Based on your patient's ABG's what acid-base imbalance is present? pH 7.30 HCO3 23 PaCO2 49.

Respiratory alkalosis

Respiratory acidosis

Metabolic alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is B

A. Respiratory alkalosis – Respiratory alkalosis is characterized by elevated pH (>7.45) and low PaCO₂ (<35 mm Hg) due to hyperventilation.
B. Respiratory acidosis – The pH is low (7.30) indicating acidosis, and the PaCO₂ is elevated (49 mm Hg), indicating that the cause is respiratory (CO₂ retention due to hypoventilation). The HCO₃ is normal (23 mEq/L), which supports that the cause is not metabolic.
C. Metabolic alkalosis – This would show an elevated pH (>7.45) and elevated HCO₃ (>28 mEq/L), which is not present here.
D. Metabolic acidosis – Metabolic acidosis is indicated by low pH and low HCO₃ (<21 mEq/L), which is not the case in these ABG values.

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Correct Answer is C

Explanation

A. The client has become addicted to the medication. – Addiction involves compulsive drug-seeking behavior and use despite harm. In a hospice setting, tolerance and dependence are expected and should not be confused with addiction.
B. The client is experiencing episodes of confusion. – While morphine may cause confusion, especially in elderly or very ill clients, this does not explain the need for a higher dose for pain relief.
C. The client developed a tolerance to the medication. – Tolerance occurs when the body becomes accustomed to a drug, requiring higher doses to achieve the same effect. This is common with long-term opioid use for chronic or terminal pain.
D. The client has not been taking the medication properly. – There is no indication of noncompliance. The need for a higher dose is more accurately attributed to tolerance, especially in terminal illness.

A. Perform a 12 lead EKG B. Check the patient's blood pressure C. Auscultate the patient's heart sounds D. Determine is the pain radiates to the left arm

Correct Answer is A

Explanation

A. Perform a 12 lead EKG – A 12-lead electrocardiogram (EKG/ECG) is the most appropriate and immediate diagnostic tool to assess for myocardial infarction (MI). It can detect ST segment changes, T wave inversions, or Q waves that indicate ischemia or infarction.
B. Check the patient's blood pressure – While important for overall assessment, blood pressure alone cannot confirm or rule out an MI.
C. Auscultate the patient's heart sounds – This may reveal abnormalities (e.g., S3, murmurs), but it is not diagnostic for MI.
D. Determine if the pain radiates to the left arm – Radiation of pain is a classic symptom of MI, but it is subjective and not sufficient to confirm the diagnosis without further diagnostic tests like an EKG.

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Based on your patient's ABG's what acid-base imbalance is present? pH 7.30 HCO3 23 PaCO2 49.

Nursing Test Bank

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