18. The client's arterial blood gases (ABGs) are: pH 7.32; PaCO2 48 mm Hg, and HCO3 25 mEq/L. A nurse should anticipate that an appropriate order for this client will be:
18. The client's arterial blood gases (ABGs) are: pH 7.32; PaCO2 48 mm Hg, and HCO3 25 mEq/L. A nurse should anticipate that an appropriate order for this client will be:
. Incentive spirometer to be used hourly.
. O2 via mask with a rebreather mask.
. Antianxiety medication to slow respiratory rate.
. Sodium bicarbonate IV to raise the pH.
Test-Taking Tip
Choose an option that will "blow off" CO2.
Content Area: Adult Health, Acid-Base Balance; Integrated Process: Nursing Process, Analysis; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Fluid and Electrolyte Imbalances
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Answer 1 is correct because the ABGs show respiratory acidosis (pH below 7.35 and CO2 above 45), which would be decreased with effective deep breathing. Answer 2 is incorrect because, with a rebreather mask, the client rebreathes CO2, increasing the CO2 level even more. Answer 3 is incorrect because the respiratory acidosis may be due to hypoventilation and a decreased respiratory rate. Slowing the respiratory rate would not be desirable. Answer 4 is incorrect because IV sodium bicarbonate is not indicated for respiratory acidosis. Increasing the pH does not correct the respiratory problem. Drugs that improve breathing would be indicated.