The nurse is caring for a patient with end-stage kidney disease (ESKD). Which arterial blood gas results (ABG) will the nurse correlate with the patient's condition?
pH 7.21, PaCO2 36, HCO3 14
pH 7.50, PaCO2 29, HCO3 22
pH 7.47, PaCO2 45, HCO3 33
pH 7.31, PaCO2 48, HCO3 24
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The patient with heart failure whose pulse oximetry is 94% on 2L oxygen is stable at the moment. While they require monitoring, they do not take immediate priority over the patient with altered consciousness.
Choice B reason: Altered level of consciousness and restlessness are critical symptoms that require immediate assessment. These could indicate a life-threatening condition such as hypoxia, electrolyte imbalance, or stroke, necessitating prompt evaluation and intervention.
Choice C reason: The patient with dyspnea on exertion who wants to be discharged against medical advice is important, but altered consciousness takes precedence due to its potential severity.
Choice D reason: The patient with an ejection fraction of 50% and 2+ bilateral lower extremity edema is stable and does not require immediate intervention compared to the patient with altered consciousness.
Correct Answer is A
Explanation
Choice A reason: Wheezing is a typical sound heard during bronchoconstriction, which occurs in conditions like asthma and COPD. It indicates that the airways are narrowed, causing the characteristic sound.
Choice B reason: Pulmonary edema typically presents with crackles or rales rather than wheezing. Wheezing would not be the primary indication of this condition.
Choice C reason: Hemoptysis refers to coughing up blood and does not typically present with wheezing. It might present with other sounds if there is an underlying lung issue, but wheezing is not specific to it.
Choice D reason: Pneumothorax generally presents with decreased or absent breath sounds on one side, not wheezing. It occurs when air enters the pleural space, causing lung collapse.
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