Page 292 - Saunders Comprehensive Review For NCLEX-RN
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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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