A nurse is assisting with the care of a client who has chronic obstructive pulmonary disease (COPD) and is short of breath. When reviewing the client's arterial blood gases (ABGs), which of the following conditions should the nurse anticipate the client to be experiencing?

Respiratory acidosis

Respiratory alkalosis

Metabolic acidosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is A

A. Respiratory acidosis: COPD often results in impaired gas exchange and decreased removal of carbon dioxide, leading to its accumulation in the blood. This results in respiratory acidosis, characterized by elevated PaCO2 and a decreased pH.

B. Respiratory alkalosis: This condition is generally associated with hyperventilation, where excessive loss of carbon dioxide leads to a higher blood pH. It is less common in COPD, where hypoventilation is more typical.

C. Metabolic acidosis: While COPD can sometimes lead to metabolic acidosis, it is not the primary condition associated with the disease. Metabolic acidosis usually results from conditions affecting the kidneys or metabolic processes.

D. Metabolic alkalosis: This is characterized by an increased blood pH due to a loss of acid or an excess of bicarbonate. It is not typically associated with COPD.

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Correct Answer is D

Explanation

A. Impaired carbon dioxide elimination due to shunting: In ARDS, shunting can impair oxygenation but not directly carbon dioxide elimination. Shunting refers to blood flow through areas of the lung that are not ventilated properly, primarily affecting oxygenation.

B. Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch: ARDS is typically associated with increased, not decreased, pulmonary arterial pressure due to the inflammatory process and reduced lung compliance. V/Q mismatch in ARDS usually results in elevated pulmonary arterial pressure.

C. Hypoxemia due to dead space: ARDS hypoxemia results from impaired gas exchange in damaged alveoli rather than dead space, which is more related to ventilation without perfusion.

D. Decreased pulmonary compliance due to stiffness: ARDS is characterized by decreased pulmonary compliance, which is due to the stiffening of lung tissue from inflammation and edema. This stiffness makes lung expansion more difficult and is a key feature of ARDS.

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

Correct Answer is B

Explanation

A. Respiratory acidosis is caused by hypoventilation, leading to an increase in carbon dioxide levels in the blood. This condition is characterized by confusion, drowsiness, and headache, but it does not typically present with vomiting, tingling, or slow respirations as described in this scenario.
B. Metabolic alkalosis occurs due to a loss of hydrogen ions or an excess of bicarbonate, commonly caused by prolonged vomiting. The symptoms described, including persistent vomiting, tingling, and slow, shallow respirations, are consistent with metabolic alkalosis.
C. Metabolic acidosis results from the accumulation of acid or loss of bicarbonate, often presenting with rapid, deep breathing (Kussmaul respirations). The client’s slow respirations and other symptoms do not align with metabolic acidosis, making this option less likely.
D. Respiratory alkalosis is caused by hyperventilation, which leads to a decrease in carbon dioxide levels. It is usually associated with rapid breathing and does not match the slow respirations and other symptoms seen in this client.

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A nurse is assisting with the care of a client who has chronic obstructive pulmonary disease (COPD) and is short of breath. When reviewing the client's arterial blood gases (ABGs), which of the following conditions should the nurse anticipate the client to be experiencing?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is B

Explanation

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