Respiratory Acidosis

Jessa Smyth (pronouns: she/her/hers), age 51, is admitted with severe pneumonia leading to an increased risk for respiratory acidosis. She states, "I have not been feeling well for the past 10 days. Today, I feel like I can't breathe." She has a history of asthma and was recently exposed to influenza. Admission vital signs are temperature 102.5°F (39.2°C), pulse 106, respiratory rate 32, blood pressure 118/70, and oxygen saturation 64%. Select the two priority assessment findings that indicate the client is experiencing hypoxia requiring immediate intervention.

resp rate 32 o2 64%

Review the laboratory results in Damien's electronic health record (EHR). For each potential healthcare provider prescription, indicate if the prescription is essential, non-essential, or contraindicated at this time.

see picture & rationale

The nurse is caring for a client in the post-anesthesia care unit (PACU) who is difficult to arouse 2 hours after surgery. The client's respiratory rate is 7 breaths per minute and oxygen saturation is 72%. Breathing is shallow. Arterial blood gas results are: pH 7.15 PaCO2 70 mmHg HCO3- 24 mEq/L PaO2 78 mmHg The client has___________respiratory acidosis.

uncompensated

the client has ___ resp acidosis

uncompensated

The nurse should first _________and then ________--

collect arterial blood gas specimen initiate supplemental oxygen

The healthcare provider prescribes arterial blood gas analysis. The nurse anticipates the results will show________ pH and an _______PaCO2.

decrease increase

Respiratory acidosis results in _______ pH,__________PaCO2, and _________ PaO2.

decreased increased decreased R':Respiratory acidosis results in decreased (not increased) pH, increased (not decreased) PaCO2, and decreased (not increased) PaO2. Respiratory acidosis arterial blood gas (ABG) values: pH less than 7.35 PaCO2 greater than 45 mmHg HCO3- 22-26 mEq/L (may increase due to kidney compensation) PaO2 less than 90 mmHg

The nurse is caring for a client in the emergency department with a chronic obstructive pulmonary disease (COPD) exacerbation. Arterial blood gas results are: pH 7.36 PaCO2 65 mmHg HCO3- 31 mEq/L PaO2 85 mmHg The client has _________ respiratory acidosis.

fully compensated

The client has clinical manifestations of ______caused by airway ________which places the client at risk for respiratory acidosis.

impaired gas exchange airway obstruction

Updated lab results have arrived: 03/01/XX @ 15:00 pH 7.35 PaCO2 44 mmHg PaO2 90 mmHg HCO3- 23 mEq/L After reviewing the most recent arterial blood gas results, the nurse recognizes that the client's condition has

improved

The nurse initiates supplemental oxygen and 30 minutes later, the client's oxygen saturation is 89%. Which is the priority action taken by the nurse?

Administer albuterol nebulizer. ​ Albuterol is a rapid-acting bronchodilator that will dilate the airway to assist with breathing, thus allowing the oxygen to get through the airway to the alveoli. The client needs to be stabilized before transport. Coughing, deep breathing, and using an incentive spirometer will not help with the constricted airway. The client is experiencing an asthma exacerbation caused by airway constriction. Antibiotics will not resolve this problem.

Damien Cobb (pronouns: he/him/his) is a 24-year-old client with a history of asthma who presents to the emergency department with shortness of breath and coughing following a long bike ride. He admits to forgetting to take his albuterol inhaler before exercising and did not bring the inhaler with him on the ride. He is alert and oriented but anxious and irritable. Breath sounds include bilateral wheezing, and intercostal retractions are noted. Vital signs are temperature 98.2 °F (36.8 °C), pulse 110, respiratory rate 10, blood pressure 120/82, and oxygen saturation 85% on room air.

Damien Cobb (pronouns: he/him/his) is a 24-year-old client with a history of asthma who presents to the emergency department with shortness of breath and coughing following a long bike ride. He admits to forgetting to take his albuterol inhaler before exercising and did not bring the inhaler with him on the ride. He is alert and oriented but anxious and irritable. Breath sounds include bilateral wheezing, and intercostal retractions are noted. Vital signs are temperature 98.2 °F (36.8 °C), pulse 110, respiratory rate 10, blood pressure 120/82, and oxygen saturation 85% on room air.

Which medical conditions may result in respiratory acidosis? Select all that apply.

Pulmonary edema ​ Pneumonia Opioid overdose​ Asthma exacerbation​

Respiratory acidosis is the accumulation______________Hypoventilation leads to a buildup of CO2 in the lungs and carbonic acid in the blood.

Respiratory acidosis is the accumulation of carbon dioxide (CO2) in the lungs, primarily from hypoventilation. Hypoventilation leads to a buildup of CO2 in the lungs and carbonic acid in the blood.

Adrian Smith, a 3-year-old toddler, is admitted to the hospital with respiratory syncytial virus causing bronchiolitis. The caregiver reports observing slight tremors and behavioral changes in the child over the past four days. The child is tachycardic and tachypneic with mild central cyanosis. The measurement of arterial blood gas shows pH 7.35, PaCO2 70 mmHg, and HCO3- 38 mEq/L. How should the nurse interpret these results?

Respiratory acidosis, fully compensated

George Kent (pronouns: he/him/his), a 54-year-old client with a history of chronic obstructive pulmonary disease (COPD), presents to the emergency department with worsening shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He is confused and combative. His son, Jacob, reports that George has been sick for the past three days. Crackles and wheezes are heard in the lower lung lobes. The client is tachycardic with a bounding pulse. Measurement of arterial blood gas shows pH 7.32, PaCO2 68 mmHg, HCO3- 28 mmol/L, and PaO2 60 mmHg. How should the nurse interpret these results?

Respiratory acidosis, partially compensated

Which assessment findings are consistent with respiratory acidosis? Select all that apply.

Shallow, ineffective respirations​ Restlessness and irritability​ central cyanosis