The nurse is caring for a patient diagnosed with mitral valve stenosis. The patient complains of a cough and difficulty breathing when lying down. Upon assessment, the nurse notices the presence of rales and a pulse rate of 110 beats per minute. Which of the following lab results should alert the nurse?


• ABG - pO2 of 70 mmHg, pCO2 of 65 mmHg. These values indicate hypoxia (low blood oxygen) and hypercapnia (high carbon dioxide). Normal pO2 is 80-100 mmHg and normal pCO2 is 35-45 mmHg.

• Mitral valve stenosis can lead to heart failure as evidenced by an increase in pCO2 levels and a decrease in pO2.

• Heart failure is a common complication of patients with mitral valve stenosis. This is evident by jugular vein distention, cold clammy skin, tachycardia, orthopnea, increased arterial pCO2, and a decrease in pO2. Rales may be an indication of pulmonary edema that has developed secondary to the congestive heart failure.

• Incorrect: The remaining answer choices indicate normal values.  Normal sodium range is 135-145 mEq/L. Normal bicarbonate (HCO3) level is 22-30.

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