The nurse is caring for a patient diagnosed with chronic obstructive pulmonary disease (COPD). Which lab results will the nurse expect to find to support this diagnosis?
pH 7.30, PaCO2 59, HCO3 30
pH 7.50, PaCO2 30, HCO3 24
pH 7.48, PaCO2 42, HCO3 29
pH 7.33, PaCO2 34, HCO3 18
The Correct Answer is A
Choice A reason: The lab results pH 7.30, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This is a typical finding in patients with chronic obstructive pulmonary disease (COPD) due to chronic hypoventilation and CO2 retention. The elevated PaCO2 reflects respiratory acidosis, and the elevated HCO3 indicates renal compensation to maintain acid-base balance.
Choice B reason: The lab results pH 7.50, PaCO2 30, HCO3 24 indicate respiratory alkalosis. This is not typical for COPD, where respiratory acidosis is more common.
Choice C reason: The lab results pH 7.48, PaCO2 42, HCO3 29 indicate metabolic alkalosis with partial compensation, which is not consistent with the primary respiratory issues seen in COPD.
Choice D reason: The lab results pH 7.33, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation, which is not typical for COPD. COPD primarily causes respiratory acidosis due to CO2 retention.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Kussmaul breathing is a sign of metabolic acidosis, not metabolic alkalosis. It is characterized by deep, labored breathing as the body tries to expel excess carbon dioxide.
Choice B reason: Positive Chvostek sign is an indication of hypocalcemia, which can be associated with metabolic alkalosis. It is a facial muscle twitch that occurs when the facial nerve is tapped.
Choice C reason: Hematemesis, or vomiting blood, is not a clinical manifestation of metabolic alkalosis. It is more related to gastrointestinal bleeding.
Choice D reason: Distended jugular veins are more commonly associated with conditions such as heart failure and fluid overload, not specifically with metabolic alkalosis.
Correct Answer is B
Explanation
Choice A reason: Weighing the patient using a bed scale and restricting oral fluids are important interventions for managing fluid balance in heart failure, but they are not the immediate priority. Assessing the respiratory status takes precedence to ensure the patient is not in respiratory distress.
Choice B reason: Obtaining pulse oximetry levels and assessing the respiratory status are priority actions. Dyspnea on exertion and fatigue indicate potential respiratory compromise, and it is crucial to evaluate oxygenation and respiratory function immediately.
Choice C reason: Elevating the lower extremity on two pillows while the patient is in bed can help reduce edema but is not the immediate priority. Respiratory assessment and stabilization take precedence.
Choice D reason: Obtaining a Physical Therapy consultation to evaluate activity tolerance is beneficial for long-term management but is not an immediate priority in acute care. The focus should be on assessing and stabilizing the patient's respiratory and cardiac status.
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