NURSING EXAM QUESTIONS
PAEDIATRIC NURSING
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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A client with acute respiratory distress syndrome (ARDS) is showing signs of increased dyspnea. The nurse notes the following ABGs:pH 7.35, PaCO2 25, HCO3 22, PaO2 95. Which finding is abnormal?
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pH
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PaCO2
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HCO3
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PaO2
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Explanation:
Detailed explanation-1: -Expected [HCO3] = 24 + 4 (Actual pCO2-40) / 10 Comment: With chronic acidosis, the kidneys respond by retaining HCO3, that is, renal compensation occurs. This takes a few days to reach its maximal value. Example: A patient with a chronic respiratory acidosis (pCO2 60mmHg) has an actual [HCO3] of 31mmol/l.
Detailed explanation-2: -If pH is normal but closer to the acidotic end, and both PaCO2 and HCO3 are elevated, the kidneys have compensated for a respiratory problem. If the pH is normal, but closer to the alkalotic end of the normal range, and both PaCO2 and HCO3 are elevated, the lungs have compensated for a metabolic problem (see Table 3).
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