Practice Question
Patient data
Answer Choices:
Correct Answer:
Have the client breathe into a paper bag.
Rationale:
🟦 The client’s ABG results (pH 7.51, PaCO₂ 27 mm Hg, HCO₃ 24 mEq/L) indicate respiratory alkalosis, which is most commonly caused by hyperventilation such as during a panic attack.
🟦 In respiratory alkalosis, the client is blowing off too much carbon dioxide (CO₂), leading to a high pH (alkalemia) and low PaCO₂, which explains symptoms like numbness, tingling, and lightheadedness due to decreased ionized calcium.
🟦 Having the client breathe into a paper bag allows them to rebreathe exhaled CO₂, which helps raise PaCO₂ levels and gradually lower the pH back toward normal.
🟦 This intervention directly targets the underlying cause—excessive CO₂ loss from rapid breathing—and is appropriate for a hemodynamically stable client experiencing a panic-induced hyperventilation episode.
🟦 In addition, this technique can be combined with calm coaching, reassurance, and slowing the breathing pattern, which are essential in managing a panic attack.
🟦 By correcting the abnormal breathing pattern rather than adding oxygen or medications that are not indicated, the nurse addresses the true pathophysiology of respiratory alkalosis in this scenario.
❌ Incorrect Options
❌ Encourage the client to use the incentive spirometer.
❌ An incentive spirometer promotes deeper inhalation and can increase ventilation, which would worsen hyperventilation and respiratory alkalosis.
❌ It is used to prevent atelectasis postoperatively, not to treat panic-induced hyperventilation.
❌ Apply a nonrebreather mask with 15 L of oxygen.
❌ The client’s PaO₂ is 95 mm Hg, which is normal, so there is no evidence of hypoxemia requiring high-flow oxygen.
❌ Giving high-flow oxygen does not treat respiratory alkalosis and may distract from correcting the true problem: excessive CO₂ loss.
❌ Administer sodium bicarbonate intravenously.
❌ Sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis.
❌ Giving bicarbonate here would further increase the pH, making the alkalosis worse and potentially dangerous.
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This question is from W4 NR324 NR329 Exam which contains 49 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Medical-Surgical
- Answer Choices: 4