A patient in metabolic alkalosis is admitted to the emergency ...

[codyclark]

A patient in metabolic alkalosis is admitted to the emergency department, and pulse oximetry (SpO2) indicates that the O2 saturation is 94. Which action should the nurse take next?
 
  a. Administer bicarbonate.
  b. Complete a head-to-toe assessment.
  c. Place the patient on high-flow oxygen.
  d. Obtain repeat arterial blood gases (ABGs).

Question 2

When assessing the respiratory system of an older patient, which finding indicates that the nurse should take immediate action?
 
  a. Weak cough effort
  b. Barrel-shaped chest
  c. Dry mucous membranes
  d. Bilateral crackles at lung bases

[al]

Answer to Question 1

ANS: C
Although the O2 saturation is adequate, the left shift in the oxyhemoglobin dissociation curve will decrease the amount of oxygen delivered to tissues, so high oxygen concentrations should be given. Bicarbonate would worsen the patient's condition. A head-to-toe assessment and repeat ABGs may be implemented. However, the priority intervention is to give high-flow oxygen.

Answer to Question 2

ANS: D
Crackles in the lower half of the lungs indicate that the patient may have an acute problem such as heart failure. The nurse should immediately accomplish further assessments, such as oxygen saturation, and notify the health care provider. A barrel-shaped chest, hyperresonance to percussion, and a weak cough effort are associated with aging. Further evaluation may be needed, but immediate action is not indicated. An older patient has a less forceful cough and fewer and less functional cilia. Mucous membranes tend to be drier.