George Kent is a 54-year-old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L and Pa02 60 mm Hg.
How would you interpret this?
Metabolic Acidosis. Partially Compensated
Respiratory Acidosis, Uncompensated
Respiratory Acidosis, Partially Compensated
Metabolic Alkalosis Uncompensated
The Correct Answer is C
A. Metabolic acidosis would involve a low pH and low bicarbonate level, which is not evident in the given arterial blood gas results.
B. The low pH (acidosis) and high PaCO2 (respiratory component) indicate respiratory acidosis. The increased HCO3 (normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
C. George Kent's arterial blood gas values indicate a lower pH and an elevated PaCO2, which are consistent with respiratory acidosis. The increased HCO3 ((normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
D. Metabolic alkalosis is not supported by the given arterial blood gas results.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Polyuria (excessive urination) is not typically associated with low calcium levels. It may occur in conditions such as diabetes mellitus or diabetes insipidus.
B. Hypocalcemia (low calcium levels) can lead to neuromuscular irritability, which may manifest as muscle tremors or spasms. This is a classic sign of hypocalcemia.
C. Dry, sticky mucous membranes are more indicative of dehydration rather than hypocalcemia.
D. Negative Chvostek's sign means the absence of facial muscle twitching upon tapping the facial nerve, which is not expected in hypocalcemia.
Correct Answer is ["B","C","E"]
Explanation
A. Chronic lung disease is not typically identified as a risk factor for developing kidney disease.
B. Hypertension is a significant risk factor for kidney disease as it can damage blood vessels in the kidneys over time.
C. Diabetes, especially when uncontrolled, can lead to diabetic nephropathy, a common cause of kidney disease.
D. Coronary heart disease is primarily related to the cardiovascular system and is not directly associated with kidney disease.
E. Obesity increases the risk of developing kidney disease due to associated conditions such as hypertension and diabetes.
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