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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
- Ondansetron on a PRN basis is used to manage nausea and vomiting. In patients with inflammatory bowel disease, especially during an inpatient stay, controlling nausea is important to maintain comfort and prevent dehydration. This makes it an appropriate symptomatic treatment.
Choice B reason:
- Vitamin B12 injections may be indicated in patients with Crohn’s disease who have malabsorption issues, particularly if the terminal ileum is involved. However, they are not routinely given to all patients with inflammatory bowel disease solely for the prevention of pernicious anemia.
Choice C reason:
- Antidiarrheal medications are generally contraindicated in inflammatory bowel disease, as they can mask important symptoms and may increase the risk of complications like toxic megacolon, especially if administered before meals.
Choice D reason:
- Beta adrenergic blockers are not used to reduce bowel motility. Their primary use is in cardiovascular conditions, and they do not address the gastrointestinal symptoms associated with inflammatory bowel disease.
Correct Answer is B
Explanation
Choice A reason: Normal blood pressure and deep respirations do not necessarily indicate that hyperosmolar hyperglycemic syndrome is resolving. Deep respirations, also known as Kussmaul respirations, can occur in response to severe hyperglycemia.
Choice B reason: Increased alertness and a normal heart rhythm suggest that the patient's neurological status and cardiovascular system are stabilizing, which are positive indicators that the treatment is effective in managing hyperosmolar hyperglycemic syndrome.
Choice C reason: High urine specific gravity and normal temperature do not directly indicate the effectiveness of treatment for hyperosmolar hyperglycemic syndrome. High urine specific gravity can result from dehydration.
Choice D reason: A blood glucose level of 250 mg/dL with disorientation still indicates poorly controlled hyperglycemia and ongoing metabolic disturbance, which means the treatment is not yet effective.
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