A nurse is reviewing a client's laboratory results. The client's ABGS are as follows: pH 7.6, HCO3 24 mEq/L, PaCO2 30 mm Hg, PaO2 90 mm Hg. Which of the following acid-base imbalances should the nurse identify the client is experiencing?

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is C

A) Metabolic alkalosis: Metabolic alkalosis is characterized by a high pH and elevated bicarbonate (HCO3). In this scenario, the pH is elevated at 7.6, which supports alkalosis, but the HCO3 level is normal at 24 mEq/L. The PaCO2 is slightly low, which is not typical for metabolic alkalosis, as it would usually show an elevated HCO3 with a compensatory respiratory alkalosis.

B) Respiratory acidosis: Respiratory acidosis would present with a low pH and an elevated PaCO2. In this case, the pH is high at 7.6, indicating alkalosis, and the PaCO2 is also low at 30 mm Hg, which is inconsistent with respiratory acidosis.

C) Respiratory alkalosis: Respiratory alkalosis is indicated by a high pH with a low PaCO2. Here, the pH is elevated at 7.6, and the PaCO2 is decreased at 30 mm Hg, which fits the profile of respiratory alkalosis. The normal HCO3 level suggests that the bicarbonate is not compensating, supporting a primary respiratory alkalosis.

D) Metabolic acidosis: Metabolic acidosis is characterized by a low pH and a low HCO3. In this scenario, the pH is elevated at 7.6, and the HCO3 level is normal at 24 mEq/L, which does not align with metabolic acidosis. The PaCO2 is also low, which is not typical for metabolic acidosis, as it would usually have a normal or high PaCO2.

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Correct Answer is A

Explanation

A) Talk about the special features of the baby with the client: This intervention acknowledges the baby as a real person and can provide comfort to the grieving parents by validating their loss and giving them a chance to create memories, which is an important aspect of the grieving process.

B) Post a sign indicating No Visitors: This may not be appropriate as it might isolate the client further. Some parents may want the support of family and friends during this difficult time, and such a restriction should be based on the parents' wishes rather than a standard protocol.

C) Limit the amount of time the client is allowed to have the baby in her room: Allowing parents to spend as much time as they need with their baby can help them with the grieving process. Placing limits might be perceived as insensitive and could hinder the emotional healing process.

D) Tell the parents they should hold their baby: While many parents find comfort in holding their stillborn baby, it should be offered as a choice rather than a directive. It is important to respect the parents' individual coping mechanisms and provide support based on their preferences.

Correct Answer is "{\"xRanges\":[232.4270782470703,272.4270782470703],\"yRanges\":[382.1666450500488,422.1666450500488]}"

Explanation

To determine if the child is experiencing subcostal retractions, check the area beneath the ribcage.

D - Subcostal Area:

Subcostal retractions occur below the ribs and are a sign of respiratory distress, indicating increased effort to breathe.

Observing this area can reveal inward movement during inspiration, suggesting difficulty in breathing, often seen in asthma exacerbations.

Rationale

A - Incorrect:

This area is near the clavicle and not related to subcostal retractions.

B - Incorrect:

This is the intercostal area, which can also show retractions but is not subcostal.

C - Incorrect:

This area is too central and does not correspond with subcostal retractions.

Focusing on D allows the nurse to assess the presence of subcostal retractions effectively.

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A nurse is reviewing a client's laboratory results. The client's ABGS are as follows: pH 7.6, HCO3 24 mEq/L, PaCO2 30 mm Hg, PaO2 90 mm Hg. Which of the following acid-base imbalances should the nurse identify the client is experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is developing a plan of care for a client who delivered a stillborn fetus following a placental abruption. Which of the following interventions should the nurse include?

Correct Answer is A

Explanation

Correct Answer is "{\"xRanges\":[232.4270782470703,272.4270782470703],\"yRanges\":[382.1666450500488,422.1666450500488]}"

Explanation

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