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 A
Explanation
Choice A reason: This set of values is indicative of metabolic acidosis with respiratory compensation, which is common in chronic kidney disease due to the accumulation of acids in the blood and the lungs' attempt to compensate by retaining CO2.
Choice B reason: This choice suggests respiratory alkalosis, which is less likely in chronic kidney disease unless there is a secondary respiratory condition causing hyperventilation.
Choice C reason: This choice indicates metabolic alkalosis, which is not typical for chronic kidney disease, as the kidneys are unable to excrete acid effectively.
Choice D reason: While this set of values does indicate acidosis, the expected compensatory response in chronic kidney disease would be an elevated PaCO2, not a normal or low value.
Correct Answer is A
Explanation
Choice A reason: Placing the client in a sitting position helps to lower blood pressure by promoting venous return and is the first action to take in cases of autonomic dysreflexia.
Choice B reason: Checking for a fecal impaction is important as it can be a trigger for autonomic dysreflexia, but it is not the first action to take.
Choice C reason: Examining for areas of skin breakdown is part of ongoing care for clients with spinal cord injuries but is not the immediate priority in autonomic dysreflexia.
Choice D reason: Checking blood pressure is important for monitoring the severity of autonomic dysreflexia, but the first action is to address the positioning of the client to manage the hypertensive crisis.
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