A nurse expects which of the following patients to be in Respiratory Acidosis?
Panic Attack.
Morphine overdose.
Alcohol intoxication.
Sleep Apnea.
High on cocaine.
Correct Answer : B,D
Choice A rationale
A panic attack typically leads to hyperventilation, causing excessive exhalation of carbon dioxide. This results in respiratory alkalosis, characterized by a decreased partial pressure of carbon dioxide (PaCO2) and an elevated pH, due to the rapid elimination of carbonic acid from the body.
Choice B rationale
Morphine overdose depresses the central nervous system, significantly reducing the respiratory drive. This leads to hypoventilation, which causes an accumulation of carbon dioxide (CO2) in the blood. The increased CO2 forms carbonic acid, lowering the blood pH and resulting in respiratory acidosis.
Choice C rationale
Alcohol intoxication primarily affects the central nervous system, leading to respiratory depression similar to opioid overdose. However, severe alcohol intoxication can also cause metabolic acidosis due to lactic acid accumulation from impaired tissue perfusion and metabolism.
Choice D rationale
Sleep apnea causes recurrent episodes of hypoventilation and apnea during sleep. These episodes lead to periods of elevated carbon dioxide (CO2) levels in the blood due to inadequate gas exchange, resulting in intermittent or chronic respiratory acidosis depending on the severity and duration.
Choice E rationale
Cocaine is a stimulant that typically increases respiratory rate and depth. This hyperventilation leads to increased exhalation of carbon dioxide (CO2), resulting in a decrease in PaCO2 and an elevation in blood pH, which is characteristic of respiratory alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
Choice A rationale
A positive sputum culture definitively identifies the pathogenic microorganisms responsible for the infection within the lungs. This microbiological evidence is crucial for confirming the presence of pneumonia and guiding appropriate antibiotic therapy, distinguishing VAP from other pulmonary issues.
Choice B rationale
A new fever indicates a systemic inflammatory response, often triggered by an infection. In the context of a ventilated patient, a new onset of fever, particularly above 38°C (100.4°F), strongly suggests the presence of a new infection, such as ventilator-associated pneumonia.
Choice C rationale
An SpO2 of 98% indicates excellent oxygen saturation. While desirable, it does not rule out VAP, as patients can initially maintain good oxygenation despite developing an infection, especially if the pneumonia is localized or mild in its early stages.
Choice D rationale
A respiratory rate of 14 breaths per minute is within the normal range. A normal respiratory rate does not indicate the presence or absence of VAP, as patients with early or localized pneumonia might not exhibit significant changes in their respiratory patterns initially.
Choice E rationale
New infiltrates on a Chest X-Ray indicate areas of consolidation or fluid accumulation within the lung tissue. These radiological findings are highly suggestive of pneumonia, as the inflammatory process associated with infection leads to alveolar filling and opacities visible on imaging.
Correct Answer is A
Explanation
Choice A rationale
Normal arterial blood gas (ABG) values are pH 7.35-7.45, $PaCO_2$ 35-45 mmHg, and $HCO_3^-$ 22-26 mEq/L. Olivia's ABG results of pH 7.40, $PaCO_2$ 40 mmHg, and $HCO_3^-$ 24 mEq/L all fall within these normal physiological ranges, indicating no acid-base imbalance despite her anxiety and hyperventilation episode.
Choice B rationale
Intubation is a medical procedure to secure an airway, typically for respiratory failure or severe oxygenation/ventilation issues. Olivia's ABG results are completely normal, indicating effective gas exchange and no respiratory distress requiring intubation. There is no physiological basis in these ABG numbers to warrant such an invasive intervention.
Choice C rationale
Inconclusive results suggest that the data gathered is insufficient or ambiguous to draw a definitive conclusion. However, Olivia's ABG results are clearly within normal physiological parameters. The values are precise and fall squarely within the reference ranges, making them conclusive for normal acid-base status.
Choice D rationale
Partial compensation in acid-base balance occurs when the body's compensatory mechanisms are actively trying to correct a primary imbalance but have not fully restored the pH to normal. Since Olivia's pH, $PaCO_2$, and $HCO_3^-$ are all within normal limits, there is no primary imbalance for which the body needs to compensate, thus ruling out partial compensation. .
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