A homeless person is brought into the emergency department with ...

[jwb375]

A homeless person is brought into the emergency department with indications of extremely poor nutrition. Arterial blood gases are assessed, and the nurse anticipates that this patient will demonstrate which of the following results?
 
  a. pH 7.3, PaCO2 38 mm Hg, HCO3 19 mmol/L
  b. pH 7.5, PaCO2 34 mm Hg, HCO3 20 mmol/L
  c. pH 7.35, PaCO2 35 mm Hg, HCO3 24 mmol/L
  d. pH 7.52, PaCO2 48 mm Hg, HCO3 28 mmol/L

Question 2

The nurse is evaluating the client in the hospital's postanaesthesia care unit (PACU) and determines that the Aldrete score is 8 . Based on this assessment, which of the following does the nurse anticipate will happen?
 
  a. The client will be sent to the intensive care unit.
  b. The client will be discharged back to his room on the nursing unit.
  c. The client will remain in the PACU until the score improves.
  d. The client will return to the operating room for surgical evaluation.

Question 3

A terminally ill patient is experiencing constipation secondary to pain medication. What is the best way for the nurse to improve the patient's constipation problem?
 
  a. Massage the patient's abdomen.
  b. Contact the provider to discontinue pain medication.
  c. Administer enemas twice daily for 7 days.
  d. Use a stimulant laxative and increase fluid intake.

[peter]

Answer to Question 1

A

Feedback
A Metabolic acidosis may be found in cases of starvation. At 7.3 the patient's pH is below the normal (7.35 to 7.45), the partial pressure of arterial carbon dioxide (PaCO2) is in the normal range of 35 to 45 mm Hg (at 38 mm Hg), and at 19 mmol/L, the bicarbonate concentration (HCO3) is below the normal of 22 to 26 mmol/L. These findings demonstrate metabolic acidosis.
B The values of pH 7.5, PaCO2 34 mm Hg, and HCO3 20 mmol/L are consistent with respiratory alkalosis, compensated. This would not be typical of malnutrition.
C The values of pH 7.35, PaCO2 35 mm Hg, and HCO3 24 mmol/L represent normal arterial blood gas results.
D The values of pH 7.52, PaCO2 48 mm Hg, and HCO3 28 mmol/L are consistent with metabolic alkalosis, compensated. This would not be an expected finding with extremely poor nutrition.

Answer to Question 2

B
The client must receive a composite Aldrete score of 8 to 10 before being discharged from the PACU. The nurse may anticipate that the client with an Aldrete score of 8 will be discharged back to his room on the nursing unit.
If the client's condition is still poor after two to three hours (an Aldrete score below , the phy-sician may transfer the client to an intensive care unit.
If the client's condition is still poor after two to three hours (an Aldrete score below , the phy-sician may lengthen the client's stay in the PACU until the score improves.
A client with an Aldrete score of 8 is unlikely to return to the operating room for surgical evalua-tion.

Answer to Question 3

D
Opioid medication is known to slow gastrointestinal transit time, which places the patient at high risk for constipation. Stimulant laxatives are indicated for opioid-induced constipation. Added water to the diet will allow water to be pulled into the GI tract, softening up stool. Massaging the patient's abdomen may cause further discomfort. Discontinuing pain medication is inappropriate for a terminally ill patient. Enema administration is not the first step in the treatment of opioid-induced constipation.

[jwb375]

Both answers were spot on, thank you once again

[peter]

Great! Please up vote