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 D
Explanation
A. Rounded describes a normal abdomen but does not convey the greater extent of fullness seen in this case.
B. Scaphoid describes a concave abdomen, which does not apply to this situation.
C. Flat indicates no significant contour changes, which does not apply here.
D. Protuberant is the correct term, as it describes an abdomen that is significantly distended and is characteristic of conditions like pregnancy, ascites, or obesity.
Correct Answer is D
Explanation
A. Bradypnea (slow breathing) may occur in various conditions but is not a defining characteristic of cyanosis.
B. A pale reddish color in the skin is not consistent with cyanosis, which indicates a lack of oxygen in the blood.
C. Somnolence (drowsiness) may be present in some patients, but it is not a specific finding related to cyanosis.
D. Mottled blue color in the skin is a classic sign of cyanosis, indicating inadequate oxygenation of the blood, especially in the extremities or areas with poor circulation.