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 D

Explanation

A. Inform the health care provider that there is a probable leak in the drainage system: Bubbling in the water seal chamber of a chest drainage system during client breathing is an expected finding and indicates air movement in and out of the pleural space. It does not necessarily indicate a leak in the drainage system. Documenting the observation and assessing the client for other signs of complications would be appropriate before informing the healthcare provider.

B. Encourage the client to breathe deeply so the water seal will stabilize: Deep breathing by the client will not stabilize the water seal. The bubbling occurs due to air movement in and out of the pleural space during respiration and is a normal finding.

C. Inform the health care provider that the client is ready to have the chest tube removed: Bubbling in the water seal chamber does not necessarily indicate that the client is ready to have the chest tube removed. The decision to remove a chest tube is based on various factors, including the client's clinical status and resolution of the underlying condition requiring chest drainage.

D. Document that the chest drainage system is functioning as intended: Bubbling in the water seal chamber during client breathing indicates that the chest drainage system is functioning as intended. It is an expected finding and does not typically require intervention.

A. The client expresses feelings of frustration and difficulty coping with the chronic nature of RA. B. The client's C-reactive protein (CRP) levels have remained stable since the initiation of treatment. C. The client demonstrates improved range of motion in the affected joints during physical therapy sessions. D. The client's radiographic images show no progression of joint erosion compared to images from six months ago.

Correct Answer is D

Explanation

A. The client expresses feelings of frustration and difficulty coping with the chronic nature of RA: This indicates the client is struggling emotionally, which is common in chronic illnesses but does not directly reflect the effectiveness of the RA treatment regimen.

B. The client's C-reactive protein (CRP) levels have remained stable since the initiation of treatment: While stable CRP levels can indicate control of inflammation, they do not show improvement. Ideally, effective treatment would reduce CRP levels.

C. The client demonstrates improved range of motion in the affected joints during physical therapy sessions: Improved range of motion is a positive outcome, but it may not fully represent the overall effectiveness of the RA treatment, as joint damage can still progress.

D. The client's radiographic images show no progression of joint erosion compared to images from six months ago: This is the best indicator of effective RA management as it directly shows that the treatment is preventing further joint damage, which is a primary goal in managing RA.

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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

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Correct Answer is D

Explanation

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Explanation

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