RNPedia PNLE Nursing Practice 4 Test 1 Practice

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When evaluating an arterial blood gas from a male client with a subdural hematoma, the Paco2 is 30 mm Hg. Which response best describes the result?

Appropriate; lowering carbon dioxide (CO2) reduces intracranial pressure (ICP). Emergent; the client is poorly oxygenated. Normal Significant; the client has alveolar hypoventilation.

Correct Answer:

Appropriate; lowering carbon dioxide (CO2) reduces intracranial pressure (ICP).

Explanation:

Lowering arterial CO2 decreases intracranial pressure by causing cerebral vasoconstriction, which reduces cerebral blood volume. In a patient with a subdural hematoma, a PaCO2 of 30 mm Hg is below normal and can be used as an acute, controlled means to lower ICP. This is why the result is considered appropriate: targeting a lower CO2 helps reduce pressure within the skull and can stabilize the patient in the short term. Normal PaCO2 SAMPLEis about 35–45 mm Hg, so 30 mm Hg is not normal. It isn’t an indication of alveolar hypoventilation, which would raise CO2 rather than lower it. Oxygenation status isn’t provided, so labeling it emergent for poor oxygenation isn’t warranted based on CO2 alone.

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