The nurse is caring for an infant who has a history of bronchopneumonia.
What should the nurse anticipate when monitoring laboratory results? Which of the following venous blood gas results should the nurse expect?
pO2: 75, pCO2: 40, HCO3: 28.
pO2: 55, pCO2: 50, HCO3: 30.
pO2: 75, pCO2: 40, HCO3: 24.
pO2: 55, pCO2: 50, HCO3: 24. .
The Correct Answer is B
Choice A rationale
A pO2 of 75, pCO2 of 40, and HCO3 of 28 would be within normal limits for an infant. This would not typically be expected in an infant with a history of bronchopneumonia, as this condition often causes hypoxemia (low blood oxygen levels)78.
Choice B rationale
A pO2 of 55, pCO2 of 50, and HCO3 of 30 would indicate respiratory acidosis, which can occur in conditions like bronchopneumonia. The low pO2 indicates hypoxemia, while the high pCO2 indicates hypercapnia (excessive carbon dioxide in the bloodstream). The increased HCO3 is a compensatory mechanism to try to maintain the pH balance.
Choice C rationale
A pO2 of 75, pCO2 of 40, and HCO3 of 24 would be within normal limits for an infant. This would not typically be expected in an infant with a history of bronchopneumonia.
Choice D rationale
A pO2 of 55, pCO2 of 50, and HCO3 of 24 would indicate respiratory acidosis without compensation. However, in a chronic condition like bronchopneumonia, some degree of compensation (increased HCO3) would typically be expected.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A 12-month-old with a weak cry, pale complexion, decreased breath sounds, retractions, and an oxygen saturation of 93% is showing signs of severe respiratory distress. The weak cry and pale complexion suggest poor oxygenation and possible hypoxia. Decreased breath sounds and retractions indicate the child is struggling to breathe. An oxygen saturation of 93% is below the normal range for infants, further indicating respiratory distress. This child should be prioritized for treatment.
Choice B rationale
A 5-year-old speaking in full sentences, pink complexion, bilateral wheezing, and an oxygen saturation of 93% is showing signs of respiratory distress, but not as severe as Choice A12. The ability to speak in full sentences and having a pink complexion suggest that the child is getting
enough oxygen. However, bilateral wheezing indicates some airway obstruction. An oxygen saturation of 93% is on the lower end of the normal range for children this age.
Choice C rationale
A 16-year-old speaking in short phrases, wheezing, sitting upright, and an oxygen saturation of 93% is also showing signs of respiratory distress. Speaking in short phrases and sitting upright are signs that the teenager is working harder to breathe. Wheezing indicates airway obstruction. An oxygen saturation of 93% is on the lower end of the normal range for teenagers.
Choice D rationale
A 9-year-old who is quiet, pale, sitting on his father’s lap, bilateral wheezing, and an oxygen saturation of 93% is showing signs of respiratory distress. Being quiet and pale can indicate poor oxygenation. Bilateral wheezing suggests airway obstruction. An oxygen saturation of 93% is below the normal range for children this age. However, this child’s symptoms are not as severe as those of the 12-month-old in Choice A.
Correct Answer is D
Explanation
Choice A rationale
Restlessness, bilateral wheezes, and poor feeding are concerning symptoms in a child. Restlessness can indicate discomfort or distress. Bilateral wheezes can suggest an airway obstruction or inflammation, often seen in conditions like asthma. Poor feeding can be a sign of general illness or specific conditions like gastrointestinal disorders. However, these symptoms, while concerning, are not as immediately threatening as the symptoms described in choice D12.
Choice B rationale
Sitting up, coarse breath sounds, coughing, and restlessness are also concerning symptoms. Coarse breath sounds and coughing can indicate a respiratory infection or other lung condition. Restlessness can again indicate discomfort or distress. However, these symptoms are not as immediately threatening as the symptoms described in choice D12.
Choice C rationale
Not eating well and increased respiratory effort are signs of potential illness. Not eating well can lead to malnutrition and weakened immunity, making the child more susceptible to infections and slowing recovery. Increased respiratory effort can be a sign of respiratory distress, which could be due to conditions like pneumonia or asthma. However, these symptoms are not as immediately threatening as the symptoms described in choice D12.
Choice D rationale
A toddler in the tripod position (sitting up and leaning forward, using the arms to support the upper body), with diminished breath sounds and grunting, is showing signs of severe respiratory distress. The tripod position is often used instinctively to maximize airway patency and ease breathing. Diminished breath sounds can indicate significant airway obstruction or lung disease. Grunting is a sign of increased work of breathing and is often seen in conditions like pneumonia or severe asthma. These symptoms together suggest that the child may be in respiratory failure, which is a life-threatening emergency requiring immediate medical attention.
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