Week 3: Lab Quiz (Acid Base)

What is the range of pH, in general?

0-14

What is the range of HCO3?

21-28

What is the range of PaCO2?

35-45

What is the range for pH, within the body?

7.35-7.45

What is the range for PaO2?

80-100

What is the range for O2 saturation?

94-100%

For O2 saturation, what is the critical low for a patient?

<75%

The nurse observes that a client with a history of panic attacks is hyperventilating. What action should the nurse take? A: Have the client breathe into a paper bag. B: Instruct the client to put the head between the knees. C: Give the client a low concentration of oxygen by nasal cannula. D: Tell the client to take several deep, slow breaths and exhale normally.

A: Have the client breathe into a paper bag. (The best way to ease symptoms caused by hyperventilation is to have the client breathe into a paper bag. This helps to raise carbon dioxide level, which encourages deeper, slower breathing.)

Is CO2 acidic or alkaline to the body?

Acidic (Acid)

Is HCO3 acidic or alkaline to the body?

Alkaline (Basic)

With pH, it becomes alkaline when? (Looking for range on 0-14 scale)

Anything above 7 is considered basic.

With pH, it becomes acidic when? (Looking for range on 0-14 scale)

Anything below 7 is considered acidic.

A client with acute respiratory distress syndrome is showing signs of increased dyspnea. The nurse reviews a report of blood gas values. Which finding is abnormal? A: pH- 7.35 B: PaCO2- 25mm C: HCO3- 22mEq D: PaO2.- 95mm

B: PaCO2- 25mm

On admission, the client's arterial blood gas (ABG) values were: pH, 7.20; PaO2, 64 mm Hg (8.5 kPa); PaCO2, 60 mm Hg (8 kPa); and HCO3-, 22 mEq/L (22 mmol/L). A chest tube is inserted, and oxygen at 4 L/minute is started. Thirty minutes later, repeat blood gas values are: pH, 7.30; PaO2, 76 mm Hg (10.1 kPa); PaCO2, 50 mm Hg (6.7 kPa); and HCO3-, 22 mEq/L (22 mmol/L). This change would indicate: A: impending respiratory failure. B: improving respiratory status. C: developing respiratory alkalosis. D: obstruction in the chest tubes.

B: improving respiratory status.

A nurse working in the emergency department receives arterial blood gas results on four clients. Which laboratory result requires immediate nursing intervention? A: pH 7.48, PaCO2 35 mm Hg, and PaO2 65 mm Hg B: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg C: pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg D: 7.33, PaCO2 58 mm Hg, and PaO2 64 mm Hg

B: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg (Indicates that the client has severe uncompensated respiratory acidosis and hypoxemia)

The emergency department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? A: Lactate B: Nitrogen C: Carbonic acid D: Bicarbonate

D: Bicarbonate

A nurse is caring for a 12-month-old infant with dehydration with resulting metabolic acidosis. The infant exhibits lethargy and poor skin turgor. Which action by the nurse takes priority? A: offering the infant sucralose by bottle B: obtaining blood cultures C: obtaining a urine sample via catheterization D: obtaining a patent intravenous site

D: obtaining a patent intravenous site (The nurse's priority is to correct the dehydration by first obtaining a patent IV line for the administration of fluids and medications. Obtaining a blood sample for a white blood count and blood cultures and a urine sample will not change the outcome of the need for fluid and electrolyte correction.)

For PaCO2, what is the critical high and low for a patient?

H: >60 L: <20

For pH, what is the critical high and low for a patient?

H: >7.55 L: <7.25

Out of HCO3, pH, and PaCO2, which one is related to the metabolic acid base balance?

HCO3

A client in the emergency department reports that they have been vomiting excessively for the past 2 days. The client's arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?

Metabolic Alkalosis

Out of HCO3, pH, and PaCO2, which one is related to the respiratory acid base balance?

PaCO2

A client has a dull headache, is dizzy, and has an increased pulse rate. The results of arterial blood gas analysis are as follows: pH 7.26; partial pressure of carbon dioxide, 50 mm Hg (6.7 kPa); and bicarbonate, 24 mEq/L (24 mmol/L). These findings indicate which acid-base imbalance?

Respiratory Acidosis

A client who is being treated for pneumonia reports sudden shortness of breath. An arterial blood gas (ABG) is drawn, yielding the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect?

Respiratory Acidosis

What's the rule about pH when it comes to it being acidic or alkaline?

The lower the pH level the more acidic, the higher the more basic.

At what range, for PaO2, would the patient be experiencing respiratory failure?

Under 60