A nurse is reviewing their client’s lab results. Their client is being treated for hyperosmolar hyperglycemic state (HHS). Which of the following arterial blood gas values will the client exhibit?
PaCO2 31
HCO3 15
pH 7.39
pH 7.27
The Correct Answer is C
Choice A reason: PaCO2 31 mmHg (normal 35-45 mmHg) suggests respiratory alkalosis, not typical in HHS. HHS primarily causes metabolic acidosis or normal pH due to severe hyperglycemia and dehydration, not respiratory compensation, making this an incorrect finding for HHS’s acid-base profile.
Choice B reason: HCO3 15 mEq/L (normal 21-28 mEq/L) indicates metabolic acidosis, more common in DKA than HHS. HHS typically has normal or slightly reduced HCO3 due to minimal ketone production, making this finding less consistent with HHS’s metabolic profile.
Choice C reason: pH 7.39 (normal 7.35-7.45) is expected in HHS, as it typically presents with minimal acidosis due to low ketone production compared to DKA. Severe hyperglycemia and hyperosmolarity dominate, with pH often remaining near normal, making this the correct finding.
Choice D reason: pH 7.27 indicates significant acidosis, typical of DKA, not HHS. HHS involves severe hyperglycemia and dehydration with minimal ketosis, resulting in normal or slightly acidotic pH, making this finding inconsistent with the expected acid-base balance in HHS.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Nausea is a common post-EGD symptom but not the priority. It is less critical than airway safety, as EGD involves throat anesthesia, risking aspiration if the gag reflex is impaired, making this choice secondary.
Choice B reason: Assessing the gag reflex is the priority post-EGD, as throat anesthesia can impair swallowing, risking aspiration. Ensuring the reflex returns before oral intake prevents airway compromise, making this the most critical assessment.
Choice C reason: Level of consciousness is important, especially post-sedation, but airway protection via gag reflex is more urgent. An intact gag reflex ensures safe swallowing, preventing aspiration, making this choice less immediate.
Choice D reason: Pain is a concern post-EGD but not the priority. Airway safety, ensured by an intact gag reflex, is critical to prevent aspiration, a life-threatening complication, making pain assessment secondary to this choice.
Correct Answer is A
Explanation
Choice A reason: Cirrhosis impairs vitamin K-dependent clotting factor synthesis, prolonging prothrombin time. Phytonadione (vitamin K) restores these factors, reducing bleeding risk. Administering it addresses the coagulopathy, making this the correct medication for a prolonged PT in cirrhosis.
Choice B reason: Warfarin, an anticoagulant, further prolongs prothrombin time by inhibiting vitamin K-dependent factors. In cirrhosis with bleeding risk, warfarin worsens coagulopathy, making this choice contraindicated and incorrect for the client’s condition.
Choice C reason: Alteplase, a thrombolytic, dissolves clots and increases bleeding risk, inappropriate for cirrhosis with prolonged PT. It does not address deficient clotting factors, making this choice incorrect and dangerous for a client at risk of hemorrhage.
Choice D reason: Heparin, an anticoagulant, prevents clot formation but worsens bleeding in cirrhosis with prolonged PT. It does not correct the underlying coagulopathy from impaired clotting factor synthesis, making this choice incorrect for the client.
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