The nurse is reviewing the client's following arterial blood gases: pH 7.33, PaCo2 47, HCO3 24. Which manifestation would the nurse expect the client to be experiencing with this imbalance?

Confusion

Kussmaul's Respirations

Seizures

Paresthesia in the extremities

Answer and Explanation

The Correct Answer is A

A. Confusion: Respiratory acidosis (low pH + high PaCO2) leads to decreased oxygenation of brain tissues, causing confusion, drowsiness, and lethargy.

B. Kussmaul's Respirations: Seen in metabolic acidosis, not respiratory acidosis.

C. Seizures: Seizures are more common with alkalosis (high pH) due to neuronal excitability.

D. Paresthesia in the Extremities: More common in respiratory alkalosis due to calcium shifts.

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Correct Answer is A

Explanation

A. The development of malignant hyperthermia: Malignant hyperthermia (MH) is a life-threatening reaction to certain anesthetics (e.g., succinylcholine, halothane). It causes rapid muscle breakdown, severe hyperthermia, tachycardia, muscle rigidity, and metabolic acidosis. Immediate treatment with IV dantrolene and cooling measures is required.

B. The development of fluid volume excess: Fluid overload may cause hypertension and pulmonary edema but does not cause sudden high fever.

C. The development of an allergic response to the pain medication: Drug allergies typically present with rash, itching, or anaphylaxis, not extreme fever.

D. The development of an infection. Post-op infections usually develop over several days, not immediately in PACU.

A. Abdomen rigid with decreased bowel sounds B. Glucose 220mg/d C. No dialysis for 24 hours D. Crackles throughout the lungs E. WBC 17,000 mm3 F. Hemoglobin 10g/dL G. Potassium 7mEq/L H. Creatinine 3 mg/dL

Correct Answer is ["A","B","D","E","G"]

Explanation

A. Abdomen rigid with decreased bowel sounds: A rigid, tender abdomen suggests peritonitis, a life-threatening complication of peritoneal dialysis requiring immediate intervention.

B. Glucose 220 mg/Dl: Elevated glucose is concerning but not immediately life-threatening compared to the other findings.

C. No dialysis for 24 hours: Missing dialysis leads to toxin accumulation, hyperkalemia, and fluid overload, all of which can be life-threatening.

D. Crackles throughout the lungs: Fluid overload can cause pulmonary edema, leading to respiratory distress. Immediate intervention is needed to prevent respiratory failure.

E. WBC 17,000 mm³: Leukocytosis suggests infection, possibly peritonitis, which requires urgent antibiotic therapy.

F. Hemoglobin 10 g/dL: Mild anemia is expected in CKD and not an emergency.

G. Potassium 7 mEq/L: Severe hyperkalemia is a medical emergency due to the risk of life-threatening cardiac arrhythmias.

H. Creatinine 3 mg/dl: Creatinine is chronically elevated in CKD and not an acute concern.

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The nurse is reviewing the client's following arterial blood gases: pH 7.33, PaCo2 47, HCO3 24. Which manifestation would the nurse expect the client to be experiencing with this imbalance?

Nursing Test Bank

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