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","D","E"]
Explanation
A. Bicarbonate excess is not a clinical manifestation but rather the underlying cause of metabolic alkalosis.
B. Metabolic alkalosis can lead to potassium depletion, which may cause muscle weakness.
C. Kussmaul's respirations, characterized by deep and labored breathing, are more commonly associated with metabolic acidosis, not alkalosis, as the body tries to compensate for acidemia by expelling more carbon dioxide through deep breaths.
D. Alkalosis can cause peripheral vasodilation and decreased calcium ionization, leading to circumoral and digital paresthesia.
E. Alkalosis can cause cerebral vasoconstriction and decreased cerebral perfusion, leading to dizziness.
Correct Answer is D
Explanation
A. Consuming excessive animal protein can increase the risk of kidney stones due to the metabolism of protein leading to increased excretion of calcium and oxalate.
B. Restricting calcium intake is not recommended for preventing calcium oxalate kidney stones. Adequate calcium intake from dietary sources can actually help prevent kidney stone formation by binding to oxalate in the intestines and reducing its absorption.
C. High doses of vitamin C can increase oxalate levels in the urine, which can contribute to the formation of calcium oxalate kidney stones.
D. Adequate fluid intake, typically recommended at least 3 liters (about 100 ounces) per day, helps dilute urine and reduce the concentration of stone-forming substances, thereby reducing the risk of kidney stone formation.
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