradycardia is not typically associated with respiratory acidosis. In fact, it is more commonly associated with respiratory alkalosis, where hyperventilation can lead to decreased CO2 levels and subsequent compensatory metabolic alkalosis.

c. Fever: Fever is not a direct consequence of respiratory acidosis. It may occur in response to an underlying infection or inflammation, which could exacerbate respiratory symptoms in a client with COPD. However, it is not a specific finding associated with respiratory acidosis itself.

d. ABG: pH 7.31, PaCO2 42 mmHg, HCO3 19 mEq/L: This ABG result confirms respiratory acidosis. The pH is below the normal range (acidosis), the PaCO2 is elevated (indicating respiratory acidosis), and the HCO3 is decreased (indicating compensation through renal mechanisms). This ABG finding supports the diagnosis of respiratory acidosis in a client with COPD.

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A client reports episode of dyspnea and chest pain unrelated to activity. Which valve disorder does the nurse suspect may be causing these symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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