A nurse is reviewing a client's arterial blood gas (ABG) results. Which of the following ABG results should the nurse anticipate when caring for a client with acidosis?

pH 7.42, PaCO2 48 mm HG, HCO3 25 mEq/L

pH 7.28, PaCO2 63 mm HG, HCO3 22 mEq/L

pH 7.49, PaCO2 30 mm Hg, HCO3 35 mEq/L

pH 7.36; PaCO2 42 mm Hg, HCO3 26 mEq/L

Answer and Explanation

The Correct Answer is B

A.   This result shows a slightly elevated PaCO2, which could suggest respiratory compensation for a metabolic alkalosis, not acidosis, as the pH is within the normal range.
B.   This result indicates both a low pH and an elevated PaCO2, which are consistent with respiratory acidosis. The low HCO3 also suggests a metabolic acidosis component, making it the best match for a client with acidosis.

C.   The elevated pH indicates alkalosis. The low PaCO2 and high HCO3 further suggest a primary respiratory alkalosis with metabolic compensation.
D.   These values are within normal limits, indicating neither acidosis nor alkalosis.

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Correct Answer is ["B","D","E"]

Explanation

A. Consumes spicy snacks daily: Consuming spicy snacks daily is not a known risk factor for laryngeal cancer. Risk factors for laryngeal cancer typically include tobacco use, alcohol consumption, exposure to certain chemicals, and occupational hazards.

B. Uses flavored chewing tobacco: Chewing tobacco, especially flavored varieties, is a known risk factor for laryngeal cancer. Tobacco contains carcinogenic substances that can damage the cells of the larynx, increasing the risk of cancer development.

C. Employed as x-ray technician: Being employed as an x-ray technician is not a known risk factor for laryngeal cancer. However, prolonged exposure to radiation may increase the risk of other types of cancer, such as lung cancer.

D. Partner smokes cigarettes: Secondhand smoke exposure from a partner who smokes cigarettes is a risk factor for laryngeal cancer. Inhaling tobacco smoke, even indirectly, can expose the individual to carcinogens that may contribute to the development of cancer.

E. Employed as industrial painter: Occupational exposure to certain chemicals, such as those found in paint and industrial solvents, is a known risk factor for laryngeal cancer. Industrial painters may be exposed to carcinogens through inhalation or skin contact, increasing their risk of developing cancer.

A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain B. Bumetanide 1 mg IV bolus every 12 hr C. Laboratory testing of serum potassium upon admission D. 0.9% normal saline IV at 75 mL/hr

Correct Answer is B

Explanation

A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain: This prescription is appropriate for managing pain associated with acute heart failure and MI.

B. Bumetanide 1 mg IV bolus every 12 hr: Bumetanide is a loop diuretic commonly used in heart failure to reduce fluid overload. However, the frequency of administration (every 12 hours) may not be sufficient for managing acute heart failure, where more frequent dosing may be necessary initially.

C. Laboratory testing of serum potassium upon admission: This is a routine and appropriate order to monitor electrolyte balance, especially with the use of diuretics.

D. 0.9% normal saline IV at 75 mL/hr: This is a maintenance IV fluid rate that may be appropriate depending on the client's fluid status. However, it does not directly address acute heart failure.

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A nurse is reviewing a client's arterial blood gas (ABG) results. Which of the following ABG results should the nurse anticipate when caring for a client with acidosis?

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