Question

A client comes to the emergency department (ED) with pronounced wheezing and mild dyspnea. The initial ABG results are pH 7.32, PaCO 2 48 mm Hg (6.38 kPa), HCO 3 24 mEq/L (24 mmol/L), and PaO 2 51 mm Hg (6.78 kPa). The client is given 1 L/min of oxygen per nasal cannula and placed in high Fowler position. An hour later the ABG results are pH 7.35, PaCO 2 38 mm Hg (5.05 kPa), HCO 3 24 mEq/L (24 mmol/L), and PaO 2 60 mm Hg (7.98 kPa). Which action does the nurse take first?

A) Increase the oxygen flow rate.
B) Prepare the client for admission to the intensive care unit.
C) Continue to monitor the client.
D) Place the client in semi-Fowler position.

Answer 1

The nurse's first action would be to continue to monitor the client.

Step-by-step explanation:

The initial ABG results indicate that the client is in respiratory acidosis, as evidenced by the low pH (7.32) and high PaCO2 (48 mm Hg). The client is given supplemental oxygen and placed in a high Fowler position, which improves oxygenation and ventilation. The repeat ABG results show some improvement, with a higher pH (7.35) and lower PaCO2 (38 mm Hg), indicating partial compensation. Therefore, the nurse's first action would be to continue to monitor the client.