Sample Nursing Paper on Nursing of Adults with Complex Needs

Situation: Benedict Santos, A 59-year-old man, presents with three days of dyspnea, fever, chest pain, and a productive cough with bloody sputum. The medical assistant in the emergency room finds the saturation of at 86% value. The medic decided to get the arterial blood gas (ABG) of the room as they wait for a radiographer to do a chest X-ray on him.

Background:  One week ago, a 59-year-old man was diagnosed with pulmonary thrombosis. He has a history of thyroid gland surgery, used salicylates to reduce the pain for a long. He has smoked cigarettes for the past 15 years. Doctors have advised him to quit smoking, and he claims he uses electronic cigarettes currently.

Assessment: BP 136/89 (MAP 106) VS: HR 75 RR 5 spontaneous on a ventilator. Temp 98.2. Cardiac: WNL Neuro: lethargic Axillary. Pain: S&S pain noted Symmetry: even Resp: Lung sounds- moderately coarse. ETT- size 8 O2 sat 94%. Labs: Chem panel WNL CBC WNL. ABG: PaCO2 25 pH 7.50 PO2 65 HCO3 24. Chest x-ray- indication: moderate white patches present in the lung bases.

Recommendations: Keenly take note of the signs of neuromuscular, neurologic, and cardiovascular functioning.  Monitor ABGS and vital signs

Q.1- A person in a coma had his arterial blood gas showing the following values: HCO3 – 5 mmol/l PCO2 16 mm Hg, and pH 7.1. What was the acid-base disorder?

  1. a) Metabolic Alkalosis
  2. b) Metabolic Acidosis
  3. c) Respiratory Alkalosis
  4. d) Respiratory Acidosis

Q.2- It was prudent to aspirate a man’s contents in the upper part of the gastrointestinal tract while undergoing surgery. Later, the following arterial blood sample values were obtained, PCO2 52   pH 7.55mm Hg and HCO3 – 40 mmol/l. Mention the disorder that ensued.

  1. a) Metabolic Alkalosis
  2. b) Metabolic Acidosis
  3. c) Respiratory Alkalosis
  4. d) Respiratory Acidosis

 

Q.3- A woman is nervous on her wedding day and breathes rapidly. What would be the outcome?

  1. Respiratory Acidosis
  2. Respiratory Alkalosis
  3. Metabolic Acidosis
  4. Metabolic Alkalosis

 

 

 

 

Answers and Rationale

  1. The normal ranges for PaCO2 is often 38 to 42mmHG, Ph. of Arterial blood 7.38. Sao2 between 94- 100% and Bicarbonate 22-28mEq/L (Zaher, Asim, Jaya, Desiree, Kelsey Nicholas, Kirk, William, & Andrew, 2019).
  2. The patient’s Ph value was above the normal range, which is often between 7.38 to 7.42. Consequently, the arterial blood became alkaline (Zaher, Asim, Jaya, Desiree, Kelsey Nicholas, Kirk, William, & Andrew, 2019).
  3. The alkalosis happens when one breath was rapidly causing the CO2 level to reduce drastically; thus, the blood PH rises.

 

References

Zaher, F., Asim, A., Jaya, D., Desiree, T., Kelsey, D., Nicholas, G., Kirk, N., William, S., & Andrew J. (2019). Inadequacy of pulse oximetry in the catheterization laboratory: An exploratory study monitoring respiratory status using Arterial Blood Gases during cardiac catheterization with conscious sedation, 20 (6), 461-467