The client has just experienced a 90-second grand mal seizure and has the arterial blood gas values shown below. How should the nurse be prepared to intervene? pH 6.88, HCO3– 22 mEq/L, PCO2 60 mm Hg, PO2 50 mm Hg
A. Applying oxygen by mask or nasal cannula
B. Applying a paper bag over the client's nose and mouth
C. Administering 50 mL of sodium bicarbonate intravenously
D. Administering 50 mL of 20% glucose and 20 units of regular insulin
A
The client has experienced a combination of metabolic and acute respiratory acidosis through heavy skeletal muscle contractions and no gas exchange. When the seizures have stopped and the client can breathe again, the fastest way to return to acid-base balance is to administer oxygen. Sodium bicarbonate should not be administered because the client's arterial bicarbonate level is normal. Applying a paper bag over the client's nose and mouth would worsen the acidosis.
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