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nomejodas nomejodas
wrote...
Posts: 513
Rep: 1 0
6 years ago
A patient's assessment data present as follows: pH, 7.10; PaCO2, 60 mm Hg; PaO2, 40 mm Hg; HCO3, 24 mEq/L; RR, 34 breaths/min; HR, 128 beats/min; and BP, 180/92 mm Hg.
 
  This condition is best described as
 
  a. uncompensated respiratory acidosis.
  b. uncompensated metabolic acidosis.
  c. compensated metabolic acidosis.
  d. compensated respiratory acidosis.

Question 2

Which of the following criteria are representative of the patient in normal sinus rhythm?
 
  a. Heart rate, 64 beats/min; rhythm regular; PR interval, 0.10 second; QRS, 0.04 second
  b. Heart rate, 88 beats/min; rhythm regular; PR interval, 0.18 second; QRS, 0.06 second
  c. Heart rate, 54 beats/min; rhythm regular; PR interval, 0.16 second; QRS, 0.08 second
  d. Heart rate, 92 beats/min; rhythm irregular; PR interval, 0.16 second; QRS, 0.04 second

Question 3

Why would the nurse perform an inspection of the oral cavity during a complete pulmonary assessment?
 
  a. To provide evidence of hypoxia
  b. To provide evidence of dyspnea
  c. To provide evidence of dehydration
  d. To provide evidence of nutritional status

Question 4

On admission, a patient presents as follows: pH, 7.38; respiratory rate, 24 breaths/min, regular, pursed-lip breathing; PaO2, 66 mm Hg; heart rate, 112 beats/min, sinus tachycardia;
 
  PaCO2, 52 mm Hg; blood pressure, 110/68 mm Hg; HCO3, 34 mEq/L; and SpO2, 90 on O2 2 L/min nasal cannula. These gases show
 
  a. uncompensated metabolic alkalosis.
  b. uncompensated respiratory acidosis.
  c. compensated respiratory acidosis.
  d. compensated respiratory alkalosis.

Question 5

Which of the following conditions will commonly reveal breath sounds with inspiration greater than expiration on assessment?
 
  1. Normal lung
  2. Bronchiectasis
  3. Emphysema
  4. Acute bronchitis
  5. Diffuse pulmonary fibrosis
  6. Consolidating pneumonia
 
  a. 1, 2, 5
  b. 3, 5, 6
  c. 2, 3, 4
  d. 1, 2, 4
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Replies
wrote...
6 years ago
The answer to question 1

A
The pH is below normal range (7.35-7.45), so this is uncompensated acidosis. The PaCO2 is markedly elevated, and the HCO3 is normal. This indicates uncompensated respiratory acidosis. Uncompensated respiratory acidosis values include a pH below 7.35, PACO2 above 45 mm Hg, and HCO3 of 22 to 26 mEq/L. Uncompensated metabolic acidosis values include a pH below 7.35, PACO2 of 35 to 45 mm Hg, and HCO3 above 22 mEq/L. Compensated metabolic acidosis values include a pH of 7.35 to 7.39, PACO2 below 35 mm Hg, and HCO3- below 22 mEq/L. Compensated respiratory acidosis values include a pH of 7.35 to 7.35, PACO2 above 45 mm Hg, and HCO3 above 26 mEq/L.

The answer to question 2

B
The parameters for normal sinus rhythm are heart rate, 60 to 100 beats/min; rhythm, regular; PR interval, 0.12 to 0.20 second; and QRS, 0.06 to 0.10 second.

The answer to question 3

A
Severe hypoxia will be manifested by central cyanosis, which is evident in the oral and circumoral areas. Although dehydration and nutritional status can both be partially assessed by oral cavity inspection; this information is not as vital as determining hypoxia. Dyspnea means difficulty breathing.

The answer to question 4

C
The pH is closer to the acidic level, so the primary disorder is acidosis. Compensated respiratory acidosis values include a pH of 7.35 to 7.39, PACO2 greater than 45 mm Hg, and HCO3 greater than 26 mEq/L. Uncompensated respiratory acidosis values include a pH below 7.35, PACO2 above 45 mm Hg, and HCO3- of 22 to 26 mEq/L. Compensated respiratory alkalosis values include a pH of 7.41 to 7.45, PACO2 below 35 mm Hg, and HCO3 below 22 mEq/L. Uncompensated metabolic alkalosis values include a pH above 7.45, PACO2 of 35 to 45 mm Hg, and HCO3- above 26 mEq/L.

The answer to question 5

D
The normal lung, bronchiectasis, and acute bronchitis will commonly present with an inspiration greater than expiration ratio. Acute bronchitis can also have inspiration that equals expiration ratio as also seen with emphysema, diffuse pulmonary fibrosis, and consolidating pneumonia. Noting that many conditions present with the same findings affirms the need for further assessment and evaluation.
nomejodas Author
wrote...
6 years ago
Just confirmed the same answer from my friend, thanks
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