MULTIPLE CHOICE
1. A patient has coronary artery bypass graft surgery and is transported to the surgical
intensive care unit at noon. He is placed on mechanical ventilation. Interpret his initial
arterial blood gas le
...
MULTIPLE CHOICE
1. A patient has coronary artery bypass graft surgery and is transported to the surgical
intensive care unit at noon. He is placed on mechanical ventilation. Interpret his initial
arterial blood gas levels:
pH 7.31
PaCO2 48 mm Hg
Bicarbonate 22 mEq/L
PaO2 115 mm Hg
O2 saturation 99%
a. Normal arterial blood gas levels with a high oxygen level
b. Partly compensated respiratory acidosis, normal oxygen
c. Uncompensated metabolic acidosis with high oxygen levels
d. Uncompensated respiratory acidosis; hyperoxygenated
ANS: D
The high PaO2 level reflects hyperoxygenation; the PaCO2 and pH levels show
respiratory acidosis. The respiratory acidosis is uncompensated as indicated by a
pH of 7.31 (acidosis) and a normal bicarbonate level. No metabolic compensation
has occurred.
DIF: Cognitive Level: Analysis REF: pp. 178-179 | Box 9-2 | Box 9-3
OBJ: Describe methods for assessing the respiratory system, including physical assessment,
interpretation of arterial blood gases, and noninvasive techniques.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
2. The physician orders the following mechanical ventilation settings for a patient who
weighs 75 kg. The patient's spontaneous respiratory rate is 22 breaths/min. What
arterial blood gas abnormality may occur if the patient continues to be tachypneic
at these ventilator settings?
Settings:
Tidal volume: 600 mL (8 mL per kg)
FiO2: 0.5
Respiratory rate: 14 breaths/min
Mode assist/control
Positive end-expiratory pressure: 10 cm H2O
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
ANS: D
Assist/control ventilation may result in respiratory alkalosis, especially when the
patient is breathing at a high rate. Each time the patient initiates a spontaneous
breath—in this case 22 times per minute—the ventilator will deliver 600 mL of
volume.
DIF: Cognitive Level: Analysis REF: p. 197
OBJ: Relate complications associated with mechanical ventilation.
TOP: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity
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