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) Identify the client's preferred relaxation technique to use prior to each step of the therapy:
Systematic desensitization involves gradually exposing the client to the anxiety-inducing stimulus while using relaxation techniques to manage anxiety. Identifying the client's preferred relaxation technique is crucial to help them remain calm and reduce their phobia-related anxiety during each step of the therapy.

B) Administer an anxiolytic medication 1 hr prior to the scheduled therapy session:
While anxiolytic medications can help reduce anxiety, systematic desensitization typically relies on non-pharmacological methods to help the client gradually overcome their phobia. The goal is for the client to develop coping mechanisms without medication.

C) Expose the client to an excess amount of anxiety-inducing stimulus to extinguish the phobia:
Exposing the client to an excess amount of anxiety-inducing stimuli is not appropriate for systematic desensitization. This method, known as flooding, can overwhelm the client and increase their anxiety, potentially worsening the phobia rather than alleviating it.

D) Ask the client to snap a rubber band worn on the wrist to minimize anxiety when thinking about the phobia:
Snapping a rubber band on the wrist is a distraction technique that might provide temporary relief from anxiety. However, it is not a core component of systematic desensitization, which focuses on gradual exposure and the use of relaxation techniques to manage anxiety

A. Dyspepsia B. Nausea C. Hyperactive bowel sounds D. Hematemesis

Correct Answer is D

Explanation

A) Dyspepsia:
Dyspepsia, or indigestion, is a common symptom of peptic ulcer disease, causing discomfort in the upper abdomen. While it is uncomfortable and should be managed, it is not immediately life-threatening and does not require urgent intervention compared to other symptoms.

B) Nausea:
Nausea can be a distressing symptom associated with peptic ulcer disease, often resulting from irritation of the stomach lining. Although it can significantly impact the client’s well-being and appetite, it is not as critical as symptoms indicating active bleeding or more severe complications.

C) Hyperactive bowel sounds:
Hyperactive bowel sounds may be present in peptic ulcer disease due to increased gastrointestinal activity. This finding suggests heightened digestive activity but does not indicate an immediate life-threatening condition that would take precedence over signs of active bleeding.

D) Hematemesis:
Hematemesis, or vomiting blood, is a serious and potentially life-threatening symptom that indicates active gastrointestinal bleeding. This requires immediate medical attention to prevent significant blood loss, shock, and other complications. It is the priority finding because it poses the most immediate risk to the client’s health and stability.

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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?

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