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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. While a slightly elevated hematocrit can be associated with dehydration, it's not as specific as urine specific gravity.
B. This indicates concentrated urine, which is a classic sign of dehydration. Normal urine specific gravity is typically between 1.005 and 1.030.
C. This is a normal creatinine level and does not indicate dehydration.
D. This is within the normal range for sodium.
Correct Answer is B
Explanation
A. Increasing sodium intake would exacerbate hypernatremia, not correct it. Hypernatremia is characterized by an excess of sodium in the blood, so the goal of treatment is to lower sodium levels, not increase them.
B. Infusing hypotonic IV fluids, such as 0.45% NaCl or D5W (5% dextrose in water), helps to dilute the high sodium concentration in the blood and can assist in correcting hypernatremia. Hypotonic fluids move water into cells and help balance the sodium levels by promoting hydration and lowering the sodium concentration.
C. Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia (elevated potassium levels), not hypernatremia. It works by exchanging potassium for sodium in the gastrointestinal tract and would not address hypernatremia.
D. Implementing a fluid restriction is generally not the best approach for treating hypernatremia. In fact, fluid restriction could worsen hypernatremia by limiting the client's fluid intake and not addressing the sodium imbalance. The primary goal in hypernatremia is usually to rehydrate the patient with appropriate fluids.
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