The nurse reviews the arterial blood gas results of a client and notes the following:
pH 7.45, [normal range: 7.35-7.45]
Paco2 of 30 mm Hg (30 mmol/L), [normal range: 35-45]
HCO3- of 20 mEq/L (20 mmol/L), [normal range: 22-26]
Which condition would the nurse analyze these results to indicate?
Metabolic alkalosis
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis
The Correct Answer is C
A. Metabolic alkalosis is characterized by a high pH and a high HCO3- level; this does not match the provided values.
B. Metabolic acidosis would show a low pH and a low HCO3-, which does not match the findings.
C. The pH is high (7.45) while the Paco2 is low (30 mm Hg), indicating respiratory alkalosis. The low HCO3- could be a compensatory mechanism but does not change the primary interpretation of respiratory alkalosis.
D. Respiratory acidosis would be indicated by a low pH and a high Paco2, which is not the case here.
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Correct Answer is C
Explanation
A. Restlessness is an objective sign that may indicate pain, but it is not a subjective report from the client.
B. Pupil dilation is an objective physiological response often associated with pain or stress, not a subjective indicator.
C. A report of a burning sensation is a subjective indicator because it is based on the client’s own description of their pain experience.
D. Grimacing is an objective observation by the nurse, not a subjective report from the client.
Correct Answer is D
Explanation
A. The iliac pulse is located near the pelvis and is not used for assessing circulation in the lower extremities.
B. The femoral pulse is located in the upper thigh, not near the posterior tibial area.
C. The popliteal pulse is found at the back of the knee and is higher than the posterior tibial location.
D. The posterior tibial pulse is correctly located behind the medial malleolus on the inner side of the ankle. This location is where the posterior tibial artery is accessible and is commonly used to assess blood flow to the lower extremities.