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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
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.
Correct Answer is C
Explanation
A. Administer supplemental oxygen: Hypokalemia primarily affects cardiac and neuromuscular function, not oxygenation. Oxygen may be needed if dysrhythmias develop but is not the highest priority.
B. Seizure precautions: While severe hypokalemia can cause muscle weakness, seizures are not the primary concern. Cardiac effects take priority.
C. Cardiac monitoring: A potassium level of 2.2 mEq/L is critically low, increasing the risk of life-threatening cardiac arrhythmias. Continuous cardiac monitoring helps detect dangerous dysrhythmias like ventricular tachycardia.
D. Initiating a fluid restriction: Fluid restriction is more relevant for hyperkalemia or fluid overload, not hypokalemia.
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