A patient is post-op from knee surgery. The patient has been receiving Morphine 4 mg IV every 2 hours. The nurse notices the patient is exhibiting a respiratory rate of 8 and is extremely drowsy. Which of the following conditions is the patient at risk for?
Respiratory acidosis
Hypokalemia
Metabolic acidosis
Respiratory alkalosis
The Correct Answer is A
A. Respiratory acidosis:
This occurs when there is inadequate removal of carbon dioxide (CO2) by the respiratory system. In the case of the patient post-op from knee surgery receiving Morphine, the opioid can cause respiratory depression, leading to the retention of CO2 and the development of respiratory acidosis. Signs include a decreased respiratory rate and drowsiness.
B. Hypokalemia:
This is a condition characterized by low levels of potassium in the blood. While opioids can cause constipation, they are not directly associated with hypokalemia.
C. Metabolic acidosis:
This occurs when there is an increase in acid production or a loss of bicarbonate, leading to an imbalance in the body's acid-base status. The symptoms of metabolic acidosis are not typically associated with opioid use.
D. Respiratory alkalosis:
This occurs when there is excessive elimination of CO2, leading to decreased carbon dioxide levels in the blood. Opioids, especially in higher doses, are more likely to cause respiratory depression and acidosis rather than alkalosis. The patient's low respiratory rate and drowsiness are indicative of respiratory acidosis rather than alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Metabolic Acidosis
Metabolic acidosis is characterized by a low pH and low bicarbonate (HCO3) level. In this case, the pH is low (indicating acidosis), but the bicarbonate level is within the normal range, which is inconsistent with metabolic acidosis.
B. Respiratory Acidosis
This is correct. Respiratory acidosis is characterized by an elevated partial pressure of carbon dioxide (PaCO2), leading to a decrease in pH. The ABG values in this case indicate elevated PaCO2 and a low pH, consistent with respiratory acidosis.
C. Metabolic Alkalosis
Metabolic alkalosis is characterized by a high pH and high bicarbonate (HCO3) level. In this case, the pH is low (indicating acidosis), which is inconsistent with metabolic alkalosis.
D. Respiratory Alkalosis
Respiratory alkalosis is characterized by a low partial pressure of carbon dioxide (PaCO2) and a high pH. In this case, the PaCO2 is elevated, which is inconsistent with respiratory alkalosis.
Correct Answer is C
Explanation
A. Development of a buffalo hump and moon face:
This is associated with Cushing's syndrome, a disorder characterized by prolonged exposure to high levels of cortisol.
B. Central obesity and purple striations:
Also indicative of Cushing's syndrome, where excess cortisol can lead to the accumulation of fat in the abdominal area (central obesity) and the development of purple stretch marks (striae).
C. Sudden weight loss without dieting:
This is more characteristic of hyperthyroidism, where the thyroid gland is overactive, leading to increased metabolism and unintended weight loss.
D. Positive Trousseau's sign when checking the client's blood pressure:
Trousseau's sign is associated with hypocalcemia and is seen in conditions affecting the parathyroid gland rather than the thyroid. It involves carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes.
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