A patient who has been on a high-protein diet comes to the ...

[fahad]

A patient who has been on a high-protein diet comes to the emergency department with respiratory symptoms. Upon analysis of arterial blood gases (ABGs), the patient is diagnosed with hypercapnia.
 
  The nurse will note the ABG results that confirm this diagnosis include: Select all that apply.
  A)
  pH 7.31 (normal 7.35 to 7.45).
  B)
  PO2 of 97.
  C)
  PCO2 of 58 mm Hg (normal 38 to 42).
  D)
  Serum HCO3of -33 mEq/L (normal 22 to 28).
  E)
  Serum K+ (potassium)of 3.6 mmol/L (normal 3.5 to 5.0).

Question 2

A nurse will be providing care for a female patient who has a diagnosis of heart failure that has been characterized as being primarily right sided.
 
  Which of the following statements best describes the presentation that the nurse should anticipate? The client
  A)
  has a distended bladder, facial edema, and nighttime difficulty breathing.
  B)
  complains of dyspnea and has adventitious breath sounds on auscultation (listening).
  C)
  has pitting edema to the ankles and feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain.
  D)
  has cyanotic lips and extremities, low urine output, and low blood pressure.

[recede]

Answer to Question 1

Ans:
A, C, D

Feedback:

Hypercapnia affects a number of body functions, including acid-base balance and renal, neurological, and CV functions. Elevated levels of PCO2 (38 to 42) produce a decrease in pH (7.35 to 7.45) and respiratory acidosis. Compensatory mechanisms result in an increase in serum HCO3 (22 to 28). In this example, the PO2 level is within normal range. Serum K+ is not part of the ABG analysis.

Answer to Question 2

Ans:
C

Feedback:

Right-sided failure is associated with peripheral edema, fatigue, and, on occasion, upper right quadrant pain. Abdominal distention can occur with right-sided failure when the liver becomes engorge. Facial edema, pulmonary edema, peripheral cyanosis, low urine output, and low blood pressure are less associated with right-sided failure. Left-sided failure is primarily associated with pulmonary signs and symptoms like dyspnea, pulmonary edema, frothy pink sputum, and respiratory congestion.