A nurse assesses a diabetic client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.39, PaCO2 27 mm Hg, and HCO3 19 mEq/L. Which sign or symptom does the nurse identify as an example of the client's compensatory mechanisms?

Increased release of acids from the kidneys.

Increased urinary output.

Increased thirst and hunger.

Increased rate and depth of respirations.

Answer and Explanation

The Correct Answer is D

A.   This is not a compensatory mechanism for metabolic acidosis. In fact, during metabolic acidosis, the kidneys excrete hydrogen ions (acid) and reabsorb bicarbonate (base) to help normalize the pH of the blood.
B.   Increased urinary output (polyuria) is not typically a direct compensatory response to metabolic acidosis. However, metabolic acidosis can lead to osmotic diuresis in certain conditions, which may increase urinary output as the body tries to excrete excess acids and maintain electrolyte balance.
C.   Increased thirst (polydipsia) and hunger (polyphagia) are not typical compensatory responses to metabolic acidosis. These symptoms are more associated with hyperglycemia in diabetes rather than acid-base disturbances.
D.   During metabolic acidosis, the respiratory system compensates by increasing the rate and depth of respirations (hyperventilation). By blowing off more CO2 (carbon dioxide), the body tries to decrease the

amount of carbonic acid in the blood, thereby increasing the pH towards normal. This compensatory mechanism helps to raise the pH back towards the normal range (7.35-7.45).

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Correct Answer is A

Explanation

A. Metabolic acidosis is characterized by a low pH (<7.35) and a decreased bicarbonate (HCO3) level (<22 mEq/L). The ABG results show a pH of 7.30 and HCO3 of 18 mEq/L, which are consistent with metabolic acidosis. The low HCO3 indicates that there is an accumulation of acids or loss of bicarbonate in the blood.
B. Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate level (>26 mEq/L). The ABG results show a low pH and low HCO3, which do not support metabolic alkalosis.
C. Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). The pH in this scenario is low (7.30), which does not align with respiratory alkalosis.
D. Respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2 (>45 mm Hg). While the pH is low, indicating acidosis, the PaCO2 in this case is low (28 mm Hg), which does not support respiratory acidosis.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"E"}

Explanation

Correct choices are; Metabolic acidosis:

This can occur due to the client's diarrhea, leading to loss of bicarbonate (HCO3-) through the gastrointestinal tract. The ABG results show a pH slightly below normal (7.33) and a decreased bicarbonate level (19 mEq/L), indicative of metabolic acidosis.

Hypernatremia:

The client's sodium level is elevated at 149 mEq/L (normal range is 136-145 mEq/L). This indicates hypernatremia, which could be due to dehydration from diarrhea and possibly inadequate fluid intake.

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A nurse assesses a diabetic client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.39, PaCO2 27 mm Hg, and HCO3 19 mEq/L. Which sign or symptom does the nurse identify as an example of the client's compensatory mechanisms?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has the following arterial blood gas results: HCO3 18 mEq, PaCO2 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?

Correct Answer is A

Explanation

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"E"}

Explanation

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