The nurse is caring for a patient diagnosed with small bowel obstruction. A nasogastric tube with low continuous suction has been in place for 72 hours. Upon reviewing the blood work, which lab results will the nurse expect to see?

pH 7.46, PaCO2 30, HCO3 24

pH 7.48, PaCO2 42, HCO3 29

pH 7.31, PaCO2 34, HCO3 18

Answer and Explanation

The Correct Answer is B

Choice A reason: The lab results pH 7.46, PaCO2 30, HCO3 24 suggest a slightly alkaline state with normal bicarbonate levels, which could indicate respiratory alkalosis with compensation. However, for a patient with a small bowel obstruction and nasogastric suction, this is less likely.

Choice B reason: The lab results pH 7.48, PaCO2 42, HCO3 29 indicate metabolic alkalosis. This is a common finding in patients with small bowel obstruction who have been on nasogastric suction, which removes stomach acids and leads to an increase in bicarbonate levels. The elevated pH and bicarbonate levels are consistent with this condition.

Choice C reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to metabolic alkalosis due to loss of gastric acid.

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Correct Answer is D

Explanation

Choice A reason: Respiratory alkalosis with uncompensated imbalance would show a low PaCO2, not a normal value.

Choice B reason: Respiratory acidosis with partially compensated imbalance would show a low pH and high PaCO2 with an elevated bicarbonate level.

Choice C reason: Metabolic acidosis with uncompensated imbalance would show a low pH and low bicarbonate level.

Choice D reason: Metabolic alkalosis with partially compensated imbalance is indicated by the elevated pH and bicarbonate level, while

A. Remind the patient that they will be responsible for caring for the ileostomy after discharge. B. Reassure the patient that this procedure will be reversed in a few months. C. Acknowledge the patient's reluctance and initiate discussion to explore their feelings. D. Discuss with the medical team during interdisciplinary rounds the need for a psychiatric referral.

Correct Answer is C

Explanation

Choice A reason: Reminding the patient that they will be responsible for caring for the ileostomy after discharge may increase their anxiety and reluctance. It does not address the underlying concerns or feelings.

Choice B reason: Reassuring the patient that the procedure will be reversed in a few months is not always accurate and may provide false hope. Each patient's situation is unique, and not all ileostomies are temporary.

Choice C reason: Acknowledging the patient's reluctance and initiating a discussion to explore their feelings is the most appropriate response. This approach allows the nurse to understand the patient's concerns, provide emotional support, and offer practical solutions to help the patient feel more comfortable with ostomy care.

Choice D reason: Discussing the need for a psychiatric referral during interdisciplinary rounds is not the immediate step. The nurse should first address the patient's feelings and concerns directly and provide support.

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The nurse is caring for a patient diagnosed with small bowel obstruction. A nasogastric tube with low continuous suction has been in place for 72 hours. Upon reviewing the blood work, which lab results will the nurse expect to see?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who is lethargic and dehydrated. Arterial blood gas (ABG) results show pH 7.50, PaO2 85 mmHg, PaCO2 45 mmHg, HCO3 35 mEq/L. What acid-base imbalance will the nurse recognize the patient is at risk for?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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