A female client is in the first trimester of pregnancy. She has experienced approximately one week of severe nausea with frequent vomiting. Interpret the following ABG for this patient. pH 7.44, pCO2 30. HCO3 30.
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Normal ABG
The Correct Answer is A
Rationale:
A. The pH is on the upper edge of normal, indicating alkalosis. The HCO₃ is elevated (30 mEq/L), pointing to a metabolic cause (consistent with vomiting, which leads to hydrogen ion loss). The low pCO₂ (30 mmHg) suggests respiratory compensation for the metabolic alkalosis.
B. Respiratory acidosis is associated with low pH and high pCO₂, which are not present here.
C. Respiratory alkalosis would show high pH and low pCO₂ with normal or low HCO₃ — not elevated HCO₃.
D. Although the pH is within the normal range (7.35–7.45), the values of pCO₂ and HCO₃ are both abnormal, indicating compensated metabolic alkalosis, not a normal ABG.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. The respiratory system responds within minutes by altering CO₂ levels through breathing, but it is not the slowest system.
B. Chemical buffer systems act immediately to maintain pH balance but are only a temporary solution.
C. The endocrine system plays a role in general homeostasis but is not a primary regulator of acid-base balance.
D. The renal system is the slowest but most powerful regulator of acid-base balance. It maintains long-term pH stability by excreting hydrogen ions and reabsorbing bicarbonate.
Correct Answer is A
Explanation
Rationale:
A. The pH is on the upper edge of normal, indicating alkalosis. The HCO₃ is elevated (30 mEq/L), pointing to a metabolic cause (consistent with vomiting, which leads to hydrogen ion loss). The low pCO₂ (30 mmHg) suggests respiratory compensation for the metabolic alkalosis.
B. Respiratory acidosis is associated with low pH and high pCO₂, which are not present here.
C. Respiratory alkalosis would show high pH and low pCO₂ with normal or low HCO₃ — not elevated HCO₃.
D. Although the pH is within the normal range (7.35–7.45), the values of pCO₂ and HCO₃ are both abnormal, indicating compensated metabolic alkalosis, not a normal ABG.
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