A patient's arterial blood gas (ABG) values include a pH of 7.48, a PaCO2 of 38, and an HCO3- of 30. Around which acid-base imbalance would the nurse plan the patient's care?

Metabolic acidosis.

Metabolic alkalosis.

Respiratory acidosis.

Respiratory alkalosis.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level (<22 mEq/L) The given arterial blood gas (ABG) values indicate a pH of 7.48 (which is alkalotic), a PaCO2 of 38 (within the normal range of 35-45 mm Hg), and an HCO3- of 30 (which is elevated) These values indicate metabolic alkalosis, not metabolic acidosis.

Choice B rationale:

Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate level (>26 mEq/L) The given ABG values indicate a pH of 7.48 (which is alkalotic) and an elevated HCO3- of 30, indicating metabolic alkalosis. This condition can result from excessive loss of acids (e.g., vomiting) or excessive intake of bicarbonate or alkali substances.

Choice C rationale:

Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2 (>45 mm Hg) The given ABG values indicate a normal pH of 7.48 and a PaCO2 of 38 (within the normal range), ruling out respiratory acidosis.

Choice D rationale:

Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg) The given ABG values indicate a pH of 7.48 (which is alkalotic) and a PaCO2 of 38 (within the normal range), ruling out respiratory alkalosis.

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Correct Answer is ["A","B","D"]

Explanation

Choice A rationale:

Increased bilirubin levels can occur in thalassemia major due to the destruction of red blood cells, leading to elevated bilirubin, which is a breakdown product of hemoglobin. This elevation can contribute to jaundice and other symptoms.

Choice B rationale:

Thalassemia major leads to the destruction of red blood cells, causing the bone marrow to release more reticulocytes (immature red blood cells) into the bloodstream. Therefore, an increased reticulocyte level is expected in thalassemia major.

Choice C rationale:

Increased mean corpuscular volume (MCV) is not a typical finding in thalassemia major. Thalassemia major is characterized by microcytic (smaller than normal) red blood cells, leading to a decreased MCV.

Choice D rationale:

Thalassemia major causes increased iron absorption by the intestines, leading to elevated total iron-binding capacity (TIBC) TIBC measures the body's capacity to bind and transport iron in the blood, and elevated levels are seen in conditions with increased iron demand, such as thalassemia major.

A. Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L. B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L. C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L. D. Sodium level of 144 mEq/L, potassium level of 3.7 mEq/L.

Correct Answer is C

Explanation

Choice A rationale:

The sodium level is within the normal range, but the potassium level is slightly elevated. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice B rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice C rationale:

Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L is the correct answer. In this option, both sodium and potassium levels are within normal ranges. Changing the IV prescription to DSNS with 20 mEq KCl/L ensures that the patient receives adequate hydration (from the dextrose and normal saline) without causing hyperkalemia.

Choice D rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

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A patient's arterial blood gas (ABG) values include a pH of 7.48, a PaCO2 of 38, and an HCO3- of 30. Around which acid-base imbalance would the nurse plan the patient's care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which laboratory report finding would support the nurse's conclusion that a patient has thalassemia major? Select all that apply.One, some, or all responses may be correct.

Correct Answer is ["A","B","D"]

Explanation

The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?

Correct Answer is C

Explanation

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