Which blood gas result will the nurse expect to observe in a patient with respiratory alkalosis?

pH 7.53, PaCO2 30 mm Hg, HCO3-24 mEq/L

pH 7.35, PaCO2 35 mm Hg. HCO3-26 mEq/L

pH 7.25, PaCO2 48 mm Hg. HCO3-23 mEq/L

pH 7.60, PaCO2 40 mm Hg, HCO3-30 mEq/L

Answer and Explanation

The Correct Answer is A

A.   pH: Elevated (above 7.45), indicating alkalosis. PaCO₂: Decreased (below 35 mm Hg), reflecting hyperventilation and CO₂ loss. HCO₃⁻: Usually normal (around 24 mEq/L) or slightly decreased, as metabolic compensation might not be immediate. The results here show an elevated pH, decreased PaCO₂, and normal HCO₃⁻, which are consistent with respiratory alkalosis.
B.   pH: Decreased (acidic), indicating acidosis. PaCO₂: Slightly elevated (near normal), not indicative of respiratory alkalosis. HCO₃⁻: Normal (around 26 mEq/L), suggesting no significant metabolic component or compensation. This profile does not match respiratory alkalosis; it is more consistent with a mixed or different type of acid-base imbalance.
C.   pH: Decreased (acidic), indicating acidosis. PaCO₂: Elevated (above 45 mm Hg), indicating CO₂ retention, which is characteristic of respiratory acidosis, not alkalosis. HCO₃⁻: Normal (around 23 mEq/L), showing no significant metabolic compensation or disturbance. This profile indicates respiratory acidosis rather than respiratory alkalosis.
D.   pH: Elevated (alkaline), which is consistent with alkalosis. PaCO₂: Normal (around 40 mm Hg), indicating that CO₂ levels are not the primary cause of the alkalosis. HCO₃⁻: Elevated (above 28 mEq/L), suggesting a metabolic alkalosis or compensation for a respiratory acidosis, but not respiratory alkalosis alone.

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Correct Answer is B

Explanation

A. 0.9% sodium chloride, also known as Normal Saline, is an isotonic solution. It has the same concentration of solutes as blood plasma, which means it does not change the cell's fluid volume but rather maintains it. It is not considered hypotonic.

B. 0.45% sodium chloride, commonly known as Half Normal Saline, is a hypotonic solution. It has a lower concentration of sodium chloride compared to the normal saline and is used to provide hydration and to help correct electrolyte imbalances by allowing water to move into the cells.
C. Dextrose 5% in Lactated Ringer's is not a hypotonic solution. It is actually a type of hypertonic solution. Initially, dextrose 5% is isotonic, but once the dextrose is metabolized, the solution becomes hypotonic due to the electrolyte content of Lactated Ringer’s. However, the classification is generally based on the solution before metabolism, and it is not commonly used as a hypotonic solution.
D. Lactated Ringer's solution is an isotonic solution. It contains electrolytes in concentrations similar to those found in the body's plasma, and it is used to restore fluids and electrolytes. It does not have a hypotonic effect on cells.

A. Spoon nails B. Peripheral edema C. Pleural friction rub D. Barrel chest

Correct Answer is D

Explanation

A. This is associated with iron deficiency anemia, not COPD.
B. While peripheral edema can occur in advanced COPD due to right-sided heart failure (cor pulmonale), it's not a typical early finding.
C. This is associated with inflammation of the pleural layers, typically due to pneumonia or pleurisy, not COPD.
D. Barrel chest is a classic sign of COPD, resulting from air trapping in the lungs, causing the chest to become hyperinflated

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Which blood gas result will the nurse expect to observe in a patient with respiratory alkalosis?

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