CHAPTER 18: PULMONARY DIAGNOSTIC PROCEDURES {Urden: Critical Care Nursing, 9th Edition}

C HAPTER 18: P ULMONARY D IAGNOSTIC
P ROCEDURES
Urden: Critical Care Nursing, 9th Edition



MULTIPLE CHOICE


1. Which patient would be considered hypoxemic?
a. A 70-year-old man with a PaO2 of 72
b. A 50-year-old woman with a PaO2 of 65
c. A 84-year-old man with a PaO2 of 96
d. A 68-year-old woman with a PaO2 of 80



ANS: B



Normal PaO2 is 80 to 100 mm Hg in persons younger than 60 years.
The formula for determining PaO2 for a person older than 60 years of
age is 80 mm Hg minus 1 mm Hg for e very year of age above 60 years
of age, for example, 70 years old = 80 mm Hg – 10 mm Hg = 70 mm
Hg; 84 years old = 80 mm Hg – 20 mm Hg = 60 mm Hg; and 68 years
old = 80 mm Hg – 8 mm Hg = 72 mm Hg.



PTS: 1 DIF: Cognitive Level: Anal ysis REF: p. 445
OBJ: Nursing Process Step: Diagnosis TOP:
Pulmonary MSC: NC LEX: Physiologic Integrit y

,2. Which blood gas parameter is the acid –base component that reflects
kidney function?
a. pH
b. PaO2
c. PaCO2
d. HCO3¯



ANS: D



The bicarbonate (HCO3¯) is the acid –base component that reflects
kidney function. The bicarbonate is reduced or increased in the plasma
by renal mechanisms. The normal range is 22 to 26 mEq/ L. pH
measures the hydrogen ion concentration of plasma. PaO2 measures
partial pressure of oxygen dissolved in arterial bloo d plasma. PaCO2
measures the partial pressure of carbon dioxide dissolved in arterial
blood plasma.



PTS: 1 DIF: Cognitive Level: Anal ysis REF: p. 445 |
p. 446 OBJ: Nursing Process Step: Assessment TOP:
Pulmonary MSC: NC LEX: Physiologic Integrit y



3. Which arterial blood gas (ABG) values represent uncompensated
metabolic acidosis?
a. pH, 7.29; PaCO2, 57 mm Hg; HCO3¯, 22 mEq/L
b. pH, 7.36; PaCO2, 33 mm Hg; HCO3¯, 18 mEq/L
c. pH, 7.22; PaCO2, 42 mm Hg; HCO3¯, 18 mEq/L
d. pH, 7.52; PaCO2, 38 mm Hg; HCO3¯, 29 mEq/L



ANS: C

, A pH of 7.22 is below normal, reflecting acidosis. The metabolic
component (HCO3¯) is low, indicating that the acidosis is metabolic in
origin. Uncompensated metabolic acidosis values include a pH below
7.35, PaCO2 of 35 to 45 mm Hg, and HCO3¯ below 2 2 mEq/L.



PTS: 1 DIF: Cognitive Level: Anal ysis REF: p. 446 |
Box 18-2 | p. 447 | Table 18 -1 OBJ: Nursing Process Step:
Diagnosis TOP: Pulmonary MSC: NC LEX: Physiologic
Integrit y



4. Which ABG values reflect compensation?
a. pH, 7.26; PaCO2, 55 mm Hg; HCO3 ¯, 24 mEq/L
b. pH, 7.30; PaCO2, 32 mm Hg; HCO3¯, 18 mEq/L
c. pH, 7.48; PaCO2, 30 mm Hg; HCO3¯, 22 mEq/L
d. pH, 7.38; PaCO2, 58 mm Hg; HCO3¯, 30 mEq/L



ANS: D



The pH is within normal limits, and both the PaCO2 and the HCO3¯
values are abnormal. Compensated respirat ory acidosis values include a
pH of 7.35 to 7.39, PaCO2 above 45 mm Hg, and HCO3¯ above 26
mEq/L.



PTS: 1 DIF: Cognitive Level: Understanding REF: p.
446 | Box 18-3 | p. 448 | Table 18 -1 OBJ: Nursing Process
Step: Assessment TOP: Pulmonary MSC: NC LEX:
Physiologic Integrit y