A patient has a long history of smoking. He has blood studies done because he is very tired, short of breath, and does not feel well. His blood gases reveal the following findings: pH 7.3, HCO3- 25 mEq/L, PaCO2 48 mmHg. What is the interpretation of these gases?

Select all that apply:

Normal range:

• pH: 7.35-7.45
• PaCO2: 36-44 mmHg
• HCO3-: 22-26 mEq/L

Choice A Reason:

Bronchoconstriction is the narrowing of the airways in the lungs due to the tightening of surrounding smooth muscle. This response is typically associated with conditions like asthma and is not a common reaction to acute stress. During stress, the sympathetic nervous system actually causes bronchodilation to increase airflow and oxygen delivery to the muscles.

Choice B Reason:

This is the correct answer. Increased glucose production is a typical response to acute stress. The body releases stress hormones like adrenaline and cortisol, which stimulate the liver to produce more glucose. This process, known as glycogenolysis, ensures that the body has enough energy to handle the stressor. This response is part of the “fight-or-flight” mechanism, preparing the body for immediate physical activity.

Choice C Reason:

Decreased cortisol release is not expected during acute stress. In fact, cortisol levels typically increase as part of the body’s stress response. Cortisol helps to mobilize energy stores, suppress inflammation, and support cardiovascular function. Therefore, this choice is incorrect.

Choice D Reason:

Bradycardia, or a slower than normal heart rate, is not a typical response to acute stress. Instead, the sympathetic nervous system increases heart rate (tachycardia) to ensure that more blood is pumped to vital organs and muscles. This helps the body to respond more effectively to the stressor.

Choice A Reason:

Vomiting is not a risk factor for a heart attack but rather a symptom that can occur during a heart attack. Risk factors are conditions or behaviors that increase the likelihood of developing a disease. Vomiting can be a sign of various conditions, including gastrointestinal issues or even a heart attack, but it does not contribute to the risk of having a heart attack.

Choice B Reason:

Hypertension, or high blood pressure, is a significant risk factor for heart attacks. It causes the heart to work harder than normal, leading to the thickening of the heart muscle and narrowing of the arteries. Over time, this increased workload can damage the arteries, making them more susceptible to blockages that can cause a heart attack. Managing blood pressure through lifestyle changes and medication is crucial in reducing the risk of heart attacks.

Choice C Reason:

Chest pain is a common symptom of a heart attack but not a risk factor. Risk factors are pre-existing conditions or behaviors that increase the likelihood of developing a disease. Chest pain, also known as angina, occurs when there is reduced blood flow to the heart muscle, often due to blockages in the coronary arteries. While chest pain indicates a potential heart problem, it is not a contributing factor to the development of a heart attack.

Choice D Reason:

Cell necrosis refers to the death of cells, which can occur during a heart attack when the blood supply to part of the heart muscle is blocked. This is a consequence of a heart attack rather than a risk factor. Risk factors are conditions or behaviors that increase the likelihood of developing a disease, whereas cell necrosis is a result of the disease process.