What condition do these results indicate? A nurse is reviewing arterial blood gas lab values on her newly admitted elderly client. The ABG results are as follows: pH 7.21, PaCO2 50, HCO3 26.
Respiratoty acidosis
Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
The Correct Answer is A
A) Respiratory acidosis:
This condition is characterized by an increase in PaCO2 and a decrease in pH, which is exactly what is seen in these ABG results. The pH of 7.21 indicates acidosis (normal pH range is 7.35–7.45), and the PaCO2 of 50 is elevated (normal PaCO2 range is 35–45 mmHg), indicating that carbon dioxide retention is contributing to the acidosis. In respiratory acidosis, the lungs are unable to adequately expel CO2, leading to an accumulation of CO2 in the blood, which decreases the pH. The HCO3 (bicarbonate) is within normal range (22–28 mEq/L), suggesting that there has not yet been compensation by the kidneys, which would typically increase bicarbonate levels to buffer the acidosis.
B) Metabolic alkalosis:
Metabolic alkalosis is characterized by an elevated pH (above 7.45) and an elevated HCO3 (above 28 mEq/L). In this case, the pH is low (7.21), and the bicarbonate level (HCO3) is normal (26), so metabolic alkalosis is not the correct diagnosis.
C) Respiratory alkalosis:
Respiratory alkalosis occurs when there is decreased PaCO2 (below 35 mmHg) and an elevated pH (above 7.45), typically due to hyperventilation. Since the PaCO2 is elevated (50 mmHg) in this case, it rules out respiratory alkalosis.
D) Metabolic acidosis:
Metabolic acidosis is characterized by a low pH (below 7.35) and a low HCO3 (below 22 mEq/L). While the pH is low in this case, the HCO3 is normal (26 mEq/L), which suggests that the acidosis is not metabolic in origin. Metabolic acidosis would typically show a low bicarbonate level, indicating that the kidneys are not able to compensate effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) "ALS is caused by excess chemicals in the brain. The symptoms can be controlled with medication."
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that results in the progressive loss of motor neurons, which leads to muscle weakness, atrophy, and paralysis. It is not caused by "excess chemicals in the brain," and there are currently no medications that can cure ALS or completely control its symptoms. Medications such as riluzole can slow the progression slightly, but they do not stop or reverse the disease.
B) "The disease is progressive and will eventually lead to paralysis while maintaining cognitive function."
ALS is indeed a progressive neurodegenerative disease that leads to the gradual loss of muscle function due to the death of motor neurons. Over time, the patient will experience muscle weakness, atrophy, and paralysis, while the cognitive function typically remains intact until the later stages of the disease, although some patients may develop frontotemporal dementia. it is essential for the patient to understand that the disease will progressively impair their physical abilities while leaving cognitive functions largely unaffected in most cases.
C) "Before you lose cognitive function, you should consider creating an advanced directive."
While it is important for individuals with ALS to plan for the future, this statement is not entirely accurate. Cognitive function in ALS is often preserved throughout most of the disease, although there is a subset of patients who may develop frontotemporal dementia. It would be more appropriate to discuss advanced directives early in the disease, but it is not guaranteed that cognitive function will be lost before physical decline.
D) "Despite severe symptoms right now, most patients recover with treatment."
ALS is a progressive disease with no cure, and it does not typically result in recovery. While certain treatments can help manage symptoms or slow the progression of the disease, recovery is not a realistic expectation. Most patients with ALS experience gradual worsening of symptoms and ultimately may require assistance with daily activities as the disease progresses.
Correct Answer is B
Explanation
A. 250 mg:
This represents the amount of levodopa in the tablet, not carbidopa. Sinemet contains two active ingredients: carbidopa (25 mg) and levodopa (250 mg), as shown on the label.
B. 25 mg:
This is the correct answer, as the label indicates that each tablet contains 25 mg of carbidopa. Carbidopa is combined with levodopa to improve its effectiveness and reduce side effects like nausea.
C. 5 mg:
This is not accurate; the label clearly states that the carbidopa dose is 25 mg per tablet.
D. 200 mg:
This does not correspond to the dose of carbidopa or levodopa in this medication. The label specifies 25 mg of carbidopa and 250 mg of levodopa.
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