Question

A nurse assesses a client who is experiencing an acid-base imbalance. The client's arterial blood gas values are pH 7.33, PaO2 88 mm Hg. PaCO2 38 mm Hg, and HCO3- 19 mEq/L. Which assessment should the nurse perform first? A. Cardiac rate and rhythm B. Skin and mucous membranes C. Musculoskeletal strength D. Level of orientation A nurse assesses a client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3- 16 mEq/L. What action should the nurse take next? A. Assess client's rate, rhythm, and depth of respiration. B. Measure the client's reflexes C. Document the findings and continue to monitor. D. Notify the health care provider as soon as possible A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm Hg. PaCO2 65 mm Hg, and HCO3- 22 mEg/L. Which clinical situation should the nurse correlate with these values? A. Diabetic ketoacidosis in a person with emphysema B. Bronchial obstruction related to aspiration of a piece of food C. Anxiety-induced hyperventilation in an adolescent D. Diarhea for 36 hours in an older, frail woman A nurse is caring for a client who has just experienced a seizure and brief episode of apnea. The client's arterial blood gas values are pH 6.88, PaO2 50 mm Hg. PaCO2 60 mm Hg, and HCO3 22 mEg/L. Which action should the nurse take first? A. Apply a paper bag over the client's nose and mouth. B. Apply oxygen by mask or nasal cannula C. Administer 50 ml. of sodium bicarbonate intravenously. D. Administer 50 ml. of 20% glucose and 20 units of regular insulin. A nurse is caring for a client who has chronic emphysema and is receiving oxygen therapy at 6 L/min via nasal cannula. The following clinical data are available Vital Signs: Arterial blood gases: pH= 7.28 Pa02= 85 mm/Hg PaCo2= 55 mm/Hg HCO3 26 mEq/L 02 saturation Pulse rate 96 beats/min Blood pressure 135/45 Respiratory rate 6 breaths/min 88 % Which action should the nurse take first? A. Notify the Rapid Response Team and provide ventilation support. B. Change the nasal cannula to a mask and reassess in 10 minutes C. Place the client in Fowler's position if he or she is able to tolerate it D. Decrease the flow rate of oxygen to 2 to 4 L/min, and reassess. aking

Answer 1

# The correct option is D)

The nurse should assess the cardiac rate and rythm because their is metabolic acidosis and it can be due to increased potassium levels .

# The correct option is A ) the nurse should assess clients rate ,rythm and depth of respiration because it is a case of metabolic acidosis

# The correct option is A) Diabetic ketoacidosis in a person with emphsema because their is respiratory acidosis and it causes kussmaul respiration

# The correct option is B ) apply oxygen by mask or nasal cannula because it is a case of respiratory acidosis and patient has rapid and fast breathing