A nurse is reviewing the arterial blood gas report of a client who is in metabolic acidosis. Which of the following findings should the nurse expect?

pH 7.28 (7.35 to 7.45)

PaCO2, 31 mm Hg (35 to 45 mm Hg)

HCO2 18 mEq/L (21 to 28 mEq/L)

Pa02, 85 mm Hg (72 to 100 mm Hg)

Answer and Explanation

The Correct Answer is A

A) pH 7.28 (7.35 to 7.45): In metabolic acidosis, the pH is typically below the normal range, which is 7.35 to 7.45. A pH of 7.28 indicates acidemia, which is consistent with metabolic acidosis.

B) PaCO2, 31 mm Hg (35 to 45 mm Hg): In metabolic acidosis, the PaCO2 level may be decreased as a compensatory mechanism by the lungs to expel more carbon dioxide and counteract the acidosis. However, a PaCO2 of 31 mm Hg is slightly low but not a direct indicator of metabolic acidosis; it reflects respiratory compensation rather than the primary problem.

C) HCO3 18 mEq/L (21 to 28 mEq/L): In metabolic acidosis, the bicarbonate (HCO3) level is usually low, as it is the primary buffer that decreases in response to the acidosis. An HCO3 of 18 mEq/L is lower than the normal range, indicating a decrease consistent with metabolic acidosis.

D) PaO2, 85 mm Hg (72 to 100 mm Hg): The PaO2 level, which measures oxygen in the blood, is generally not directly affected by metabolic acidosis. While the PaO2 of 85 mm Hg is within the normal range and does not specifically indicate metabolic acidosis, it is more relevant to assessing oxygenation rather than the acid-base balance.

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Correct Answer is A

Explanation

A) Diphenhydramine:
Diphenhydramine is an antihistamine that effectively treats allergic reactions such as hives and urticaria. It works by blocking histamine, a substance in the body that causes allergic symptoms. Administering diphenhydramine can help alleviate itching, swelling, and redness associated with an allergic reaction to IV contrast dye.

B) Desmopressin:
Desmopressin is a synthetic hormone used to treat conditions like diabetes insipidus and bedwetting. It is not indicated for treating allergic reactions or symptoms like hives and urticaria. Using desmopressin in this context would not address the client’s immediate allergic symptoms.

C) Spironolactone:
Spironolactone is a potassium-sparing diuretic used primarily to treat conditions like heart failure, hypertension, and edema. It has no role in managing allergic reactions or symptoms such as hives and urticaria caused by contrast dye. Administering spironolactone would not provide any benefit in this scenario.

D) Metoclopramide:
Metoclopramide is an antiemetic and prokinetic agent used to treat nausea, vomiting, and gastroparesis. It does not have antihistamine properties and would not be effective in treating hives and urticaria following an allergic reaction to IV contrast dye. Using metoclopramide would not address the client's allergic symptoms.

A. Fever B. Cloudy effluent C. Increased heart rate D. Generalized abdominal pain

Correct Answer is B

Explanation

A. Fever
Fever is a common sign of infection, but it may not be the earliest indicator of peritonitis in peritoneal dialysis. It often appears after other more specific symptoms, like changes in the dialysis effluent.
B. Cloudy effluent
Cloudy effluent is the earliest and most specific sign of peritonitis in clients undergoing peritoneal dialysis. It indicates the presence of white blood cells and bacteria, suggesting an infection in the peritoneal cavity.
C. Increased heart rate
An increased heart rate can occur with infection or pain, but it is not specific to peritonitis and may arise later. It is a less direct indicator compared to changes in the dialysis fluid.
D. Generalized abdominal pain
Abdominal pain is a significant symptom but typically follows the early sign of cloudy effluent. It indicates inflammation and irritation in the peritoneal cavity, often accompanying infection progression.

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A nurse is reviewing the arterial blood gas report of a client who is in metabolic acidosis. Which of the following findings should the nurse expect?

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