The nurse is caring for a client with sickle cell anemia. The ...

[Marty]

The nurse is caring for a client with sickle cell anemia. The nurse teaches the client that the inherited alteration of which type of hemoglobin causes the abnormal shape to the red blood cell?
 
  A) Hgb A
  B) Hgb S
  C) Hgb B
  D) Hgb E

Question 2

The nurse is analyzing the client's arterial blood gas report, which reveals a pH of 6.58. The client has just suffered a cardiac arrest. Which consequences of this pH value does the nurse consider for this client?
 
  A) Decreased cardiac output
  B) Increase magnesium levels
  C) Decreased free calcium in the ECT
  D) Increased myocardial contractility

[yasmina]

Answer to Question 1

Answer: B
The inherited alteration of Hgb S causes the abnormal sickle-shaped red blood cell in sickle cell anemia.

Answer to Question 2

Answer: A

The nurse knows that severe acidosis (pH of 7.0 or less) depresses myocardial contractility, which leads to decreased cardiac output. Acid-base imbalances also affect electrolyte balance. In acidosis, potassium is retained as the kidney excretes excess hydrogen ion. Excess hydrogen ions also enter the cells, displacing potassium from the intracellular space to maintain the balance of cations and anions within the cells. The effect of both processes is to increase serum potassium levels. Also in acidosis, calcium is released from its bonds with plasma proteins, increasing the amount of ionized (free) calcium in the blood. Magnesium levels may fall in acidosis.