A new nurse is admitting a patient with a history of emphysema. The new nurse's preceptor is going over the patient's past lab reports with the new nurse
The nurse takes note that the patient's PaCO2 has been between 56 and 64mm Hg for several months. The preceptor asks the new nurse why they will be cautious administering oxygen. What is the new nurse's best response?
A) The patient's calcium will rise dramatically due to pituitary stimulation.
B) The oxygen will increase the patient's intracranial pressure and create confusion.
C) The oxygen may cause the patient to hyperventilate and become acidotic.
D) Using oxygen may result in the patient developing carbon dioxide narcosis and hypoxemia.
Ans: D
Feedback: When PaCO2 chronically exceeds 50mm Hg, it creates insensitivity to CO2 in the respiratory medulla, and the use of oxygen may result in the patient developing carbon dioxide narcosis and hypoxemia. Option A is incorrect; there is no information that indicates the patient's calcium will rise dramatically due to pituitary stimulation. Option B is incorrect; there is no feedback system that oxygen stimulates that would create an increase in the patient's intracranial pressure and create confusion. Option D is incorrect; increasing the oxygen would not stimulate the patient to hyperventilate and become acidotic; rather it would cause hypoventilation and acidosis.
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