Question

A 72 year old male patient is admitted with 5 broken ribs after a fall from a ladder. He is complaining of pain level 7 on the 0-10 scale and of feeling very anxious. VS are TPR-99.4/110/32, BP - 142/88. Which ABG result would not be unusual in this situation? A. pH-7.28, PaCO2-57, HCO3-32 B. pH-7.51, PaCO2- 26, HCO3-16 C. pH-7.29, PaCO2-52, HCO3 14 D. pH- 7.50, PaCO2-28, HCO3 -32 What interventions would the nurse expect to do with this client? An 18 year old female patient is admitted with confusion and extreme weakness. Upon obtaining a history the nurse realizes the patient has been obsessed with losing weight. She has been eating only 300- 400 calories per day and running for hours on a treadmill. Her Na+ level is 130 and K+ level is 2.8. Which ABG result would not be unusual in this situation? A. pH-7.28, PaCO2-57, HCO3 32 B. pH-7.51, PaCO2-26, HCO3 16 C. pH-7.29, PaCO2 52, HCO3-14 D. pH-7.50, PaCO2 - 28, HCO3-32 What interventions would the nurse expect to do with this client?

Answer 1

A, d, pH - 7.50, paco2- 28, HCo3 - 32

Patient having severe pain and more anxiety it increase his metabolic demands..patient pH level will be more than 7.45 and HCo3 increased and Paco2 <35mmofHg it indicate respiratory alkalosis..patient experience hyperventilation which commonly occurs with anxiety and pain .

Intervention:

- stabilize the patient with pain medication and sedative as per doctor advice.

- monitor respiratory rate and level of anxiety and pain .

- inform orthopaedic surgeon to see the patient for surgical intervention.

- Encourage patient to breath slowly and monitor patient serum electrolytes.

- use rebreathing mask to administer oxygen..

- administer sodium bicarbonate with doctors order..

B, a, PH - 7.28, paco2 - 57, HCo3 - 32

Patient having symptoms like confusion, weight loss, and extreme weakness and her pH is low, Hco3 increased, paco2 also increased..her sodium and potassium level less it shows electrolyte imbalance it indicate respiratory acidosis.

Intervention:

- monitor the respiratory level of consciousness, respiratory rate, and heart rate.

- administer oxygen to meet the respiratory demand.

- check patient hydration level.

- treat the patient underlying causes..keep the patient with calm environment.

- provide intravenous solutions to replace the sodium and potassium level.

- administer sodium bicarbonate as per Physician advice.

- inform dietician for nutrition requirement..