A patient's arterial blood gas (ABG) results include a pH of 7.32, a PaCO2 of 56 mm Hg, and an HCO3 of 24 mEq/L. Which acid-base imbalance would the nurse use when developing the patient's plan of care?

Metabolic acidosis.

Metabolic alkalosis.

Respiratory acidosis.

Respiratory alkalosis.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Metabolic acidosis is characterized by low blood pH and low bicarbonate ion levels. The patient's bicarbonate ion level (24 mEq/L) is within the normal range, and the low pH (7.32) and elevated PaCO2 (56 mm Hg) indicate respiratory acidosis, not metabolic acidosis.

Choice B rationale:

Metabolic alkalosis is characterized by high blood pH and high bicarbonate ion levels. The patient's pH is low (7.32), and the bicarbonate ion level (24 mEq/L) is within the normal range, indicating respiratory acidosis rather than metabolic alkalosis.

Choice C rationale:

Respiratory acidosis is characterized by low blood pH and high PaCO2 levels. In this case, the patient has a low pH (7.32) and elevated PaCO2 (56 mm Hg), indicating respiratory acidosis. The bicarbonate ion level (24 mEq/L) is a compensatory response. Respiratory alkalosis would present with high pH and low PaCO2 levels.

Choice D rationale:

Respiratory alkalosis is characterized by high blood pH and low PaCO2 levels. The patient's PaCO2 level is elevated (56 mm Hg), indicating respiratory acidosis, not alkalosis. The low pH (7.32) further supports the diagnosis of respiratory acidosis.

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Correct Answer is B

Explanation

Choice A rationale:

0.459% saline is a hypotonic solution with a lower concentration of salt than the normal physiological range (0.9% NaCl) Hypotonic solutions can cause red blood cells to swell and potentially burst due to the osmotic imbalance, making it inappropriate for hypovolemic shock.

Choice B rationale:

0.9% NaCl, also known as normal saline, is an isotonic solution with a salt concentration similar to the body's own fluids. Isotonic solutions are ideal for hypovolemic shock as they help to expand the intravascular volume without causing significant shifts of fluid and electrolytes within the body compartments.

Choice C rationale:

5% dextrose in 0.45% saline is a hypotonic solution with a low salt concentration. While it provides some fluid replacement, it doesn't address the electrolyte imbalance adequately, which is crucial in hypovolemic shock.

Choice D rationale:

Dextran is a plasma volume expander but is not the first-line choice for hypovolemic shock. It might be used in certain situations, but isotonic crystalloids like 0.9% NaCl are preferred for rapid volume expansion and stabilization of the patient.

A. Serotonin. B. Platelet factor III. C. Von Willebrand factor. D. Adenosine diphosphate.

Correct Answer is C

Explanation

Choice A rationale:

Serotonin is a neurotransmitter that plays a role in mood regulation, sleep, and other functions in the body. It is not a component that forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process.

Choice B rationale:

Platelet factor III is not a component that forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process. Platelet factor III is not widely recognized in the context of clotting; it is more commonly referred to as tissue factor and is involved in the extrinsic pathway of coagulation.

Choice C rationale:

Von Willebrand factor (VWF) is a protein that plays a crucial role in hemostasis. It forms an adhesive bridge between platelets and vascular subendothelial structures, particularly at sites of vascular injury. VWF helps platelets adhere to the injured vessel wall, leading to the formation of a stable blood clot. This process is essential for preventing excessive bleeding. A deficiency or dysfunction in VWF can lead to von Willebrand disease, a bleeding disorder characterized by prolonged bleeding times.

Choice D rationale:

Adenosine diphosphate (ADP) is a molecule released by platelets when they are activated. ADP helps in the aggregation of platelets, but it does not directly form an adhesive bridge between platelets and vascular subendothelial structures.

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A patient's arterial blood gas (ABG) results include a pH of 7.32, a PaCO2 of 56 mm Hg, and an HCO3 of 24 mEq/L. Which acid-base imbalance would the nurse use when developing the patient's plan of care?

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Naxlex Comprehensive Predictor Exams

Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?

Correct Answer is B

Explanation

Which component forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process?

Correct Answer is C

Explanation

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