During acute respiratory distress syndrome (ARDS), the client's lung cells that produce surfactant have become damaged. The nurse knows this pathologic change will lead to what outcome?

pulmonary edema

atelectasis

bronchoconstriction

upper airway blockage

Answer and Explanation

The Correct Answer is B

A. Pulmonary edema: Pulmonary edema is a condition where fluid accumulates in the lungs, typically due to heart failure or other conditions that increase pressure in the blood vessels of the lungs. While pulmonary edema may occur in ARDS, the primary issue in ARDS related to surfactant damage is not fluid accumulation in the lungs but the inability of the lungs to properly expand and maintain gas exchange.

B. Atelectasis: In ARDS, damage to the lung cells that produce surfactant impairs the lungs' ability to maintain surface tension in the alveoli. Surfactant is a substance that helps keep the alveoli open by reducing surface tension. Without sufficient surfactant, the alveoli can collapse, leading to atelectasis (collapse of the alveoli), which further impairs oxygen exchange and contributes to hypoxemia in ARDS.

C. Bronchoconstriction: Bronchoconstriction refers to the narrowing of the airways due to muscle contraction, often seen in conditions like asthma. While bronchoconstriction may occur in other respiratory conditions, it is not the primary pathologic process in ARDS. ARDS is primarily characterized by damage to the alveolar-capillary membrane and impaired surfactant production, leading to atelectasis and impaired gas exchange.

D. Upper airway blockage: Upper airway blockage refers to an obstruction in the airway above the level of the trachea, often due to foreign objects, swelling, or other causes. This is not the primary concern in ARDS, which is a lower respiratory issue affecting the alveoli and gas exchange in the lungs.

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Correct Answer is D

Explanation

A. Measure heart chamber pressures to assess for heart failure: While measuring heart chamber pressures may be important in other situations, it is not the immediate goal in the treatment of a suspected STEMI (ST-Elevation Myocardial Infarction). The priority in STEMI is to restore blood flow to the affected area of the heart, not to assess for heart failure through pressure measurements.

B. Evaluate the extent of occlusion of the coronary arteries involved: Although evaluating the extent of coronary artery occlusion is a part of the procedure, it is not the immediate goal. The priority in STEMI treatment is rapid reperfusion of the blocked artery to minimize myocardial damage. The catheterization will help guide interventions like angioplasty or stent placement to restore blood flow.

C. Determine cardiac output during the procedure: While cardiac output may be monitored during the procedure, the primary goal of the catheterization in a suspected STEMI is not to determine cardiac output but to restore blood flow to the heart and minimize the damage to the heart muscle.

D. Prevent extensive myocardial damage: The primary goal of immediate treatment for STEMI is to restore blood flow to the blocked coronary artery as quickly as possible, either through primary PCI (Percutaneous Coronary Intervention), angioplasty, or thrombolytics, in order to prevent extensive damage to the heart muscle. The earlier blood flow is restored, the less damage occurs to the heart tissue, which is critical for improving outcomes.

A. 7.47 pC02 30 PHCO3 24 p02 98 B. pH 7.31 p C02 52 pH PHCO3 30 p02 85 C. pH 7.29 p C02 57 pHCO3 25 p02 78 D. pH 7.37 p C02 61 pHCO3 33 p 02 71

Correct Answer is B

Explanation

A. pH 7.47, pCO2 30, HCO3 24, pO2 98

pH is alkaline (7.47), and the pCO2 is low (30), indicating respiratory alkalosis, not acidosis. This is not the correct answer.

B. pH 7.31, pCO2 52, HCO3 30, pO2 85

pH is low (7.31), indicating acidosis.

pCO2 is elevated (52), indicating respiratory acidosis.

HCO3 is elevated (30), indicating that the kidneys are attempting to compensate by retaining bicarbonate.

This fits the criteria for respiratory acidosis with partial compensation.

C. pH 7.29, pCO2 57, HCO3 25, pO2 78

pH is low (7.29), indicating acidosis.

pCO2 is elevated (57), suggesting respiratory acidosis.

HCO3 is normal (25), so there is no compensation yet.

This indicates uncompensated respiratory acidosis, not partial compensation.

D. pH 7.37, pCO2 61, HCO3 33, pO2 71

pH is normal (7.37), which does not indicate acidosis.

pCO2 is elevated (61), indicating respiratory acidosis.

HCO3 is elevated (33), indicating that the kidneys are compensating.

However, since the pH is normal, this likely indicates full compensation rather than partial compensation.

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During acute respiratory distress syndrome (ARDS), the client's lung cells that produce surfactant have become damaged. The nurse knows this pathologic change will lead to what outcome?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is B

Explanation

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