The nurse is reviewing the arterial blood gas of a client with ...

[stock]

The nurse is reviewing the arterial blood gas of a client with chronic obstructive pulmonary disease (COPD). The results of the gas are: pH 7.34, CO2 55, PaO2 70, HCO3 28. What action should the nurse take?
 
  1. Place the client on 10 L of oxygen.
  2. Notify the charge nurse immediately.
  3. Nothing; this is a normal gas for this client.
  4. Notify the physician.

Question 2

A client with chronic lung disease is having difficulty breathing, and is slumped in the bed. The priority nursing intervention would be to:
 
  1. place the client on oxygen.
  2. have the client breathe into a paper bag.
  3. call and request a code team.
  4. place the client in a high Fowler's position.

[kilada]

Answer to Question 1

Answer: 3

1. In clients with chronic high CO2, a lower PaO2 level is the client's stimulus to breathe. Giving oxygen will risk respiratory failure in the client.
2. This is a normal gas for the client with COPD; the charge nurse is not notified.
3. This is a normal gas for this client.
4. Since this is the expected result, the physician is not notified.

Answer to Question 2

Answer: 4

1. The client with chronic lung disease should not be placed on oxygen, as the client might experience respiratory failure.
2. Breathing into a paper bag will increase CO2 levels.
3. The client probably does not need the code team until the nurse has performed an assessment.
4. Clients with chronic lung disease need to be positioned in a semi-Fowler's or high Fowler's position, preferably leaning over a table or pillow to promote lung expansion. The nurse first would position the client correctly and then would assess the vital signs.