How would you interpret the following ABG results?
pH:7.47
CO2: 33
HCO3:24
respiratory acidosis
uncompensated respiratory alkalosis
metabolic acidosis
partially compensated respiratory alkalosis
The Correct Answer is B
A. Respiratory acidosis: Respiratory acidosis occurs when there is hypoventilation leading to CO2 retention, which lowers blood pH. In this case, the CO2 is decreased (33 mmHg) and the pH is elevated (7.47), indicating that the issue is not acid buildup but rather excess CO2 loss.
B. Uncompensated respiratory alkalosis: The elevated pH (7.47) shows alkalosis, and the low CO2 (33 mmHg) confirms that the alkalosis is respiratory in origin due to hyperventilation. Because the bicarbonate level (24 mEq/L) is normal, the kidneys have not yet adjusted.
C. Metabolic acidosis: Metabolic acidosis would present with a low pH and a low bicarbonate level from loss of base or gain of acid. The client’s pH is high, and the bicarbonate is normal, which rules out a metabolic origin.
D. Partially compensated respiratory alkalosis: If partial compensation were present, the bicarbonate would be slightly decreased as the kidneys excrete bicarbonate to balance pH. Since bicarbonate remains normal, no compensation has occurred.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A patient with COPD: Clients with COPD often retain CO2 due to chronic hypoventilation, leading to a reliance on low oxygen levels (hypoxic drive) to stimulate breathing. Administering high concentrations of oxygen can suppress this drive, causing CO2 retention and respiratory acidosis.
B. A patient with pneumonia: Pneumonia impairs gas exchange due to alveolar inflammation and fluid accumulation, making oxygen therapy essential to maintain SpO2 above 92%. Maintaining higher oxygen saturation helps prevent hypoxemia and tissue hypoxia in these patients.
C. A patient with asthma: Asthma causes airway constriction that leads to impaired oxygenation during attacks. Supplemental oxygen is indicated to maintain saturation above 92%, as hypoxemia can worsen bronchospasm and increase respiratory effort.
D. A patient who has been admitted to the hospital for only one day: The duration of hospital admission does not influence oxygen saturation targets. SpO2 goals are based on underlying pathology, not length of stay, making this factor irrelevant to adjusting oxygen therapy.
Correct Answer is C
Explanation
A. Normal fluctuation with breathing: Normal fluctuation, known as tidaling, involves the water level in the water seal chamber rising during inspiration and falling during expiration. Continuous bubbling, however, is not normal and indicates a different issue.
B. Fluid accumulation in the pleural space: Fluid in the pleural space would be indicated by increased drainage in the collection chamber, not by continuous bubbling in the water seal chamber. Bubbling is related to air movement, not fluid buildup.
C. Air leak from the patient’s lung: Continuous bubbling in the water seal chamber suggests that air is escaping from the pleural space into the drainage system. This indicates an air leak, which may originate from the lung itself, the chest tube insertion site, or the tubing connections.
D. Chest tube obstruction: An obstruction would cause absent or decreased drainage and loss of tidaling, not continuous bubbling. Bubbling requires airflow through the system, which would not occur if the tube were blocked.
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