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
Explanation
A. Observing for facial symmetry assesses cranial nerves VII (facial nerve) rather than cranial nerve III.
B. Checking the pupillary response to light assesses cranial nerve III (oculomotor nerve), which controls pupil constriction and extraocular eye movements.
C. Testing visual acuity assesses cranial nerve II (optic nerve), not cranial nerve III.
D. Eliciting the gag reflex assesses cranial nerves IX (glossopharyngeal) and X (vagus), not cranial nerve III.
Correct Answer is D
Explanation
A. Urinary frequency is characterized by the need to urinate more often but does not necessarily cause cloudy urine, odor, or hematuria.
B. Urinary retention involves the inability to empty the bladder fully but does not specifically present with cloudy urine, odor, or blood.
C. Urinary incontinence refers to the involuntary loss of urine and does not directly correlate with the urine's appearance or presence of blood.
D. A urinary tract infection (UTI) commonly causes cloudy urine, foul odor, and hematuria due to inflammation and infection in the urinary tract.