The nurse is reading the arterial blood gas results of a patient admitted for sepsis. Which of the following would the nurse expect for a patient in metabolic acidosis?
pH 7.25. CO2 40. HCO3-16
pH 7.5, CO2 35, HCO3-30
pH 7.5, CO2 30 HCO3- 22
pH 7.25, CO2 55. HCO3. 25
The Correct Answer is A
A) pH 7.25, CO2 40, HCO3- 16:
In metabolic acidosis, the pH is decreased indicating acidemia. The bicarbonate level is low which is a hallmark of metabolic acidosis. The CO2 level of 40 is within the normal range suggesting that the body is not compensating for the acidosis through respiratory compensation yet. In metabolic acidosis, the body will often try to compensate by increasing respiratory rate to blow off CO2, but this takes time.
B) pH 7.5, CO2 35, HCO3- 30:
In metabolic alkalosis, the pH is increased above 7.45, and the bicarbonate level (HCO3-) is elevated both of which are seen here. The CO2 level of 35 is within normal limits, and while respiratory compensation could increase CO2 in response to metabolic alkalosis,
C) pH 7.5, CO2 30, HCO3- 22:
The pH is increased above 7.45, and the bicarbonate level is within the normal range. The CO2 level of 30 is low, which is typical in respiratory alkalosis, where the body compensates for the increased pH by blowing off CO2.
D) pH 7.25, CO2 55, HCO3- 25:
The pH is low, but the bicarbonate level is normal. The CO2 level is elevated, which is indicative of hypoventilation or inadequate respiratory compensation, commonly seen in respiratory acidosis, where the lungs cannot excrete CO2 effectively
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["250"]
Explanation
Given:
Total volume to infuse: 250 mL
Infusion time: 60 minutes
To find:
Infusion rate (mL/hr)
Step 1: Calculate the infusion rate in mL/min
Infusion rate (mL/min) = Total volume / Infusion time
Infusion rate (mL/min) = 250 mL / 60 minutes = 4.17 mL/min
Step 2: Convert mL/min to mL/hr
Infusion rate (mL/hr) = Infusion rate (mL/min) x 60 minutes/hr
Infusion rate (mL/hr) = 4.17 mL/min x 60 minutes/hr = 250 mL/hr
Therefore, the nurse should set the pump to deliver 250 mL/hr.
Correct Answer is C
Explanation
A) "5% Dextrose in water (D5W)":
. D5W is an isotonic solution that, once metabolized by the body, becomes hypotonic because the glucose is rapidly utilized, leaving water. It is typically used to provide free water for hydration or for patients who need a small amount of calories or fluid, but it is not the best choice for this client. The client's low blood pressure and symptoms of dehydration (nausea, vomiting, dizziness, and weakness) suggest that normal saline (0.9% sodium chloride) is the more appropriate choice to help restore circulatory volume and improve blood pressure.
B) "10% Dextrose in water (D10W)":
. D10W is a hypertonic solution with a higher concentration of glucose, used in specific situations such as severe hypoglycemia or for patients requiring a high amount of glucose. It is not appropriate for this patient, whose primary issue seems to be volume depletion due to nausea and vomiting. The focus should be on replenishing circulatory volume and addressing the hypotension, which normal saline (0.9% sodium chloride) would do more effectively than D10W.
C) "0.9% Sodium Chloride":
. 0.9% Sodium Chloride (normal saline) is an isotonic solution and is the most appropriate choice for fluid resuscitation in a client with low blood pressure (hypotension) and signs of dehydration (nausea, vomiting, dizziness). This solution will help restore circulatory volume, correct hypovolemia, and improve blood pressure. It is commonly used for initial fluid resuscitation in clients who are hypotensive and experiencing fluid loss due to vomiting.
D) "0.45% Sodium Chloride (half-normal saline)":
. 0.45% Sodium Chloride is a hypotonic solution, which is more appropriate for treating patients who have conditions like hypernatremia or require gradual hydration. However, in this case, the patient is presenting with hypotension, dizziness, and weakness, which are signs of fluid depletion. A hypotonic solution would not be appropriate in this context, as it could potentially worsen the patient's hypotension or lead to further fluid shifts. The focus should be on using normal saline (0.9% sodium chloride) to help restore circulatory volume and improve the low blood pressure.
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