A nurse is reviewing ABG results for a client who has COPD. Which of the following findings should the nurse expect?

PaCO2 48 mm Hg (35 to 45 mm Hg)

HCO3- 25 mEq/L (21 to 28 mEq/L)

PaO2 85 mm Hg (80 to 100 mm Hg)

pH 7.38 (7.35 to 7.45)

Answer and Explanation

The Correct Answer is A

Rationale:

A. PaCO2 48 mm Hg (35 to 45 mm Hg): In COPD, the body may have difficulty exhaling carbon dioxide, leading to elevated PaCO2 levels. A PaCO2 of 48 mm Hg indicates hypercapnia, especially in advanced stages where respiratory function is impaired.

B. HCO3- 25 mEq/L (21 to 28 mEq/L): HCO3- (bicarbonate) is within the normal range in the acute phase of COPD exacerbation. However, in chronic cases of COPD, bicarbonate levels may increase as the kidneys compensate for respiratory acidosis over time.

C. PaO2 85 mm Hg (80 to 100 mm Hg): A PaO2 of 85 mm Hg is within the normal range, but in clients with COPD, oxygen levels are often lower due to impaired gas exchange. It is common to see PaO2 values closer to or below 60 mm Hg in individuals with COPD.

D. pH 7.38 (7.35 to 7.45): A pH of 7.38 is normal and does not indicate acid-base imbalance. COPD clients often have a tendency towards respiratory acidosis, which may lower the pH, especially during exacerbations, but this value is not concerning for an acute problem.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Rationale:

A. "Make sure family members wear masks whenever they are in the same room as you."
Masks are mainly recommended for the client with tuberculosis, not family members unless they are at high risk. The focus should be on good hygiene and cough etiquette.

B. "Return to work after two consecutive sputum cultures are negative." While negative sputum cultures are important, returning to work depends on completing the full treatment regimen and clinical improvement. Full treatment is essential for transmission control.

C. "Before coughing or sneezing, cover your mouth and nose with a tissue." This is the correct advice to prevent the spread of tuberculosis. Covering the mouth and nose with a tissue when coughing or sneezing helps contain respiratory droplets and protect others.

D. "Wear a high-filtration mask at home when family members are nearby." Wearing a high-filtration mask is generally necessary for healthcare settings. At home, focus should be on cough etiquette, good ventilation, and completing prescribed treatment.

A. Pulse oximeter B. Sterile water C. Nasal cannula D. Yankauer catheter

Correct Answer is B

Explanation

Rationale:

A. Pulse oximeter: A pulse oximeter is useful for monitoring oxygen saturation during suctioning, but it is not required for the procedure itself. The primary equipment needed is related to suctioning and maintaining airway patency.

B. Sterile water: Sterile water is essential for tracheostomy suctioning to keep the suction catheter sterile and to irrigate the catheter as needed. It helps to prevent infection and maintain hygiene during the procedure.

C. Nasal cannula: A nasal cannula is used for oxygen delivery, but it is not required for the suctioning procedure itself. Suctioning may be performed independently of oxygen therapy, although oxygen may be administered after suctioning if needed.

D. Yankauer catheter: A Yankauer catheter is used for oral suctioning, not for tracheostomy suctioning. For tracheostomy suctioning, a specific tracheal suction catheter is required to fit the airway.

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A nurse is reviewing ABG results for a client who has COPD. Which of the following findings should the nurse expect?

Nursing Test Bank

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