The pediatric nurse is caring for a 2-year-old with a respiratory rate of 42 breaths per minute and a FLACC score 8. Which acid-base imbalance does the pediatric team expect to find with sustained tachypnea?
Respiratory acidosis
Metabolic alkalosis
Metabolic acidosis
Respiratory alkalosis
The Correct Answer is D
A. Respiratory acidosis results from hypoventilation, where CO₂ is retained, leading to increased carbonic acid and decreased blood pH. This is the opposite of what is expected with tachypnea.
B. Metabolic alkalosis is typically caused by loss of gastric acid (e.g., vomiting) or excessive bicarbonate intake, not by altered respiratory rates.
C. Metabolic acidosis occurs in conditions such as diarrhea, renal failure, or diabetic ketoacidosis—not directly from changes in respiratory rate.
D. Sustained tachypnea (rapid breathing), especially in a child, leads to excessive exhalation of CO₂, reducing carbonic acid levels and raising blood pH, resulting in respiratory alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The sweat chloride test is the gold standard for diagnosing cystic fibrosis (CF). A chloride concentration greater than 60 mEq/L is diagnostic for CF in children.
B. Pulmonary function tests can assess lung capacity and function, but they are not diagnostic and may be difficult to perform reliably in very young children.
C. Stool fat analysis can indicate malabsorption, which is common in CF, but it is not specific or confirmatory for the disease.
D. A sputum culture may detect bacterial colonization (e.g., Pseudomonas), which is common in CF, but it does not confirm the diagnosis.
Correct Answer is A
Explanation
A. Coarctation of the aorta is a congenital narrowing of the aorta, typically after the branches that supply the upper body. This results in increased blood pressure in the upper extremities and decreased perfusion (and lower blood pressure) in the lower extremities.
B. Clubbing and shortness of breath are more characteristic of chronic hypoxemia, often seen in cyanotic congenital heart defects such as Tetralogy of Fallot, not coarctation of the aorta.
C. Cyanosis is typically associated with defects that cause mixing of oxygenated and deoxygenated blood, such as transposition of the great arteries or tetralogy of Fallot, not coarctation.
D. Pedal edema is more commonly associated with right-sided heart failure and is not a hallmark sign of coarctation in pediatric clients.
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