A nurse is caring for a client who is receiving oxygen at 2 L/min via a nasal cannula. The nurse recognizes the client is receiving which of the following inspired oxygen concentration?

Respiratory acidosis occurs when there is inadequate removal of carbon dioxide (CO2) by the lungs, leading to an accumulation of CO2 and a decrease in pH.

Analysis:

pH 7.22: Indicates acidemia (pH below 7.35), suggesting acidosis.

PaCO2 68 mm Hg: Elevated PaCO2 indicates hypoventilation, which is characteristic of respiratory acidosis.

Base excess -2: Base excess is within normal limits and does not contribute significantly to the acid-base imbalance in this scenario.

PaO2 78 mm Hg: PaO2 is slightly low but not significantly contributing to the acid-base imbalance.

Saturation 80%: Oxygen saturation is low, indicating hypoxemia, which is commonly associated with respiratory acidosis due to hypoventilation.

Bicarbonate 26 mEq/L: Bicarbonate is within normal limits, suggesting compensation for the respiratory acidosis, which is a chronic condition.

Overall, the ABG values indicate respiratory acidosis due to inadequate ventilation, leading to CO2 retention and subsequent acidemia.

A. Excessive thirst and urination:
Excessive thirst and urination are symptoms typically associated with hyperglycemia, where there is a high level of glucose in the blood, often related to diabetes. When TPN is stopped suddenly, the concern is more about hypoglycemia due to the abrupt lack of glucose infusion, not hyperglycemia.

B. Shakiness and diaphoresis:
When TPN is suddenly interrupted, the continuous supply of glucose that the patient relies on is abruptly halted. This can lead to a rapid drop in blood sugar levels, causing hypoglycemia. Symptoms of hypoglycemia include shakiness, diaphoresis (sweating), confusion, and even loss of consciousness if not promptly addressed. Monitoring for shakiness and diaphoresis is crucial in this scenario to prevent severe hypoglycemia.

C. Hypertension and crackles:
These symptoms are typically indicative of fluid overload or heart failure. While TPN can contribute to fluid overload if not managed properly, the immediate concern with the cessation of TPN is the lack of glucose and potential hypoglycemia, not fluid overload.

D. Fever and chills:
Fever and chills are generally signs of an infection, such as sepsis. While infections can be a complication of TPN due to the intravenous route of administration, they are not directly related to the sudden stopping of TPN. The primary concern when TPN stops unexpectedly is the risk of hypoglycemia due to the cessation of glucose infusion.