A nurse is reviewing laboratory results of a client. The client's ABG results are as follows: pH 7.2, HCO, 26 mEq/L, PaCO2 52 mm Hg. Which of the following acid-base imbalances should the nurse identify the client is experiencing?

Metabolic acidosis

Metabolic alkalosis

Respiratory alkalosis

Respiratory acidosis

Answer and Explanation

The Correct Answer is D

A) Metabolic acidosis: In metabolic acidosis, you would expect a low pH (acidosis) with a low bicarbonate (HCO3-) level. However, the given bicarbonate level is within the normal range (22-26 mEq/L), which indicates the acidosis is not metabolic in origin.

B) Metabolic alkalosis: Metabolic alkalosis would present with a high pH (alkalosis) and an elevated bicarbonate (HCO3-) level. The pH in this case is low, indicating acidosis, and the bicarbonate level is normal, ruling out metabolic alkalosis.

C) Respiratory alkalosis: In respiratory alkalosis, you would see a high pH (alkalosis) and a low PaCO2 due to hyperventilation. The given pH is low, indicating acidosis, and the PaCO2 is elevated, which is inconsistent with respiratory alkalosis.

D) Respiratory acidosis: Respiratory acidosis is characterized by a low pH (acidosis) and an elevated PaCO2 due to hypoventilation or impaired gas exchange. The client's ABG results show a low pH (7.2), a normal bicarbonate level (26 mEq/L), and an elevated PaCO2 (52 mm Hg), indicating the client is experiencing respiratory acidosis.

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Correct Answer is A

Explanation

A) Instruct the client to perform coughing exercises after meals.
Coughing exercises after meals can help clear the airways of mucus, which is beneficial for clients with COPD. Effective airway clearance is crucial to improve breathing and reduce the risk of infections. This intervention can enhance respiratory function and comfort.

B) Limit the client's fluid intake to 1,500 mL/day.
Limiting fluid intake is generally not recommended for clients with COPD unless there is a specific medical reason, such as heart failure. Adequate hydration helps keep mucus thin and easier to expectorate, which is important for respiratory health.

C) Encourage the client to sit in a chair for 1 hr several times per day.
Encouraging the client to sit in a chair helps promote mobility and prevent complications associated with prolonged bed rest. However, while sitting up can improve lung expansion, it is not the most specific or direct intervention to address dyspneic episodes.

D) Initiate oxygen therapy for the client via nasal cannula at 10 L/min.
Administering oxygen at a high flow rate like 10 L/min is not typically appropriate for clients with COPD due to the risk of depressing their respiratory drive. Oxygen therapy should be carefully titrated and monitored based on the client's needs and blood gas levels.

A. Manic behavior B. Deep, labored respirations C. Bradycardia D. Cold intolerance

Correct Answer is A

Explanation

A) Manic behavior: Hyperthyroidism can lead to manic or hyperactive behavior due to increased metabolic rate and overstimulation of the nervous system. This may present as irritability, anxiety, or restlessness, making manic behavior a relevant manifestation in this condition.

B) Deep, labored respirations: Hyperthyroidism generally does not cause deep, labored respirations. Instead, it may lead to increased respiratory rate due to heightened metabolic activity. Deep, labored respirations are more indicative of respiratory or cardiac issues rather than hyperthyroidism.

C) Bradycardia: Hyperthyroidism usually causes tachycardia (elevated heart rate) rather than bradycardia (slow heart rate). Tachycardia is a common symptom due to the increased metabolic rate and sympathetic nervous system activity associated with hyperthyroidism.

D) Cold intolerance: Cold intolerance is more characteristic of hypothyroidism, where there is decreased metabolic activity and reduced heat production. Hyperthyroidism typically causes heat intolerance due to the increased metabolic rate and elevated body temperature.

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A nurse is reviewing laboratory results of a client. The client's ABG results are as follows: pH 7.2, HCO, 26 mEq/L, PaCO2 52 mm Hg. Which of the following acid-base imbalances should the nurse identify the client is experiencing?

Nursing Test Bank

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Explanation

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