The nurse is caring for a patient whose ABG results reveal the ...

[leo leo]

The nurse is caring for a patient whose ABG results reveal the following: pH 7.56, PaCO2 32 mm Hg, HCO3 42 mEq/L, PaO2 90 mm Hg. Which condition will the nurse expect to see in the patient's chart as the underlying cause of these results?
 
  a. Gastroenteritis with severe nausea, vomiting, and diarrhea
  b. Widespread tissue ischemia caused by cardiogenic shock
  c. Respiratory failure caused by pneumonia with pleural effusions
  d. Hyperventilation after a panic attack

Question 2

The nurse is caring for a patient who has a history of congestive heart failure. The nurse includes the diagnosis fluid volume excess in the patient's care plan. Which goal statement has the highest priority for the patient and nurse?
 
  a. The patient's lung sounds will remain clear.
  b. The patient will have urine output of at least 30 mL/hr.
  c. The patient will verbalize understanding of fluid restrictions.
  d. The patient's pitting pedal edema will resolve within 72 hours.

[Leostella20]

Answer to Question 1

ANS: A
Gastroenteritis with nausea, vomiting, and diarrhea will lead to a metabolic alkalosis resulting from loss of electrolytes and acids through emesis and loose stools. Metabolic alkalosis features the elevated pH of 7.56, elevated HCO3 42 mEq/L and normal PaCO2 of 32 mm Hg. Widespread tissue ischemia would lead to metabolic acidosis with low pH resulting from release of lactic acid from the tissues. Respiratory failure leads to a respiratory acidosis with a low pH and elevated PaCO2 level. Hyperventilation leads to respiratory alkalosis with an elevated pH and elevated HCO3 level.

Answer to Question 2

ANS: A
Oxygenation is the highest priority for the patient with congestive heart failure and fluid volume excess. Keeping the patient's lungs clear is the most important goal for the nurse to consider when caring for this patient.

[leo leo]

Excellent

[bblaney]

TYSM