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The nurse reviews the client's arterial blood gases and has the following results: pH 7.30. PaCO2 58, and HCO3 of 26. The nurse interprets these results that the client has which acid-base imbalance?

Respiratory Alkalosis

Metabolic Acidosis

Metabolic alkalosis

Respiratory acidosis

Answer and Explanation

The Correct Answer is D

A. Respiratory Alkalosis: Would have high pH (>7.45) and low PaCO2 (<35 mmHg).

B. Metabolic Acidosis: Would have low pH and low HCO3 (<22 mEq/L).

C. Metabolic Alkalosis: Would have high pH and high HCO3 (>26 mEq/L).

D. Respiratory Acidosis: A low pH (<7.35) and high PaCO2 (>45 mmHg) indicate respiratory acidosis, which occurs due to hypoventilation, COPD, or respiratory failure. The bicarbonate (HCO3) is normal, meaning there is no metabolic compensation yet.

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Correct Answer is B

Explanation

A. pH 7.30, PaCO₂ 38, HCO₃ 15: Metabolic acidosis (low HCO₃, normal PaCO₂).

B. pH 7.32, PaCO₂ 56, PO₂ 84, HCO₃ 26: The client has respirations of 8/min, which indicates hypoventilation → CO₂ retention → respiratory acidosis. pH 7.32 indicates acidosis. PaCO₂ 56 mmHg - Elevated CO₂ (hypercapnia), confirming respiratory acidosis. HCO₃ 26- Normal bicarbonate suggests that compensation has not yet occurred

C. pH 7.37, PaCO₂ 45, HCO₃ 24: Normal ABG values.

D. pH 7.48, PaCO₂ 32, HCO₃ 22: Respiratory alkalosis (low PaCO₂ due to hyperventilation, not hypoventilation).

A. Administer scheduled medications B. Explain that dialysis occurs via the peritoneum C. Weigh the client to determine a baseline for comparison D. Obtain a serum creatinine to determine kidney function

Correct Answer is C

Explanation

A. Administer scheduled medications: Some medications (e.g., antihypertensives, water-soluble vitamins, and antibiotics) should be held before dialysis to prevent removal during treatment.

B. Explain that dialysis occurs via the peritoneum: This describes peritoneal dialysis, not hemodialysis.

C. Weigh the client to determine a baseline for comparison: Pre-dialysis weight is crucial to determine fluid removal needs during dialysis. Weight differences before and after dialysis indicate fluid loss or retention.

D. Obtain a serum creatinine to determine kidney function: Serum creatinine levels are monitored regularly but are not a required step before every dialysis session.

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The nurse reviews the client's arterial blood gases and has the following results: pH 7.30. PaCO2 58, and HCO3 of 26. The nurse interprets these results that the client has which acid-base imbalance?

Nursing Test Bank

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