Question

A patient, who is postoperative for abdominal surgery, presents to the medical-surgical unit from the post-anesthesia care unit (PACU). The nurse's admission assessment reveals the following: shallow and irregular respirations with a rate of 12 breaths per minute. Lung sounds clear but decreased bilaterally. ABG result post-extubation: pH 7.29, PCO₂ 46 mm Hg, O2 sat 88?

Answer 1

The patient shows signs of respiratory acidosis indicated by low pH, elevated PCO₂, and decreased O₂ saturation post-abdominal surgery, suggesting hypoventilation as a contributory factor.

Step-by-step explanation:

A patient who has undergone abdominal surgery is showing symptoms that may suggest respiratory insufficiency. The admission assessment indicates shallow and irregular respirations with a rate lower than normal (12 breaths per minute), clear but decreased lung sounds bilaterally, and an arterial blood gas (ABG) analysis post-extubation with a pH of 7.29, PCO₂ of 46 mm Hg, and an O₂ saturation of 88%. According to reference values, a normal pH ranges from 7.35 to 7.45, suggesting that the patient is in a state of acidosis. The elevated PCO₂ indicates a respiratory rather than metabolic cause. The lowered O₂ saturation signals hypoxemia, a condition of decreased oxygen in the blood, which may contribute to the acidotic state. The combination of clinical findings and lab results indicates respiratory acidosis, possibly due to hypoventilation postoperation. It's important to monitor the patient closely, manage pain effectively, and encourage deep breathing and coughing exercises to promote better lung expansion and gas exchange. Immediate interventions may include supplemental oxygen to manage hypoxemia and potential adjustments in pain control to reduce respiratory depression.