The nurse is caring for a trauma patient who has the following arterial blood gas (ABG) results: pH 7.52, PaCO2 55, HCO3 30 me/L. How will the nurse interpret these results?

Respiratory alkalosis with partial compensation

Metabolic alkalosis with partial compensation

Metabolic alkalosis with no compensation

Metabolic acidosis with partial compensation

Answer and Explanation

The Correct Answer is B

Choice A reason: Respiratory alkalosis with partial compensation is characterized by a high pH, low PaCO2, and a compensatory decrease in HCO3. In this case, the pH is high (alkaline), PaCO2 is high, and HCO3 is elevated, indicating that the primary disorder is metabolic alkalosis, not respiratory alkalosis.

Choice B reason: Metabolic alkalosis with partial compensation is indicated by a high pH (alkaline), high HCO3 (bicarbonate), and a high PaCO2 (carbon dioxide) as a compensatory mechanism by the respiratory system. In this case, the pH is 7.52 (alkaline), PaCO2 is 55 mmHg, and HCO3 is 30 mEq/L, which fits the profile of metabolic alkalosis with the respiratory system attempting to compensate by retaining CO2.

Choice C reason: Metabolic alkalosis with no compensation would present with a high pH and high HCO3, but normal PaCO2. In this case, the PaCO2 is elevated, indicating that there is some level of respiratory compensation occurring, which rules out the "no compensation" scenario.

Choice D reason: Metabolic acidosis with partial compensation would present with a low pH, low HCO3, and low PaCO2 as a compensatory mechanism. In this case, the pH is high (alkaline), not low, which is inconsistent with metabolic acidosis.

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Correct Answer is B

Explanation

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.

A. Ondansetron on a PRN basis B. Vitamin B12 injections to prevent pernicious anemia C. Antidiarrheal medications 30 minutes before a meal D. Beta adrenergic blockers to reduce bowel motility

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.

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The nurse is caring for a trauma patient who has the following arterial blood gas (ABG) results: pH 7.52, PaCO2 55, HCO3 30 me/L. How will the nurse interpret these results?

Nursing Test Bank

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