The nurse reviews the arterial blood gas results of an assigned client and notes the laboratory report results
pH of 7.30, [normal pH is 7.35 to 7.45]
Paco2 of 58 mm Hg, [Normal Paco2 is 35 to 45 mm Hg]
Pao2 of 80 mm Hg. [normal is 80-100]
HCO3 of 27 mEq/L (27 mmol/L). [Normal HCO3 is 22-26]
The nurse interprets that the client has which acid-base disturbance?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
The Correct Answer is A
A. Respiratory acidosis: The pH is low (indicating acidosis), and the Paco₂ is elevated, which signifies that carbon dioxide retention is causing the acidosis. This pattern indicates respiratory acidosis, as the elevated HCO₃ suggests a compensatory response.
B. Respiratory alkalosis: Respiratory alkalosis would show a high pH with a low Paco₂. This is not consistent with the client’s lab results.
C. Metabolic acidosis: Metabolic acidosis would show a low pH with a low HCO₃. In this case, the HCO₃ is slightly elevated, ruling out metabolic acidosis.
D. Metabolic alkalosis: Metabolic alkalosis would show a high pH with an elevated HCO₃, which does not match the client’s results.
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Correct Answer is ["B","D","E","F"]
Explanation
A. Hypoactive oil and sweat glands: Pregnancy typically causes increased activity in oil and sweat glands, not decreased.
B. Increased skin pigmentation: Increased pigmentation is common during pregnancy, often affecting areas like the areolas and abdomen.
C. Persistent migraine headaches: While some women may experience headaches in pregnancy, they are not an expected or typical finding and may require further assessment.
D. Facial edema: Mild facial edema can occur as pregnancy progresses, especially due to increased blood volume and fluid retention.
E. Melasma: Melasma, or "mask of pregnancy," is a common finding characterized by dark patches on the face due to hormonal changes.
F. Linea nigra: Linea nigra is a dark line that often appears on the abdomen during pregnancy as a result of hormonal changes.
Correct Answer is ["C","D","E"]
Explanation
A. Numbness in the right arm is not a risk factor for skin cancer; it is more related to neurological issues or circulation problems.
B. While working in a beauty parlor may involve exposure to certain chemicals, it is not a significant risk factor for skin cancer compared to other options.
C. A client with a fair skin complexion and blue eyes has a higher risk for skin cancer due to lower melanin levels, making them more susceptible to UV damage.
D. Smoking is primarily associated with lung cancer; however, it can also contribute to skin damage and increased risk for skin cancer, particularly squamous cell carcinoma.
E. A roofer who spends a lot of time outdoors and experiences blistering sunburns is at significant risk for skin cancer due to excessive UV exposure and history of severe sunburns.