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. Aluminum hydroxide can lead to increased serum magnesium levels, but this is not the reason for its preference in chronic kidney disease.
B. Aluminum hydroxide is preferred because it binds to dietary phosphate, reducing serum phosphorus levels in patients with chronic kidney disease who are prone to hyperphosphatemia.
C. Aluminum hydroxide does not significantly affect serum potassium levels.
D. Aluminum hydroxide can lead to decreased serum calcium levels due to binding, but this is not the primary reason for its preference in chronic kidney disease.
Correct Answer is C
Explanation
A. Vasopressin does not typically affect blood pressure significantly.
B. Vasopressin is not used to lower blood sugar levels; it is primarily used for water retention.
C. Vasopressin, also known as antidiuretic hormone (ADH), acts on the kidneys to decrease urine output, making this the expected outcome of therapy.
D. Specific gravity of urine may increase with vasopressin therapy due to decreased urine output, rather than decrease.
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