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NurseDive Free Nursing Practice Question
A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO2 48 mm Hg and the HCO, is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Respiratory acidosis occurs when there is an excess of carbon dioxide (PaCO2) in the blood, leading to a decrease in pH. The ABG values that support this analysis are as follows: pH 7.32: A pH below the normal range of 7.35-7.45 indicates acidosis. PaCO2 48 mm Hg: An elevated PaCO2 level is consistent with respiratory acidosis. The normal range for PaCO2 is typically 35-45 mm Hg, so a value of 48 mm Hg indicates an excess of carbon dioxide. HCO3- (bicarbonate) 23 mEq/L: The bicarbonate level is within the normal range. In respiratory acidosis, the kidneys typically respond to compensate for the acidosis by retaining bicarbonate, but the bicarbonate level remains within the normal range.
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Similar Questions
A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that which of the following findings indicates fluid volume excess? (Select all that apply.)
A. Crackles upon auscultation
Explanation: Fluid volume excess can result in the accumulation of fluid in the lungs, leading to pulmonary congestion. This can manifest as crackles or rales heard upon auscultation of the lung fields. Increased fluid volume can lead to an increase in stroke volume, resulting in a bounding pulse. This can be felt as a forceful and strong pulse. Fluid volume excess can cause the accumulation of fluid in the interstitial spaces, leading to pitting edema. When pressure is applied to the edematous area, an indentation or "pit" remains after releasing the pressure. The following findings are not typically associated with fluid volume excess: Swelling at the IV site is more commonly associated with local inflammation or infiltration of the IV site rather than fluid volume excess. A urine-specific gravity greater than 1.030 typically indicates concentrated urine and is more indicative of fluid volume deficit or dehydration rather than fluid volume excess. In fluid volume excess, the urine-specific gravity is usually lower due to the dilution of urine caused by increased fluid intake. A nurse is caring for a client who is unconscious and
B. Bounding pulse
C. Pitting edema
D. Swelling at the IV site
E. Urine-specific gravity greater than 1.030
A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that which of the following findings indicates fluid volume excess? (Select all that apply.)
A. Crackles upon auscultation
Fluid volume excess can result in the accumulation of fluid in the lungs, leading to pulmonary congestion. This can manifest as crackles or rales heard upon auscultation of the lung fields. Increased fluid volume can lead to an increase in stroke volume, resulting in a bounding pulse. This can be felt as a forceful and strong pulse. Fluid volume excess can cause the accumulation of fluid in the interstitial spaces, leading to pitting edema. When pressure is applied to the edematous area, an indentation or "pit" remains after releasing the pressure. The following findings are not typically associated with fluid volume excess: Swelling at the IV site is more commonly associated with local inflammation or infiltration of the IV site rather than fluid volume excess. A urine-specific gravity greater than 1.030 typically indicates concentrated urine and is more indicative of fluid volume deficit or dehydration rather than fluid volume excess. In fluid volume excess, the urine-specific gravity is usually lower due to the dilution of urine caused by increased fluid intake.
B. Bounding pulse
C. Pitting edema
D. Swelling at the IV site
E. Urine-specific gravity greater than 1.030
A nurse is caring for a client who is unconscious and has a living will. The client's family asks if they can make changes to lifesaving measures now that the client is unconscious. Which of the following statements should the nurse make?
A. "The Patient Self-Determination Act (PSDA) will explain your rights to change lifesaving measures."
B. "The durable power of attorney for health care can cancel the client's living will."
C. "The living will states the client's wishes regarding lifesaving measures."
A living will is a legal document that outlines an individual's wishes regarding medical treatment in the event that they become incapacitated or unable to communicate their preferences. It typically includes instructions about lifesaving measures such as resuscitation, mechanical ventilation, and other interventions. In this case, since the client is unconscious and has a living will, the family should refer to the living will to understand the client's wishes regarding lifesaving measures. The living will serves as a guide for healthcare providers and family members in making decisions about the client's care. The other statements are not accurate in this context: The Patient Self-Determination Act (PSDA) requires healthcare facilities to inform patients about their rights regarding advance directives, including living wills. However, it does not address the family's ability to change the client's wishes or modify the living will. The durable power of attorney for health care, also known as a healthcare proxy or healthcare agent, is a separate legal document that designates a person to make medical decisions on behalf of an individual who is unable to do so. However, the durable power of attorney does not cancel the client's living will but rather allows the designated person to make decisions based on the client's expressed wishes. The case manager typically facilitates communication and coordination of care but does not have the authority to make changes to a client's living will. Any changes to the living will would need to follow the legal process specified in the applicable jurisdiction, such as revoking or updating the document through legal means.
D. "The case manager can make changes to the client's living will."