A client is admitted for a diagnosis of sepsis secondary to a urinary tract infection. The client's repeat ABG is: pH 7.37, PC02 30, HCO3 of 18. Which acid-base imbalance is the client exhibiting?

normal ABG

respiratory acidosis

metabolic alkalosis

metabolic acidosis

Answer and Explanation

The Correct Answer is D

Rationale:
A. The pH is at the lower limit of normal but combined with low bicarbonate indicates imbalance, so not normal.
B. Respiratory acidosis would show increased PaCO₂, but here PaCO₂ is low.
C. Metabolic alkalosis is characterized by elevated bicarbonate, which is not present.
D. Metabolic acidosis is indicated by low HCO₃ (18) and compensatory respiratory alkalosis (low PaCO₂ of 30) to maintain near-normal pH. This fits the ABG results.

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Correct Answer is B

Explanation

Rationale:
A. Labored and decreased respirations do not describe Kussmaul breathing.
B. Kussmaul respirations are characterized by deep, rapid, and regular breathing as the body attempts to blow off CO₂ to compensate for metabolic acidosis in DKA.
C. Slow respirations are not characteristic of Kussmaul breathing.
D. Respirations that cease are apnea, unrelated to Kussmaul respirations.

A. 167 mEq/L B. 142 mEq/L C. 136 mEq/L D. 116 mEq/L

Correct Answer is D

Explanation

Rationale:

A. 167 mEq/L: This indicates hypernatremia, which is typically associated with fluid volume deficit due to water loss, not fluid overload.

B. 142 mEq/L: This is a normal sodium level and does not indicate fluid imbalance on its own.

C. 136 mEq/L: Also within the normal reference range (135–145 mEq/L) and does not signal fluid excess.

D. 116 mEq/L: This level represents severe hyponatremia, commonly seen in fluid volume excess. In conditions like heart failure or renal failure, water retention can dilute serum sodium. The patient’s symptoms (dyspnea, crackles, and edema) are consistent with fluid overload and dilutional hyponatremia.

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A client is admitted for a diagnosis of sepsis secondary to a urinary tract infection. The client's repeat ABG is: pH 7.37, PC02 30, HCO3 of 18. Which acid-base imbalance is the client exhibiting?

Nursing Test Bank

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