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

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.

A. "I will take my medication even if symptoms improve." B. "I will not have my hair dyed or relaxed unless I am in a period of remission." C. "I will sunbathe as often as possible to ensure I get enough vitamin D." D. "I will report any fever to my healthcare provider immediately."

Correct Answer is C

Explanation

A. "I will take my medication even if symptoms improve." This statement indicates understanding of the importance of medication compliance in managing SLE, as symptoms may improve but the disease may still be active.

B. "I will not have my hair dyed or relaxed unless I am in a period of remission." This statement shows awareness of avoiding potential triggers for disease flare-ups during active periods of SLE.

C. "I will sunbathe as often as possible to ensure I get enough vitamin D." Sun exposure can trigger or worsen SLE symptoms, and individuals with SLE are often advised to avoid excessive sun exposure and to use sun protection to minimize flare-ups.

D. "I will report any fever to my healthcare provider immediately." This statement demonstrates understanding of the importance of monitoring for signs of infection or disease flare-ups, which can be common in SLE.

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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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Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who has acute heart failure following myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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