The nurse is admitting a patient with pulmonary edema resulting from heart failure. Upon assessment, the nurse notes that the patient is hyperventilating. What lab results will the nurse expect to see?

pH 7.46, PaCO2 30, HCO3 24

pH 7.48, PaCO2 45, HCO3 29

pH 7.26, PaCO2 59, HCO3 30

pH 7.31, PaCO2 34, HCO3 18

Answer and Explanation

The Correct Answer is A

Choice A reason: The lab results pH 7.46, PaCO2 30, HCO3 24 indicate respiratory alkalosis, which can occur due to hyperventilation. In pulmonary edema, the patient may hyperventilate to compensate for reduced oxygenation, leading to a decrease in carbon dioxide (PaCO2) and an increase in pH (alkaline).

Choice B reason: The lab results pH 7.48, PaCO2 45, HCO3 29 indicate metabolic alkalosis with partial compensation. This is not consistent with hyperventilation in pulmonary edema, where respiratory alkalosis is more likely.

Choice C reason: The lab results pH 7.26, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This finding suggests hypoventilation, which is not expected in a patient hyperventilating due to pulmonary edema.

Choice D reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical in a patient with hyperventilation and pulmonary edema.

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Correct Answer is C

Explanation

Choice A reason: Avoiding foods that are high in sodium such as canned soups and processed meats is correct. High sodium intake can worsen fluid retention and hypertension, which are concerns in chronic kidney disease.

Choice B reason: Limiting intake of high-potassium foods like bananas and tomatoes is correct. High potassium levels can lead to dangerous cardiac arrhythmias in patients with chronic kidney disease.

Choice C reason: Eating a high-protein diet with lots of dark green, leafy vegetables is incorrect. While protein is important, excessive protein intake can increase the workload on the kidneys. Patients with chronic kidney disease often need to limit protein intake to prevent further kidney damage. Additionally, dark green, leafy vegetables are high in potassium, which should be limited.

Choice D reason: Monitoring fluid intake to prevent fluid overload is correct. Fluid overload can lead to hypertension, edema, and heart failure in patients with chronic kidney disease.

A. pH 7.21, PaCO2 36, HCO3 14 B. pH 7.50, PaCO2 29, HCO3 22 C. pH 7.47, PaCO2 45, HCO3 33 D. pH 7.31, PaCO2 48, HCO3 24

Correct Answer is A

Explanation

Choice A reason: The ABG results of pH 7.21, PaCO2 36, HCO3 14 indicate metabolic acidosis, which is common in patients with end-stage kidney disease (ESKD). In ESKD, the kidneys lose their ability to excrete acid and maintain bicarbonate levels, leading to an accumulation of acid in the blood. This condition results in a low pH (acidic), normal PaCO2 (as the respiratory system attempts to compensate), and low HCO3 (bicarbonate).

Choice B reason: The ABG results of pH 7.50, PaCO2 29, HCO3 22 indicate respiratory alkalosis, which is not typically associated with ESKD. Respiratory alkalosis occurs when there is excessive exhalation of carbon dioxide, leading to a higher pH (alkaline). This condition is more likely to be seen in situations such as hyperventilation, anxiety, or certain lung diseases.

Choice C reason: The ABG results of pH 7.47, PaCO2 45, HCO3 33 indicate metabolic alkalosis, which is not typically associated with ESKD. Metabolic alkalosis occurs when there is an excess of bicarbonate or a loss of acid. This condition can result from factors such as vomiting, diuretic use, or excessive antacid consumption. It is not a common finding in patients with ESKD.

Choice D reason: The ABG results of pH 7.31, PaCO2 48, HCO3 24 indicate respiratory acidosis, which is not typically associated with ESKD. Respiratory acidosis occurs when there is an accumulation of carbon dioxide due to impaired respiratory function. This condition is more likely to be seen in chronic obstructive pulmonary disease (COPD) or other respiratory disorders. It is not a common finding in patients with ESKD.

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The nurse is admitting a patient with pulmonary edema resulting from heart failure. Upon assessment, the nurse notes that the patient is hyperventilating. What lab results will the nurse expect to see?

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