Mrs. Jamerson, who had undergone surgery in the post-anesthesia care unit (PACU), is difficult to arouse two hours following surgery. Nurse Williams in the PACU has been administering Morphine Sulfate intravenously to the client for complaints of post-surgical pain. The client's respiratory rate is 7 per minute and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the ABCs (remember Airway, Breathing, Circulation!) and obtains ABGS STAT! Arterial blood gas measurement shows pH 7.10. PaCO2 70 mm Hg, and HCO3 24 mEq/L
What does this mean?
Metabolic Acidosis, Uncompensated
Respiratory Alkalosis. Partially Compensated
Respiratory Acidosis. Uncompensated
Metabolic Alkalosis. Partially Compensated
The Correct Answer is C
A. Metabolic Acidosis, Uncompensated, is ruled out because the elevated PaCO2 and low pH indicate a respiratory problem rather than a metabolic one.
B. Respiratory Alkalosis. Partially Compensated is ruled out because the pH and PaCO2 levels are both abnormal and indicate acidosis rather than alkalosis.
C. The low pH (acidosis) along with the high PaCO2 indicate respiratory acidosis, and there is no evidence of compensation by the kidneys (normal HCO3).
D. Metabolic Alkalosis. Partially Compensated, is ruled out because the pH is low (acidosis) rather than high (alkalosis), and the PaCO2 is elevated, suggesting a respiratory problem rather than a metabolic one.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Placing the client in Trendelenburg position is not appropriate in this situation. It may worsen respiratory depression caused by magnesium sulfate.
B. Absent deep-tendon reflexes and respiratory depression are signs of magnesium toxicity.
Discontinuing the medication infusion is essential to prevent further toxicity.
C. While preeclampsia can lead to complications necessitating emergency cesarean birth, the immediate concern here is addressing magnesium toxicity.
D. Assessing maternal blood glucose is not relevant to the management of magnesium toxicity.
Correct Answer is A
Explanation
A. These values indicate elevated BUN (blood urea nitrogen) and creatinine levels indicating impaired kidney function, typical findings in chronic kidney disease.
B. These are the normal BUN and creatinine levels hence are not indicative of chronic kidney disease.
C. These values are within the normal BUN and creatinine levels hence are not indicative of chronic kidney disease.
D. These are normal BUN and creatinine levels and are not indicative of chronic kidney disease.
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