Question

A client is hospitalized for multiple rib fractures following a motor vehicle accident (MVA). The results of an arterial blood gas (ABG's) are; pH 7.30, pCO2 48, HCO3 26 and pO2 91 on 2 L/min of oxygen per nasal cannula. What intervention has the highest priority?

Answer 1

The highest priority intervention for a client with a pH of 7.30, elevated pCO2 of 48, and normal HCO3 of 26, which indicate respiratory acidosis, is to ensure adequate ventilation through respiratory support.

Step-by-step explanation:

The client's arterial blood gas (ABG) results indicate a pH of 7.30, which is below the normal range of 7.35-7.45, suggesting acidosis. The elevated pCO2 value of 48 mm Hg, when compared to normal values for males (35-48 mm Hg), is on the higher end of the range or slightly above. These results, combined with a normal HCO3 level of 26 mM (within the reference range of 22-29 mM), suggest that the client is likely experiencing respiratory acidosis. Considering that the most urgent need for a patient with multiple rib fractures and respiratory acidosis would be to ensure adequate ventilation, the highest priority intervention would be to provide respiratory support. This may involve increasing the oxygen delivery, pain management to enable better breathing, and potentially mechanical ventilation depending on the severity of the respiratory compromise.