A nurse is reviewing the arterial blood gas values for a client.
The pH is 7.32, PaCO₂ 48 mm Hg and the HCO₃ is 23 mEq/L. The nurse should recognize that these findings indicate which of the following acid-base balances?

Choice A rationale

Agitation is a common manifestation of hypoxemia due to insufficient oxygen reaching the brain and other vital organs.

Choice B rationale

Dysphagia, or difficulty swallowing, is not a typical manifestation of hypoxemia during an asthma attack.

Choice C rationale

Nausea can occur but is not a primary indicator of hypoxemia.

Choice D rationale

Hypotension may occur with severe hypoxemia but is not a direct manifestation of asthma-related hypoxemia.

Choice A rationale:

The Glasgow Coma Scale score has decreased from 14 to 12, indicating a decline in the client's level of consciousness. This finding requires immediate attention as it may signify worsening neurological status or an underlying condition such as metabolic disturbances, hypoxia, or intracranial pathology.

Choice C rationale:

The bicarbonate level is 13 mEq/L, which is significantly lower than the normal range of 21-28 mEq/L. This indicates metabolic acidosis, a condition where the blood is too acidic. It requires immediate intervention to prevent severe complications such as shock or organ failure.

Choice F rationale:

The client's blood pressure readings show hypotension with a supine blood pressure of 100/70 mm Hg and sitting blood pressure of 85/50 mm Hg. This suggests hemodynamic instability, which could be due to dehydration, sepsis, or other critical conditions requiring urgent treatment.

Choice G rationale:

The ECG findings indicate tachycardia with a prolonged PR interval, widened QRS complex, and peaked T waves. These are signs of hyperkalemia, a potentially life-threatening condition requiring immediate attention to prevent cardiac arrest.

Choice H rationale:

The sodium level is 152 mEq/L, which is higher than the normal range of 136-145 mEq/L, indicating hypernatremia. This electrolyte imbalance can lead to severe neurological symptoms and requires prompt correction to prevent complications such as seizures or coma.