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 B

Explanation

Choice A reason: Advising the patient to consume protein and carbohydrates immediately is not appropriate in this context. The presence of ketones in the urine indicates that the body is using fat for energy due to a lack of insulin. Increasing carbohydrate intake without addressing the underlying insulin deficiency can worsen hyperglycemia and ketoacidosis.

Choice B reason: Notifying the provider of the result and recommending that the patient's insulin dose be increased is the appropriate intervention. The presence of ketones in the urine indicates inadequate insulin levels, and adjusting the insulin dose can help correct the metabolic imbalance and prevent further complications such as diabetic ketoacidosis.

Choice C reason: Instructing the patient to withhold the next scheduled dose of insulin is incorrect. Insulin is essential for managing blood glucose levels and preventing ketosis in patients with type 1 diabetes. Withholding insulin can lead to severe hyperglycemia and ketoacidosis.

Choice D reason: Suggesting that the patient ask their provider to start them on metformin therapy is not appropriate for type 1 diabetes. Metformin is used primarily for type 2 diabetes and is not effective in type 1 diabetes, where insulin is required for glucose management.

A. Take your immunosuppressive medications only when you notice symptoms of rejection. B. It's important to avoid exercise for the first year after the transplant. C. You should follow the prescribed medication regimen exactly as directed, even if you feel well. D. You should take herbal supplements to boost your immune system.

Correct Answer is C

Explanation

Choice A reason: Taking immunosuppressive medications only when symptoms of rejection are noticed is incorrect. Immunosuppressive medications must be taken consistently as prescribed to prevent rejection, even when the patient feels well.

Choice B reason: Avoiding exercise for the first year after the transplant is not necessary. Patients are usually encouraged to engage in light to moderate exercise to promote overall health and recovery. The type and level of exercise should be discussed with the healthcare provider.

Choice C reason: Following the prescribed medication regimen exactly as directed is crucial for preventing organ rejection. Consistent use of immunosuppressive medications helps maintain the balance needed to prevent the immune system from attacking the transplanted organ.

Choice D reason: Taking herbal supplements to boost the immune system is incorrect. Patients with organ transplants need to suppress their immune system to prevent rejection. Herbal supplements can interact with immunosuppressive medications and are generally not recommended without consulting a healthcare provider.

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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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