George, an 85yearold man with a history of chronic obstructive pulmonary disease, was rushed to the emergency department with increasing shortness of breath, restlessness, and difficulty communicating due to his inability to complete a sentence. On assessment, tachycardia and a bounding pulse were noted. Wheezes could be heard in the lower lobes. His blood gas shows a pH of 7.3, PaCO2 of 68 mmHg, HCO3 of 28 mmol/L, and PaO2 of 60 mmHg. How would you interpret this?
Metabolic Acidosis, Uncompensated
Metabolic Acidosis, Partially Compensated
Respiratory Acidosis, Partially Compensated
Respiratory Acidosis, Uncompensated
The Correct Answer is C
Choice A reason: Metabolic acidosis is characterized by a low pH and a low HCO3. However, George's HCO3 is within normal range, indicating that metabolic acidosis is not the primary issue.
Choice B reason: Partially compensated metabolic acidosis would present with a low pH and a low HCO3, along with a low PaCO2 as the body attempts to compensate. George's PaCO2 is elevated, which is not consistent with this condition.
Choice C reason: George's high PaCO2 and near normal HCO3 suggest that his primary issue is respiratory acidosis. The body has begun to compensate by retaining HCO3, making it partially compensated.
Choice D reason: Uncompensated respiratory acidosis would present with an elevated PaCO2 and a normal HCO3. Since George's HCO3 is elevated, it indicates partial compensation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: The statement is incorrect because TSH does not attach to a protein in the blood; it stimulates the thyroid gland to produce thyroid hormones.
Choice B reason: This choice is partially correct. TSH does stimulate the thyroid gland, but the main purpose of the test is not to measure the 'feeding' of the gland but to assess its function and how well it's producing thyroid hormones.
Choice C reason: This is the correct statement. TSH levels are measured to determine the thyroid gland's activity, which directly influences the metabolic rate. The normal range for TSH levels in adults is typically 0.4 to 4.0 milliunits per liter (mU/L). However, these values can vary slightly based on the laboratory and the age of the individual.
Choice D reason: While TSH does influence energy levels by regulating thyroid hormone production, this choice does not directly explain the purpose of measuring TSH levels.
Correct Answer is C
Explanation
Choice A reason: Keeping the client NPO (nothing by mouth) is not directly related to preventing a thyroid crisis. While it may be necessary in some situations, such as preoperative care, it does not address the hyperthyroid state.
Choice B reason: Observing the client for signs of hypocalcemia is important, especially after thyroid surgery, as hypocalcemia can occur due to accidental removal or damage to the parathyroid glands. However, it is not a preventive measure for a thyroid crisis.
Choice C reason: Providing a quiet, low stimulus environment can help reduce stress and agitation, which are potential triggers for a thyroid crisis. Stress can exacerbate hyperthyroid symptoms and precipitate a crisis.
Choice D reason: Aspirin is contraindicated in clients with hyperthyroidism as it can increase thyroid hormone levels by displacing them from their binding proteins. This can potentially worsen the condition and lead to a crisis.
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