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 B
Explanation
A. Gingivitis is a form of gum disease that can occur in anyone, but it is not specifically related to low CD4-T-cell counts associated with AIDS.
B. Candidiasis, also known as oral thrush, is a fungal infection caused by Candida species. Clients with a significantly decreased CD4-T-cell count are at high risk for opportunistic infections, including candidiasis, due to their compromised immune systems.
C. Xerostomia refers to dry mouth, which can occur for various reasons but is not specifically an infectious condition linked to low CD4 counts.
D. Halitosis, or bad breath, can result from several factors, including poor oral hygiene or underlying health issues, but is not specifically linked to the immune status of a client with AIDS.