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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Correct Answer is D

Explanation

Rationale:

A. "You should use an incentive spirometer every 8 hours." Using an incentive spirometer is important for preventing respiratory complications, but the recommendation should be to use it every 1-2 hours while awake, not just every 8 hours.

B. "Clean the incision daily with hydrogen peroxide." Hydrogen peroxide is too harsh for wound care and can delay healing by damaging new tissue. The incision should be cleaned with mild soap and water or as directed by the healthcare provider.

C. "You can cross your legs at the ankles when sitting down." After a hip replacement, clients should avoid crossing their legs, especially at the knees, to prevent dislocation of the new hip joint.

D. "Install a raised toilet seat in your bathroom." After hip replacement surgery, the client should avoid bending the hip beyond 90 degrees to reduce the risk of dislocation. Installing a raised toilet seat helps the client maintain proper positioning and avoid hip flexion beyond the recommended limit.

A. "I have lunch with my friends once a week." B. "I need to get my blood pressure medicine refilled." C. "I've lost 15 pounds in the past 2 months." D. "I had to reschedule my doctor's appointment last week."

Correct Answer is A

Explanation

Rationale:

A. "I have lunch with my friends once a week." Maintaining social interactions and taking time for self-care is an indication of adapting well to the role of a caregiver. It's important to balance caregiving responsibilities with personal well-being.

B. "I need to get my blood pressure medicine refilled." This statement indicates that the client is attending to their own health needs, but it doesn't specifically reflect adaptation to the caregiver role.

C. "I've lost 15 pounds in the past 2 months." Significant weight loss could indicate stress, poor nutrition, or neglecting personal health, which suggests the client may be struggling to adapt to the caregiver role. This would need further assessment.

D. "I had to reschedule my doctor's appointment last week." Rescheduling medical appointments can sometimes happen due to caregiving demands, but it also could indicate difficulty in managing personal and caregiving responsibilities.

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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?

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