Page 292 - Saunders Comprehensive Review For NCLEX-RN

These occur as a result of the compensatory action by the lungs. In bradypnea,
respirations are regular but abnormally slow. Apnea is described as respirations that
cease for several seconds.
Test-Taking Strategy: Focus on the subject, the characteristics of Kussmaul’s
respirations. Use knowledge of the description of Kussmaul’s respirations. Recalling
that this type of respiration occurs in diabetic ketoacidosis will assist you in
answering correctly.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Foundations of Care: Acid-Base
Health Problem: Adult Health: Endocrine: Diabetes Mellitus
Priority Concepts: Acid-Base Balance; Glucose Regulation
Reference: Lewis et al. (2017), pp. 467, 1144.

59. Answer: 4

Rationale: The acid-base disturbance is respiratory acidosis without
compensation. The normal pH is 7.35 to 7.45. The normal Paco is 35 to 45 mm Hg (35
2
to 45 mm Hg). In respiratory acidosis the pH is decreased and the Pco is elevated.
2
The normal bicarbonate ) level is 21 to 28 mEq/L (21 to 28 mmol/L). Because the
bicarbonate is still within normal limits, the kidneys have not had time to adjust for
this acid-base disturbance. In addition, the pH is not within normal limits. Therefore,
the condition is without compensation. The remaining options are incorrect
interpretations.
Test-Taking Strategy: Focus on the data in the question and the subject,
interpretation of arterial blood gas results. Remember that in a respiratory imbalance
you will find an opposite response between the pH and the Paco . Also, remember
2
that the pH is decreased in an acidotic condition and that compensation is reflected
by a normal pH.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Foundations of Care: Acid-Base
Health Problem: N/A
Priority Concepts: Acid-Base Balance; Clinical Judgment
Reference: Lewis et al. (2017), pp. 291, 457.

60. Answer: 1, 2, 4, 6

Rationale: Respiratory alkalosis is defined as a deficit of carbonic acid or a
decrease in hydrogen ion concentration that results from the accumulation of base or
from a loss of acid without a comparable loss of base in the body fluids. This occurs
in conditions that cause overstimulation of the respiratory system. Clinical
manifestations of respiratory alkalosis include lethargy, lightheadedness, confusion,
tachycardia, dysrhythmias related to hypokalemia, nausea, vomiting, epigastric
pain, and numbness and tingling of the extremities. Hyperventilation (tachypnea)

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