A nurse is providing care for a client experiencing obstructive shock. Which of the following diagnoses should the nurse expect?
Cardiac tamponade
Third spacing
Ruptured aneurysm
Cardiomyopathy
The Correct Answer is A
A. Cardiac tamponade is a condition where fluid accumulates in the pericardial space, exerting pressure on the heart and impeding its ability to pump effectively, leading to obstructive shock.
B. Third spacing refers to fluid accumulation in the interstitial spaces but is not a specific diagnosis of obstructive shock.
C. A ruptured aneurysm may lead to hypovolemic shock due to blood loss rather than obstructive shock, which is characterized by physical obstruction to blood flow.
D. Cardiomyopathy is a disease of the heart muscle that affects its ability to pump blood, leading to cardiogenic shock, not obstructive shock.
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Correct Answer is A
Explanation
A. Respiratory acidosis is indicated by the low pH (7.22) and elevated PaCO2 (68 mm Hg), demonstrating that CO2 is retained due to hypoventilation (as seen with a respiratory rate of 7/min). The bicarbonate level is within normal range, suggesting no metabolic compensation is present.
B. Metabolic acidosis would be indicated by a low pH and low bicarbonate level, which is not the case here since the bicarbonate is normal at 26 mEq/L.
C. Metabolic alkalosis would present with a high pH and high HCO3, which does not match these values.
D. Respiratory alkalosis would show a high pH and low PaCO2, which is contrary to the provided ABG results.
Correct Answer is D
Explanation
A. Cortisol levels are not directly affected by furosemide; monitoring for adrenal function is not a priority.
B. Bicarbonate levels are not specifically monitored for clients on furosemide; this medication's main effect does not relate directly to bicarbonate balance.
C. Albumin levels are not primarily affected by furosemide; although low albumin can affect fluid status, it is not the critical monitoring focus.
D. Potassium levels should be monitored because furosemide is a loop diuretic that can lead to hypokalemia, which is a common and significant side effect due to increased renal excretion of potassium.