Mrs. Jamerson, who is in the post anesthesia care unit (PACU) following surgery, is difficult to arouse and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the patient and obtains arterial blood gas (ABG) measurements STAT. The ABG shows a pH of 7.10, PaCO2 of 70 mm Hg, and HCO3 of 24 mEq/L. What does this mean?
Respiratory Alkalosis Partially Compensated
Respiratory Acidosis Uncompensated
Metabolic Alkalosis Partially Compensated
Metabolic Acidosis Uncompensated
The Correct Answer is B
Choice A reason: Respiratory Alkalosis Partially Compensated is characterized by an elevated pH over 7.45 and a PaCO2 under 35 mmHg, with a compensatory acidic HCO3 under 22 mEq/L. This does not match the patient's ABG results.
Choice B reason: Respiratory Acidosis Uncompensated is indicated by an acidic pH under 7.35 and an elevated PaCO2 over 45 mmHg, with HCO3 in the normal range of 2226 mEq/L. The patient's ABG results show a low pH and high PaCO2, which aligns with this condition.
Choice C reason: Metabolic Alkalosis Partially Compensated would show a basic pH over 7.45 and a basic HCO3 over 26 mEq/L, with a compensatory acidic PaCO2 over 45 mmHg[^10^]. The patient's ABG values do not support this diagnosis.
Choice D reason: Metabolic Acidosis Uncompensated would present with an acidic pH under 7.35 and an acidic HCO3 under 22 mEq/L, with PaCO2 in the normal range of 3545 mmHg⁸. The patient's normal HCO3 level does not indicate metabolic acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The visibility of chest tube eyelets is not typically a concern unless there is evidence that the tube is dislodged. In normal circumstances, the eyelets may not be visible, and this does not necessarily indicate a need for intervention.
Choice B reason: The development of subcutaneous emphysema, which is the presence of air in the subcutaneous tissue, can be a sign of a serious complication such as a pneumothorax. It requires immediate assessment and possible intervention to prevent further complications.
Choice C reason: Tidal fluctuation in the water seal chamber is a normal finding when a chest tube is in place. It indicates that the system is patent and functioning correctly as it reflects the pressure changes in the pleural space during respiration.
Choice D reason: Continuous bubbling in the suction control chamber may indicate an air leak in the system, which could be normal if the system is set to continuous suction. However, if the bubbling is vigorous and the system is not set to continuous suction, it may indicate a new air leak and require intervention.
Correct Answer is C
Explanation
Choice A reason: Diabetes mellitus is not directly associated with acute pancreatitis. However, longstanding diabetes can lead to chronic pancreatitis due to the damage it causes to the pancreas over time.
Choice B reason: Hyperlipidemia, specifically high levels of triglycerides in the blood, can be a risk factor for acute pancreatitis. Elevated triglyceride levels above 1000 mg/dL can precipitate an episode of acute pancreatitis.
Choice C reason: Gallstones are a common cause of acute pancreatitis. They can block the bile duct, leading to pancreatitis. It's estimated that gallstone disease is responsible for 3040% of acute pancreatitis cases.
Choice D reason: A criminal record is not a medical condition and has no relevance to the development of acute pancreatitis.
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